1
|
Tsumura M, Miki M, Mizoguchi Y, Hirata O, Nishimura S, Tamaura M, Kagawa R, Hayakawa S, Kobayashi M, Okada S. Enhanced osteoclastogenesis in patients with MSMD due to impaired response to IFN-γ. J Allergy Clin Immunol 2021; 149:252-261.e6. [PMID: 34176646 DOI: 10.1016/j.jaci.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Patients with Mendelian susceptibility to mycobacterial disease (MSMD) experience recurrent and/or persistent infectious diseases associated with poorly virulent mycobacteria. Multifocal osteomyelitis is among the representative manifestations of MSMD. The frequency of multifocal osteomyelitis is especially high in patients with MSMD etiologies that impair cellular response to IFN-γ, such as IFN-γR1, IFN-γR2, or STAT1 deficiency. OBJECTIVES This study sought to characterize the mechanism underlying multifocal osteomyelitis in MSMD. METHODS GM colonies prepared from bone marrow mononuclear cells from patients with autosomal dominant (AD) IFN-γR1 deficiency, AD STAT1 deficiency, or STAT1 gain of function (GOF) and from healthy controls were differentiated into osteoclasts in the presence or absence of IFN-γ. The inhibitory effect of IFN-γ on osteoclastogenesis was investigated by quantitative PCR, immunoblotting, tartrate-resistant acid phosphatase staining, and pit formation assays. RESULTS Increased osteoclast numbers were identified by examining the histopathology of osteomyelitis in patients with AD IFN-γR1 deficiency or AD STAT1 deficiency. In the presence of receptor activator of nuclear factor kappa-B ligand and M-CSF, GM colonies from patients with AD IFN-γR1 deficiency, AD STAT1 deficiency, or STAT1 GOF differentiated into osteoclasts, similar to GM colonies from healthy volunteers. IFN-γ concentration-dependent inhibition of osteoclast formation was impaired in GM colonies from patients with AD IFN-γR1 deficiency or AD STAT1 deficiency, whereas it was enhanced in GM colonies from patients with STAT1 GOF. CONCLUSIONS Osteoclast differentiation is increased in AD IFN-γR1 deficiency and AD STAT1 deficiency due to an impaired response to IFN-γ, leading to excessive osteoclast proliferation and, by inference, increased bone resorption in infected foci, which may underlie multifocal osteomyelitis.
Collapse
Affiliation(s)
- Miyuki Tsumura
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Mizuka Miki
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Pediatrics, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yoko Mizoguchi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Osamu Hirata
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Hidamari Children Clinic, Hiroshima, Japan
| | - Shiho Nishimura
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Pediatrics, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Moe Tamaura
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Pediatrics, Hiroshima-Nishi Medical Center, Hiroshima, Japan
| | - Reiko Kagawa
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Seiichi Hayakawa
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Masao Kobayashi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Japanese Red Cross, Chugoku-Shikoku Block Blood Center, Hiroshima, Japan
| | - Satoshi Okada
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
| |
Collapse
|
2
|
Human Lentiviral Gene Therapy Restores the Cellular Phenotype of Autosomal Recessive Complete IFN-γR1 Deficiency. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2020; 17:785-795. [PMID: 32355867 PMCID: PMC7184269 DOI: 10.1016/j.omtm.2020.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/02/2020] [Indexed: 12/29/2022]
Abstract
Autosomal recessive (AR) complete interferon-γ receptor 1 (IFN-γR1) deficiency, also known as one genetic etiology of Mendelian susceptibility to mycobacterial disease (MSMD), is a life-threatening congenital disease leading to premature death. Affected patients present a pathognomonic predisposition to recurrent and severe infections with environmental mycobacteria or the Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccine. Current therapeutic options are limited to antibiotic treatment and hematopoietic stem cell transplantation, however with poor outcome. Given the clinical success of gene therapy, we introduce the first lentiviral-based gene therapy approach to restore expression and function of the human IFN-γR-downstream signaling cascade. In our study, we developed lentiviral vectors constitutively expressing the human IFN-γR1 and demonstrate stable transgene expression without interference with cell viability and proliferation in transduced human hematopoietic cells. Using an IFN-γR1-deficient HeLa cell model, we show stable receptor reconstitution and restored IFN-γR1 signaling without adverse effect on cell functionality. Transduction of both SV40-immortalized and primary fibroblasts derived from IFN-γR1-deficient MSMD patients was able to recover IFN-γR1 expression and restore type II IFN signaling upon stimulation with IFN-γ. In summary, we highlight lentiviral vectors to correct the IFN-γ mediated immunity and present the first gene therapy approach for patients suffering from AR complete IFN-γR1 deficiency.
Collapse
|
3
|
Michniacki TF, Walkovich KJ, Frame DG, Vander Lugt MT. Interferon-γ Receptor 1 Deficiency Corrected by Umbilical Cord Blood Transplantation. J Clin Immunol 2019; 39:257-260. [PMID: 30953286 DOI: 10.1007/s10875-019-00621-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/31/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Thomas F Michniacki
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Hematology/Oncology, University of Michigan, 1500 E. Medical Center Drive, D4202 Medical Professional Building, Ann Arbor, MI, 48109, USA
| | - Kelly J Walkovich
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Hematology/Oncology, University of Michigan, 1500 E. Medical Center Drive, D4202 Medical Professional Building, Ann Arbor, MI, 48109, USA
| | - David G Frame
- Department of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | - Mark T Vander Lugt
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Hematology/Oncology, University of Michigan, 1500 E. Medical Center Drive, D4202 Medical Professional Building, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
4
|
Nekooie-Marnany N, Deswarte C, Ostadi V, Bagherpour B, Taleby E, Ganjalikhani-Hakemi M, Le Voyer T, Rahimi H, Rosain J, Pourmoghadas Z, Sheikhbahaei S, Khoshnevisan R, Petersheim D, Kotlarz D, Klein C, Boisson-Dupuis S, Casanova JL, Bustamante J, Sherkat R. Impaired IL-12- and IL-23-Mediated Immunity Due to IL-12Rβ1 Deficiency in Iranian Patients with Mendelian Susceptibility to Mycobacterial Disease. J Clin Immunol 2018; 38:787-793. [PMID: 30255293 DOI: 10.1007/s10875-018-0548-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/10/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Inborn errors of IFN-γ-mediated immunity underlie Mendelian Susceptibility to Mycobacterial Disease (MSMD), which is characterized by an increased susceptibility to severe and recurrent infections caused by weakly virulent mycobacteria, such as Bacillus Calmette-Guérin (BCG) vaccines and environmental, nontuberculous mycobacteria (NTM). METHODS In this study, we investigated four patients from four unrelated consanguineous families from Isfahan, Iran, with disseminated BCG disease. We evaluated the patients' whole blood cell response to IL-12 and IFN-γ, IL-12Rβ1 expression on T cell blasts, and sequenced candidate genes. RESULTS We report four patients from Isfahan, Iran, ranging from 3 months to 26 years old, with impaired IL-12 signaling. All patients suffered from BCG disease. One of them presented mycobacterial osteomyelitis. By Sanger sequencing, we identified three different types of homozygous mutations in IL12RB1. Expression of IL-12Rβ1 was completely abolished in the four patients with IL12RB1 mutations. CONCLUSIONS IL-12Rβ1 deficiency was found in the four MSMD Iranian families tested. It is the first report of an Iranian case with S321* mutant IL-12Rβ1 protein. Mycobacterial osteomyelitis is another type of location of BCG infection in an IL-12Rβ1-deficient patient, notified for the first time in this study.
Collapse
Affiliation(s)
- Nioosha Nekooie-Marnany
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Caroline Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France
| | - Vajiheh Ostadi
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahram Bagherpour
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Taleby
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France
| | - Hamid Rahimi
- Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France.,Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris AP-HP, Necker Hospital for Sick Children, Paris, EU, France
| | - Zahra Pourmoghadas
- Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saba Sheikhbahaei
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Khoshnevisan
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Daniel Petersheim
- Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, EU, Germany
| | - Daniel Kotlarz
- Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, EU, Germany
| | - Christoph Klein
- Department of Pediatrics, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-Universität München, Munich, EU, Germany
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Howard Hughes Medical Institute, New York, NY, USA.,Pediatric Hematology-Immunology Unit, Assistance Publique-Hôpitaux de Paris AP-HP, Necker Hospital for Sick Children, Paris, EU, France
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Necker Hospital for Sick Children, Paris, EU, France.,Paris Descartes University, Paris, EU, France.,Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris AP-HP, Necker Hospital for Sick Children, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Roya Sherkat
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
5
|
Carinelli S, Xufré C, Martí M, Pividori MI. Interferon gamma transcript detection on T cells based on magnetic actuation and multiplex double-tagging electrochemical genosensing. Biosens Bioelectron 2018; 117:183-190. [PMID: 29902634 DOI: 10.1016/j.bios.2018.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 05/05/2018] [Accepted: 05/21/2018] [Indexed: 12/15/2022]
Abstract
Interferon-γ is a proinflammatory cytokine, and its production is related with effective host defense against intracellular pathogens. Therefore, the level of interferon-γ is considered a good biomarker for intracellular infections. It is also useful for the assessment, treatment progression and follow-up of non-communicable diseases, including cancer and autoimmune disorders, among others. This work addresses the development of a novel interferon-γ release assay (IGRA) to evaluate the expression of interferon-γ transcripts as biomarker produced by isolated T cells, as a main advantage. The method sequentially combined three different types of magnetic separation, including the immunomagnetic separation of the T cells performed on antiCD3 modified magnetic particles, the retrotranscription and multiplex double-tagging PCR on polydT-modified magnetic particles and, finally, the electrochemical genosensing on streptavidin magnetic particles as a support. This approach is able to quantify the levels of cellular interferon-γ produced by as low as 150 T cells with outstanding analytical features. The detection of interferon-γ transcripts is performed from only 100 μL of whole blood which can be potentially obtained by fingerprick, demonstrating a further clear advantage to be considered as a promising strategy for the quantification of this important biomarker in several clinical applications.
Collapse
Affiliation(s)
| | - Cristina Xufré
- Laboratory of Cellular Immunology, Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Mercè Martí
- Laboratory of Cellular Immunology, Institute of Biotechnology and Biomedicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | |
Collapse
|
6
|
Esteve-Solé A, Sologuren I, Martínez-Saavedra MT, Deyà-Martínez À, Oleaga-Quintas C, Martinez-Barricarte R, Martinez-Nalda A, Juan M, Casanova JL, Rodriguez-Gallego C, Alsina L, Bustamante J. Laboratory evaluation of the IFN-γ circuit for the molecular diagnosis of Mendelian susceptibility to mycobacterial disease. Crit Rev Clin Lab Sci 2018; 55:184-204. [PMID: 29502462 PMCID: PMC5880527 DOI: 10.1080/10408363.2018.1444580] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The integrity of the interferon (IFN)-γ circuit is necessary to mount an effective immune response to intra-macrophagic pathogens, especially Mycobacteria. Inherited monogenic defects in this circuit that disrupt the production of, or response to, IFN-γ underlie a primary immunodeficiency known as Mendelian susceptibility to mycobacterial disease (MSMD). Otherwise healthy patients display a selective susceptibility to clinical disease caused by poorly virulent mycobacteria such as BCG (bacille Calmette-Guérin) vaccines and environmental mycobacteria, and more rarely by other intra-macrophagic pathogens, particularly Salmonella and M. tuberculosis. There is high genetic and allelic heterogeneity, with 19 genetic etiologies due to mutations in 10 genes that account for only about half of the patients reported. An efficient laboratory diagnostic approach to suspected MSMD patients is important, because it enables the establishment of specific therapeutic measures that will improve the patient's prognosis and quality of life. Moreover, it is essential to offer genetic counseling to affected families. Herein, we review the various genetic and immunological diagnostic approaches that can be used in concert to reach a molecular and cellular diagnosis in patients with MSMD.
Collapse
Affiliation(s)
- Ana Esteve-Solé
- Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain, EU
- Functional Unit of Clinical Immunology Hospital Sant Joan de Déu-Hospital Clinic, Spain, EU
| | - Ithaisa Sologuren
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain, EU
| | | | - Àngela Deyà-Martínez
- Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain, EU
- Functional Unit of Clinical Immunology Hospital Sant Joan de Déu-Hospital Clinic, Spain, EU
| | - Carmen Oleaga-Quintas
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, IN-SERM-U1163, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
| | - Rubén Martinez-Barricarte
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, Rockefeller University, New York, NY, USA
| | - Andrea Martinez-Nalda
- Pediatric Infectious Disease and Immunodeficiency Unit, Hospital Universitari Vall d’Hebron, Institut de Recerca Vall d’Hebron, Spain, EU
| | - Manel Juan
- Functional Unit of Clinical Immunology Hospital Sant Joan de Déu-Hospital Clinic, Spain, EU
- Immunology Department. Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain, EU
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, IN-SERM-U1163, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, Rockefeller University, New York, NY, USA
- Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France, EU
- Howard Hughes Medical Institute, New York, NY, USA
| | - Carlos Rodriguez-Gallego
- Department of Immunology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain, EU
| | - Laia Alsina
- Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain, EU
- Functional Unit of Clinical Immunology Hospital Sant Joan de Déu-Hospital Clinic, Spain, EU
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, IN-SERM-U1163, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, Rockefeller University, New York, NY, USA
- Center for the Study of Primary Immunodeficiencies, Necker Hospital for SickChildren, AP-HP, Paris, France, EU
| |
Collapse
|
7
|
van de Vosse E, van Dissel JT. IFN-γR1 defects: Mutation update and description of the IFNGR1 variation database. Hum Mutat 2017; 38:1286-1296. [PMID: 28744922 DOI: 10.1002/humu.23302] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/20/2017] [Accepted: 07/23/2017] [Indexed: 12/29/2022]
Abstract
IFN-γ signaling is essential for the innate immune defense against mycobacterial infections. IFN-γ signals through the IFN-γ receptor, which consists of a tetramer of two IFN-γR1 chains in complex with two IFN-γR2 chains, where IFN-γR1 is the ligand-binding chain of the interferon-γ receptor and IFN-γR2 is the signal-transducing chain of the IFN-γ receptor. Germline mutations in the gene IFNGR1 encoding the IFN-γR1 cause a primary immunodeficiency that mainly leads to mycobacterial infections. Here, we review the molecular basis of this immunodeficiency in the 130 individuals described to date, and report mutations in five new individuals, bringing the total number to 135 individuals from 98 kindreds. Forty unique IFNGR1 mutations have been reported and they exert either an autosomal dominant or an autosomal recessive effect. Mutations resulting in premature stopcodons represent the majority of IFNGR1 mutations (60%; 24 out of 40), followed by amino acid substitutions (28%, 11 out of 40). All known mutations, as well as 287 other variations, have been deposited in the online IFNGR1 variation database (www.LOVD.nl/IFNGR1). In this article, we review the function of IFN-γR1 and molecular genetics of human IFNGR1.
Collapse
Affiliation(s)
- Esther van de Vosse
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaap T van Dissel
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
8
|
Bińczak-Kuleta A, Szwed A, Walter MR, Kołban M, Ciechanowicz A, Clark JSC. Missense splice variant (g.20746A>G, p.Ile183Val) of interferon gamma receptor 1 (IFNGR1) coincidental with mycobacterial osteomyelitis - a screen of osteoarticular lesions. Bosn J Basic Med Sci 2016; 16:215-21. [PMID: 27356097 PMCID: PMC4978114 DOI: 10.17305/bjbms.2016.1232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/05/2016] [Accepted: 05/05/2016] [Indexed: 11/16/2022] Open
Abstract
Previously, dominant partial interferon-gamma receptor 1 (IFN-g-R1) susceptibility to environmental mycobacteria was found with IFNGR1 deletions or premature stop. Our aim was to search for IFNGR1 variants in patients with mycobacterial osteoarticular lesions. Biopsies from the patients were examined for acid-fast bacilli, inflammatory cell infiltration, and mycobacterial niacin. Mycobacterial rRNA was analyzed using a target-amplified rRNA probe test. Peripheral-blood-leukocyte genomic DNA was isolated from 19 patients using the QIAamp DNA Mini Kit, and all IFNGR1 exons were sequenced using an ABIPRISM 3130 device. After the discovery of an exon 5 variant, a Polish newborn population sample (n = 100) was assayed for the discovered variant. Splice sites and putative amino acid interactions were analyzed. All patients tested were positive for mycobacteria; one was heterozygous for the IFNGR1 exon 5 single-nucleotide-missense substitution (g.20746A>G, p.Ile183Val). No other variant was found. The splice analysis indicated the creation of an exonic splicing silencer, and alternatively, molecular graphics indicated that the p.Ile183Val might alter beta-strand packing (loss of van der Waals contacts; Val183/Pro205), possibly altering the IFN-g-R1/IFN-g-R2 interaction. The probability of non-deleterious variant was estimated as <10%. Heterozygous IFNGR1:p.Ile183Val (frequency 0.003%) was found to be coincidental with mycobacterial osteomyelitis. The small amount of variation detected in the patients with osteoarticular lesions indicates that screens should not yet be restricted: Intronic variants should be analyzed as well as the other genes affecting Type 1 T-helper-cell-mediated immunity.
Collapse
Affiliation(s)
- Agnieszka Bińczak-Kuleta
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | | | | | | | | | | |
Collapse
|
9
|
de Vor IC, van der Meulen PM, Bekker V, Verhard EM, Breuning MH, Harnisch E, van Tol MJD, Wieringa JW, van de Vosse E, Bredius RGM. Deletion of the entire interferon-γ receptor 1 gene causing complete deficiency in three related patients. J Clin Immunol 2016; 36:195-203. [PMID: 26931784 PMCID: PMC4792359 DOI: 10.1007/s10875-016-0244-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/14/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE Complete interferon-γ receptor 1 (IFN-γR1) deficiency is a primary immunodeficiency causing predisposition to severe infection due to intracellular pathogens. Only 36 cases have been reported worldwide. The purpose of this article is to describe a large novel deletion found in 3 related cases, which resulted in the complete removal of the IFNGR1 gene. METHODS Whole blood from three patients was stimulated with lipopolysaccharide (LPS) and IFN-γ to determine production of tumor necrosis factor (TNF), interleukin-12 p40 (IL-12p40) and IL-10. Expression of IFN-γR1 on the cell membrane of patients' monocytes was assessed using flow cytometry. IFNGR1 transcript was analyzed in RNA and the gene and adjacent regions were analyzed in DNA. Finally, IL22RA2 transcript levels were analyzed in whole blood cells and dendritic cells. RESULTS There was no expression of the IFN-γR1 on the monocytes. Consistent with this finding, there was no IFN-γ response in the whole blood assay as measured by effect on LPS-induced IL-12p40, TNF and IL-10 production. A 119.227 nt homozygous deletion on chromosome 6q23.3 was identified, removing the IFNGR1 gene completely and ending 117 nt upstream of the transcription start of the IL22RA2 gene. Transcript levels of IL22RA2 were similar in patient and control. CONCLUSIONS We identified the first large genomic deletion of IFNGR1 causing complete IFN-γR1 deficiency. Despite the deletion ending very close to the IL22RA2 gene, it does not appear to affect IL22RA2 transcription and, therefore, may not have any additional clinical consequence.
Collapse
MESH Headings
- Adult
- Blood Cells/drug effects
- Blood Cells/immunology
- Blood Cells/pathology
- Child, Preschool
- Chromosomes, Human, Pair 6
- Dendritic Cells/immunology
- Dendritic Cells/pathology
- Female
- Gene Deletion
- Gene Expression Regulation
- Homozygote
- Humans
- Immunologic Deficiency Syndromes/genetics
- Immunologic Deficiency Syndromes/immunology
- Immunologic Deficiency Syndromes/physiopathology
- Infant
- Interferon-gamma/pharmacology
- Interleukin-10/genetics
- Interleukin-10/immunology
- Interleukin-12 Subunit p40/genetics
- Interleukin-12 Subunit p40/immunology
- Lipopolysaccharides/pharmacology
- Opportunistic Infections/genetics
- Opportunistic Infections/immunology
- Opportunistic Infections/physiopathology
- Pedigree
- Primary Cell Culture
- RNA, Messenger/genetics
- RNA, Messenger/immunology
- Receptors, Interferon/deficiency
- Receptors, Interferon/genetics
- Receptors, Interferon/immunology
- Receptors, Interleukin/genetics
- Receptors, Interleukin/immunology
- Sequence Analysis, DNA
- Transcription, Genetic
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/immunology
- Interferon gamma Receptor
Collapse
Affiliation(s)
- Inge C de Vor
- Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Pomme M van der Meulen
- Department of Pediatrics, Medical Center Haaglanden, Lijnbaan 32, 2512 VA, The Hague, The Netherlands
| | - Vincent Bekker
- Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Els M Verhard
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Martijn H Breuning
- Department of Clinical Genetics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Esther Harnisch
- Department of Pediatrics, Medical Center Haaglanden, Lijnbaan 32, 2512 VA, The Hague, The Netherlands
| | - Maarten J D van Tol
- Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Jantien W Wieringa
- Department of Pediatrics, Medical Center Haaglanden, Lijnbaan 32, 2512 VA, The Hague, The Netherlands
| | - Esther van de Vosse
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Robbert G M Bredius
- Department of Pediatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| |
Collapse
|
10
|
Olbrich P, Martínez-Saavedra MT, Hurtado JMP, Sanchez C, Sanchez B, Deswarte C, Obando I, Casanova JL, Speckmann C, Bustamante J, Rodriguez-Gallego C, Neth O. Diagnostic and therapeutic challenges in a child with complete interferon-γ receptor 1 deficiency. Pediatr Blood Cancer 2015; 62:2036-9. [PMID: 26173802 PMCID: PMC4651008 DOI: 10.1002/pbc.25625] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 05/05/2015] [Indexed: 11/10/2022]
Abstract
Autosomal recessive (AR) complete Interferon-γ Receptor1 (IFN-γR1) deficiency is a rare variant of Mendelian susceptibility to mycobacterial disease (MSMD). Although hematopoietic stem cell transplantation (HSCT) remains the only curative treatment, outcomes are heterogeneous; delayed engraftment and/or graft rejection being commonly observed. This case report and literature review expands the knowledge about this rare but potentially fatal pathology, providing details regarding diagnosis, antimicrobial treatment, transplant performance, and outcome that may help to guide physicians caring for patients with AR complete IFN-γR1 or IFN-γR2 deficiency.
Collapse
Affiliation(s)
- Peter Olbrich
- Pediatric Infectious Diseases and Immunodeficiency Unit, Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla, Spain
| | | | | | - Cristina Sanchez
- Pediatric Infectious Diseases and Immunodeficiency Unit, Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla, Spain
| | - Berta Sanchez
- Department of Immunology, Hospital Virgen del Rocio, Sevilla, Spain
| | - Carolina Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris Descartes University, Imagine Institute, Paris, France
| | - Ignacio Obando
- Pediatric Infectious Diseases and Immunodeficiency Unit, Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla, Spain
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris Descartes University, Imagine Institute, Paris, France
- Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, the Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, New York, USA
| | - Carsten Speckmann
- Department of Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
- Center for Chronic Immunodeficiency, University of Freiburg, Germany
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- Paris Descartes University, Imagine Institute, Paris, France
- Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Carlos Rodriguez-Gallego
- Department of Immunology, Gran Canaria Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
- Department of Medical and Surgical Sciences, School of Medicine, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Olaf Neth
- Pediatric Infectious Diseases and Immunodeficiency Unit, Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla, Spain
| |
Collapse
|
11
|
Bustamante J, Boisson-Dupuis S, Abel L, Casanova JL. Mendelian susceptibility to mycobacterial disease: genetic, immunological, and clinical features of inborn errors of IFN-γ immunity. Semin Immunol 2014; 26:454-70. [PMID: 25453225 DOI: 10.1016/j.smim.2014.09.008] [Citation(s) in RCA: 440] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 09/28/2014] [Accepted: 09/29/2014] [Indexed: 12/20/2022]
Abstract
Mendelian susceptibility to mycobacterial disease (MSMD) is a rare condition characterized by predisposition to clinical disease caused by weakly virulent mycobacteria, such as BCG vaccines and environmental mycobacteria, in otherwise healthy individuals with no overt abnormalities in routine hematological and immunological tests. MSMD designation does not recapitulate all the clinical features, as patients are also prone to salmonellosis, candidiasis and tuberculosis, and more rarely to infections with other intramacrophagic bacteria, fungi, or parasites, and even, perhaps, a few viruses. Since 1996, nine MSMD-causing genes, including seven autosomal (IFNGR1, IFNGR2, STAT1, IL12B, IL12RB1, ISG15, and IRF8) and two X-linked (NEMO, and CYBB) genes have been discovered. The high level of allelic heterogeneity has already led to the definition of 18 different disorders. The nine gene products are physiologically related, as all are involved in IFN-γ-dependent immunity. These disorders impair the production of (IL12B, IL12RB1, IRF8, ISG15, NEMO) or the response to (IFNGR1, IFNGR2, STAT1, IRF8, CYBB) IFN-γ. These defects account for only about half the known MSMD cases. Patients with MSMD-causing genetic defects may display other infectious diseases, or even remain asymptomatic. Most of these inborn errors do not show complete clinical penetrance for the case-definition phenotype of MSMD. We review here the genetic, immunological, and clinical features of patients with inborn errors of IFN-γ-dependent immunity.
Collapse
Affiliation(s)
- Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, INSERM-U1163, Paris, France, EU; Paris Descartes University, Imagine Institute, Paris, France, EU; Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris AP-HP, Necker-Enfants Malades Hospital, Paris, France, EU.
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, INSERM-U1163, Paris, France, EU; Paris Descartes University, Imagine Institute, Paris, France, EU; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, INSERM-U1163, Paris, France, EU; Paris Descartes University, Imagine Institute, Paris, France, EU; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, INSERM-U1163, Paris, France, EU; Paris Descartes University, Imagine Institute, Paris, France, EU; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA; Howard Hughes Medical Institute, NY, USA; Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France, EU
| |
Collapse
|
12
|
Haverkamp MH, van de Vosse E, Goldbach-Mansky R, Holland SM. Impaired cytokine responses in patients with cryopyrin-associated periodic syndrome (CAPS). Clin Exp Immunol 2014; 177:720-31. [PMID: 24773462 DOI: 10.1111/cei.12361] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2014] [Indexed: 12/01/2022] Open
Abstract
Cryopyrin-associated periodic syndrome (CAPS) is characterized by dysregulated inflammation with excessive interleukin (IL)-1β activation and secretion. Neonatal-onset multi-system inflammatory disease (NOMID) is the most severe form. We explored cytokine responses in 32 CAPS patients before and after IL-1β blocking therapy. We measured cytokines produced by activated peripheral blood monuclear cells (PBMCs) from treated and untreated CAPS patients after stimulation for 48 h with phytohaemagglutinin (PHA), PHA plus IL-12, lipopolysaccharide (LPS) or LPS plus interferon (IFN)-γ. We measured IL-1β, IL-6, IL-10, tumour necrosis factor (TNF), IL-12p70 and IFN-γ in the supernatants. PBMCs from three untreated CAPS patients were cultured in the presence of the IL-1β blocker Anakinra. Fifty healthy individuals served as controls. CAPS patients had high spontaneous production of IL-1β, IL-6, TNF and IFN-γ by unstimulated cells. However, stimulation indexes (SIs, ratio of stimulated to unstimulated production) of these cytokines to PHA and LPS were low in NOMID patients compared to controls. Unstimulated IL-10 and IL-12p70 production was normal, but up-regulation after PHA and LPS was also low. LPS plus IFN-γ inadequately up-regulated the production of IL-1β, IL-6, TNF and IL-10 in CAPS patients. In-vitro but not in-vivo treatment with Anakinra improved SIs by lowering spontaneous cytokine production. However, in-vitro treatment did not improve the low stimulated cytokine levels. Activating mutations in NLRP3 in CAPS are correlated with poor SIs to PHA, LPS and IFN-γ. The impairment in stimulated cytokine responses in spite of IL-1β blocking therapy suggests a broader intrinsic defect in CAPS patients, which is not corrected by targeting IL-1β.
Collapse
Affiliation(s)
- M H Haverkamp
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands; Laboratory of Clinical Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | | | | |
Collapse
|
13
|
Qu HQ, Fisher-Hoch SP, McCormick JB. Molecular immunity to mycobacteria: knowledge from the mutation and phenotype spectrum analysis of Mendelian susceptibility to mycobacterial diseases. Int J Infect Dis 2011; 15:e305-13. [PMID: 21330176 PMCID: PMC3078969 DOI: 10.1016/j.ijid.2011.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Revised: 01/04/2011] [Accepted: 01/10/2011] [Indexed: 01/08/2023] Open
Abstract
Understanding molecular immunity against mycobacterial infection is critical for the development of effective strategies to control tuberculosis (TB), which is a major health issue in the developing world. Host immunogenetic studies represent an indispensable approach to understand the molecular mechanisms against mycobacterial infection. A superb paradigm is the identification of rare mutations causing Mendelian susceptibility to mycobacterial diseases (MSMD). Mutations in the interferon-gamma (IFN-γ) receptor genes are highly specific (although not exclusive) for mycobacterial infection. Only dominant negative mutations of STAT1 have specific susceptibility to mycobacterial infection. Mutations in the interleukin-12 (IL-12) signaling genes have phenotypes with non-specificity. Current studies highlight a complex molecular network in antimycobacterial immunity, centered on IFN-γ signaling.
Collapse
Affiliation(s)
- Hui-Qi Qu
- University of Texas Health Science Center at Houston, School of Public Health, Brownsville Campus, 80 Fort Brown, SPH Bldg, Brownsville, Texas 78520, USA.
| | | | | |
Collapse
|
14
|
van de Wetering D, van Wengen A, Savage NDL, van de Vosse E, van Dissel JT. IFN-α cannot substitute lack of IFN-γ responsiveness in cells of an IFN-γR1 deficient patient. Clin Immunol 2011; 138:282-90. [PMID: 21216674 DOI: 10.1016/j.clim.2010.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 11/19/2010] [Accepted: 12/08/2010] [Indexed: 10/18/2022]
Abstract
Patients with complete IFN-γR deficiency are unable to respond to IFN-γ and have impaired Th1-immunity and recurrent, severe infections with weakly virulent Mycobacteria. Since IFN-α and IFN-γ share signalling pathways, treatment with IFN-α has been proposed in complete IFN-γR deficiency. We stimulated cells from healthy controls and from a patient lacking IFN-γR1 with IFN-α and IFN-γ, to establish whether IFN-α would substitute for IFN-γ effects. IFN-α induced STAT1 phosphorylation in monocytes of the IFN-γR1(-/-) patient, but did not prime for LPS-induced IL-12p70, IL-12p40, IL-23 or TNF production. In control cells, IFN-α inhibited the priming effect of IFN-γ on LPS-induced pro-inflammatory cytokine release. Finally, IFN-γ but not IFN-α induced killing of M. smegmatis in cultured macrophages. In conclusion, no evidence was found to support the use of IFN-α in IFN-γR-deficient patients as intervention against mycobacterial infection; on the contrary, treatment of individuals with IFN-α may even adversely affect host defence against Mycobacteria.
Collapse
Affiliation(s)
- Diederik van de Wetering
- Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | | | | | | | | |
Collapse
|
15
|
Prando C, Boisson-Dupuis S, Grant A, Kong XF, Bustamante J, Feinberg J, Chapgier A, Rose Y, Jannière L, Rizzardi E, Zhang Q, Shanahan CM, Viollet L, Lyonnet S, Abel L, Ruga EM, Casanova JL. Paternal uniparental isodisomy of chromosome 6 causing a complex syndrome including complete IFN-gamma receptor 1 deficiency. Am J Med Genet A 2010; 152A:622-9. [PMID: 20186794 PMCID: PMC2946788 DOI: 10.1002/ajmg.a.33291] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Mendelian susceptibility to mycobacterial disease (MSMD) is a rare primary immunodeficiency associated with clinical disease caused by weakly virulent mycobacterial species. Interferon gamma receptor 1 (IFN-gammaR1) deficiency is a genetic etiology of MSMD. We describe the clinical and genetic features of a 7-year-old Italian boy suffering from MSMD associated with a complex phenotype, including neonatal hyperglycemia, neuromuscular disease, and dysmorphic features. The child also developed necrotizing pneumonia caused by Rhodococcus equi. The child is homozygous for a nonsense mutation in exon 3 of IFNGR1 as a result of paternal uniparental disomy (UPD) of the entire chromosome 6. This is the first reported case of uniparental disomy resulting in a complex phenotype including MSMD.
Collapse
Affiliation(s)
- Carolina Prando
- Laboratory of Human Genetics of Infectious Disease, Rockefeller Branch, The Rockefeller University, New York, New York, USA
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Disease, Rockefeller Branch, The Rockefeller University, New York, New York, USA
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Audrey Grant
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Xiao-Fei Kong
- Laboratory of Human Genetics of Infectious Disease, Rockefeller Branch, The Rockefeller University, New York, New York, USA
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
- French-Chinese Laboratory of Genetics and Life Science, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, People's Republic fo China
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Jacqueline Feinberg
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Ariane Chapgier
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Yoann Rose
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Lucile Jannière
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Elena Rizzardi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Padua, Padua, Italy
| | - Qiuping Zhang
- Cardiovascular Division, King's College London, James Black Centre, London, UK
| | | | - Louis Viollet
- INSERM U781, Necker Medical School, University Paris Descartes, Paris, France
| | - Stanislas Lyonnet
- INSERM U781, Necker Medical School, University Paris Descartes, Paris, France
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Disease, Rockefeller Branch, The Rockefeller University, New York, New York, USA
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
| | - Ezia Maria Ruga
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Padua, Padua, Italy
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Disease, Rockefeller Branch, The Rockefeller University, New York, New York, USA
- Laboratory of Human Genetics of Infectious Disease, Necker Branch, Necker Medical School, INSERM U550, Paris, France
- Necker Medical School, University Paris Descartes, Paris, France
- Pediatric Immunology and Hematology Unit, Necker Enfants Malades Hospital, Paris, France
| |
Collapse
|
16
|
van de Wetering D, de Paus RA, van Dissel JT, van de Vosse E. Functional analysis of naturally occurring amino acid substitutions in human IFN-gammaR1. Mol Immunol 2010; 47:1023-30. [PMID: 20015550 DOI: 10.1016/j.molimm.2009.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 11/09/2009] [Accepted: 11/13/2009] [Indexed: 11/19/2022]
Abstract
IFN-gamma plays an essential role in the IL-12/IL-23/IFN-gamma pathway that is required for the defense against intracellular pathogens. In the IFN-gammaR1 several amino acid substitutions have been reported that abrogate IFN-gamma signaling. These substitutions can lead to a null phenotype and enhanced susceptibility to infection by poorly pathogenic mycobacteria, a disorder known as Mendelian Susceptibility to Mycobacterial Disease (MSMD). More common amino acid variations in the IFN-gammaR1 may also influence IFN-gammaR function, albeit more subtle. To determine the effect of various amino acid substitutions on IFN-gammaR1 expression and function we cloned two newly identified amino acid substitutions (S149L, I352M), four common variations (V14M, V61I, H335P, L467P), seven reported missense mutations (V61Q, V63G, Y66C, C77Y, C77F, C85Y, I87T) and the 818delTTAA mutation in a retroviral expression vector. IFN-gammaR1 expression was determined as well as responsiveness to IFN-gamma stimulation. The two newly discovered variants, and the four common polymorphisms could be detected on the cell surface, however, the V14M, H335P and I352M variants were significantly lower expressed at the cell membrane, compared to the wild type receptor. Despite the variance in cell surface expression, these IFN-gammaR1 variants did not affect function. In contrast to literature, in our model the expression of the V63G variant was severely reduced and its function was severely impaired but not completely abrogated. In addition, we confirmed the severely reduced function of the I87T mutant receptor, the completely abrogated expression and function of the V61E, V61Q, C77F, C77Y and the C85Y mutations, as well as the overexpression pattern of the 818delTTAA mutant receptor. The Y66C mutation was expressed at the cell surface, it was however, not functional. We conclude that the V14M, V61I, S149L, H335P, I352M and L467P are functional polymorphisms. The other variants are deleterious mutations with V61E, V61Q, Y66C, C77F, C77Y and C85Y leading to complete IFN-gammaR1 deficiency, while V63G and I87T lead to partial IFN-gammaR1 deficiency.
Collapse
|
17
|
Kong XF, Vogt G, Chapgier A, Lamaze C, Bustamante J, Prando C, Fortin A, Puel A, Feinberg J, Zhang XX, Gonnord P, Pihkala-Saarinen UM, Arola M, Moilanen P, Abel L, Korppi M, Boisson-Dupuis S, Casanova JL. A novel form of cell type-specific partial IFN-gammaR1 deficiency caused by a germ line mutation of the IFNGR1 initiation codon. Hum Mol Genet 2010; 19:434-44. [PMID: 19880857 PMCID: PMC2800780 DOI: 10.1093/hmg/ddp507] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 10/29/2009] [Indexed: 11/14/2022] Open
Abstract
IFN-gammaR1 deficiency is a genetic etiology of Mendelian susceptibility to mycobacterial diseases, and includes two forms of complete recessive deficiency, with or without cell surface expression, and two forms of partial deficiency, dominant or recessive. We report here a novel form of partial and recessive Interferon gamma receptor 1 (IFN-gammaR1) deficiency, which is almost as severe as complete deficiency. The patient is homozygous for a mutation of the initiation codon (M1K). No detectable expression and function of IFN-gammaR1 were found in the patient's fibroblasts. However, IFN-gammaR1 expression was found to be impaired, but not abolished, on the EBV-transformed B cells, which could respond weakly to IFN-gamma. The mechanism underlying this weak expression involves leaky translation initiation at both non-AUG codons and the third AUG codon at position 19. It results in the residual expression of IFN-gammaR1 protein of normal molecular weight and function. The residual IFN-gamma signaling documented in this novel form of partial IFN-gammaR1 deficiency was not ubiquitous and was milder than that seen in other forms of partial IFN-gammaR1 deficiency, accounting for the more severe clinical phenotype of the patient, which was almost as severe as that of patients with complete deficiency.
Collapse
Affiliation(s)
- Xiao-Fei Kong
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
- French-Chinese Laboratory of Genetics and Life Science, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 200025 Shanghai, People's Republic of China
| | - Guillaume Vogt
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Ariane Chapgier
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Christophe Lamaze
- The Traffic, Signaling and Delivery Laboratory, UMR144 Curie Centre National de la Recherche Scientifique, Institut Curie, 75005 Paris, France
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Carolina Prando
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA
| | - Anny Fortin
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Jacqueline Feinberg
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Xin-Xin Zhang
- French-Chinese Laboratory of Genetics and Life Science, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 200025 Shanghai, People's Republic of China
| | - Pauline Gonnord
- The Traffic, Signaling and Delivery Laboratory, UMR144 Curie Centre National de la Recherche Scientifique, Institut Curie, 75005 Paris, France
| | - Ulla M. Pihkala-Saarinen
- Hospital for Children and Adolescents, Helsinki University and University Hospital, Helsinki, Finland
| | - Mikko Arola
- Pediatric Research Center, Tampere University and University Hospital, Tampere, Finland
| | - Petra Moilanen
- Pediatric Research Center, Tampere University and University Hospital, Tampere, Finland
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Matti Korppi
- Department of Pediatrics, Kuopio University and University Hospital, Kuopio, Finland and
| | - Stéphanie Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065, USA
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, U550, Institut National de la Santé et de la Recherche Médicale (INSERM), 75015 Paris, France
- University Paris Descartes, Necker Medical School, 75015 Paris, France
- French-Chinese Laboratory of Genetics and Life Science, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, 200025 Shanghai, People's Republic of China
- Pediatric Immunology-Hematology Unit, Necker Hospital, 75015 Paris, France
| |
Collapse
|
18
|
Gao Q, Nie P, Thompson KD, Adams A, Wang T, Secombes CJ, Zou J. The search for the IFN-gamma receptor in fish: Functional and expression analysis of putative binding and signalling chains in rainbow trout Oncorhynchus mykiss. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2009; 33:920-31. [PMID: 19454334 DOI: 10.1016/j.dci.2009.03.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 03/02/2009] [Accepted: 03/05/2009] [Indexed: 05/27/2023]
Abstract
Interferons (IFNs), consisting of three major subfamilies, type I, type II (gamma) and type III (lambda) IFN, activate vertebrate antiviral defences once bound to their receptors. The three IFN subfamilies bind to different receptors, IFNAR1 and IFNAR2 for type I IFNs, IFNgammaR1 and IFNgammaR2 for type II IFN, and IL-28R1 and IL-10R2 for type III IFNs. In fish, although many types I and II IFN genes have been cloned, little is known about their receptors. In this report, two putative IFN-gamma receptor chains were identified and sequenced in rainbow trout (Oncorhynchus mykiss), and found to have many common characteristics with mammalian type II IFN receptor family members. The presented gene synteny analysis, phylogenetic tree analysis and ligand binding analysis all suggest that these molecules are the authentic IFNgammaRs in fish. They are widely expressed in tissues, with IFNgammaR1 typically more highly expressed than IFNgammaR2. Using the trout RTG-2 cell line it was possible to show that the individual chains could be differentially modulated, with rIFN-gamma and rIL-1beta down regulating IFNgammaR1 expression but up regulating IFNgammaR2 expression. Over-expression of the two receptor chains in RTG-2 cells revealed that the level of IFNgammaR2 transcript was crucial for responsiveness to rIFN-gamma, in terms of inducing gammaIP expression. Transfection experiments showed that the two putative receptors specifically bound to rIFN-gamma. These findings are discussed in the context of how the IFNgammaR may bind IFN-gamma in fish and the importance of the individual receptor chains to signal transduction.
Collapse
Affiliation(s)
- Q Gao
- Scottish Fish Immunology Research Centre, University of Aberdeen, UK
| | | | | | | | | | | | | |
Collapse
|
19
|
Moilanen P, Korppi M, Hovi L, Chapgier A, Feinberg J, Kong XF, Boisson-Dupuis S, Arola M, Casanova JL, Saarinen-Pihkala UM. Successful hematopoietic stem cell transplantation from an unrelated donor in a child with interferon gamma receptor deficiency. Pediatr Infect Dis J 2009; 28:658-60. [PMID: 19451859 DOI: 10.1097/inf.0b013e318195092e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Interferon gamma receptor deficiency is a rare autosomal recessive inherited disorder, with poor prognosis due to early-onset, recurrent, and disseminated mycobacterial infections. Hematopoietic stem cell transplantation (HSCT), the only curative treatment, is particularly difficult in these patients owing to a high rate of graft rejection. We report the first successful hematopoietic stem cell transplantation with an unrelated donor, performed in a schoolgirl with severe interferon gamma receptor 1deficiency caused by a novel mutation.
Collapse
Affiliation(s)
- Petra Moilanen
- Pediatric Research Center, University Hospital, Tampere University, Tampere, Finland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Pessach I, Walter J, Notarangelo LD. Recent advances in primary immunodeficiencies: identification of novel genetic defects and unanticipated phenotypes. Pediatr Res 2009; 65:3R-12R. [PMID: 19190530 DOI: 10.1203/pdr.0b013e31819dbe1e] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary immunodeficiencies (PIDs) have traditionally been defined according to their immunologic phenotype. Far from being concluded, the search for human genes that, when mutated, cause PID is actively being pursued. During the last year, four novel genetic defects that cause severe combined immunodeficiency and severe congenital neutropenia have been identified. At the same time, the immunologic definition of primary immunodeficiencies has been expanded by the recognition that genetic defects affecting innate immunity may result in selective predisposition to certain infections, such as mycobacterial disease, herpes simplex encephalitis, and invasive pneumococcal infections. Studies of genetically determined susceptibility to infections have recently shown that immunologic defects may also account for novel infectious phenotypes, such as malaria or leprosy. Finally, a growing body of evidence indicates that primary immunodeficiencies may present with a noninfectious clinical phenotype that may be restricted to single organs, as in the case of atypical hemolytic uremic syndrome or pulmonary alveolar proteinosis. Overall, these achievements highlight the importance of human models, which often differ from the corresponding animal models.
Collapse
Affiliation(s)
- Itai Pessach
- Division of Immunology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA
| | | | | |
Collapse
|
21
|
Zhang SY, Boisson-Dupuis S, Chapgier A, Yang K, Bustamante J, Puel A, Picard C, Abel L, Jouanguy E, Casanova JL. Inborn errors of interferon (IFN)-mediated immunity in humans: insights into the respective roles of IFN-alpha/beta, IFN-gamma, and IFN-lambda in host defense. Immunol Rev 2009; 226:29-40. [PMID: 19161414 DOI: 10.1111/j.1600-065x.2008.00698.x] [Citation(s) in RCA: 231] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Interferon (IFN) was originally identified as a substance 'interfering' with viral replication in vitro. The first IFNs to be identified were classified as type I IFNs (IFN-alpha/beta and related molecules), two other types have since been identified: type II IFN (IFN-gamma) and type III IFNs (IFN-lambda). Each IFN binds to one of three type-specific receptors. In the mouse model of experimental infections in vivo, IFN-alpha/beta are essential for immunity to most viruses tested, whereas IFN-gamma is important for immunity to a smaller number of viruses, together with bacteria, fungi, and parasites, consistent with IFN-gamma acting as the 'macrophage activating factor.' The precise role of IFN-lambda remains unclear. In recent years, inborn errors affecting the production of, or the response to, IFNs have been reported in human patients, shedding light onto the function of IFNs in natura. Disorders of IFN-gamma production, caused by IL12B, IL12RB1, and specific NEMO mutations, or of IFN-gamma responses, caused by IFNGR1, IFNGR2, and dominant STAT1 mutations, confer predisposition to mycobacterial disease in patients resistant to most viruses. By contrast, disorders of IFN-alpha/beta and IFN-lambda production, caused by UNC93B1 and TLR3 mutations, confer predisposition to herpes simplex encephalitis (HSE) in otherwise healthy patients. Consistently, patients with impaired responses to IFN-alpha/beta, IFN-gamma, and presumably IFN-lambda (carrying recessive mutations in STAT1), or with impaired responses to IFN-alpha/beta and impaired IFN-gamma production (carrying mutations in TYK2), or with impaired production of IFN-alpha/beta, IFN-gamma, and IFN-lambda (carrying specific mutations in NEMO), are vulnerable to mycobacterial and viral infections, including HSE. These experiments of nature suggest that the three types of IFNs play at least two different roles in host defense. IFN-gamma is essential for anti-mycobacterial immunity, whereas IFN-alpha/beta and IFN-lambda are essential for anti-viral immunity. Future studies in humans aim to define the specific roles of IFN-alpha/beta and IFN-lambda types and individual molecules in host defense in natura.
Collapse
Affiliation(s)
- Shen-Ying Zhang
- Laboratory of Human Genetics of Infectious Diseases, Institut National de Santé et de Recherche Médicale, U550, Paris, France, EU
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Al-Muhsen S, Casanova JL. The genetic heterogeneity of mendelian susceptibility to mycobacterial diseases. J Allergy Clin Immunol 2009; 122:1043-51; quiz 1052-3. [PMID: 19084105 DOI: 10.1016/j.jaci.2008.10.037] [Citation(s) in RCA: 159] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 10/27/2008] [Accepted: 10/27/2008] [Indexed: 11/19/2022]
Abstract
Primary immunodeficiencies (PIDs) were long thought to be exclusively recessive traits -- autosomal recessive (AR) in most cases, with a few X-linked recessive (XR) diseases. In recent years, autosomal dominant (AD), mitochondrial, polygenic, and even somatic PIDs have been described. However, AR remains the most frequent inheritance pattern among recently described PIDs. Some PIDs have been shown to be genetically heterogeneous. Mendelian susceptibility to mycobacterial diseases (MSMD) displays a high level of genetic heterogeneity. There are 6 MSMD-causing genes, including 1 X-linked gene (nuclear factor-kappaB-essential modulator [NEMO]) and 5 autosomal genes (IFN-gamma receptor 1 [IFNGR1], IFN-gamma receptor 2 [IFNGR2], signal transducer and activator of transcription 1 [STAT1], IL-12 p40 subunit [IL12P40], and IL-12 receptor beta-subunit [IL12RB1]). The X-linked trait is XR; STAT1 deficiency is AD; the IFNGR2, IL12P40 subunit, and IL12RB1 deficiencies are AR; and IFNGR1 deficiency may be AD or AR. Two of the AR traits (IFNGR1, IFNGR2) may be subdivided into complete and partial deficiencies, and 3 AR complete deficiencies (IFNGR1, IFNGR2, IL12RB1) may be subdivided into disorders with and without cell surface expression. Finally, there are 2 types of AD STAT1 deficiency, depending on whether the mutation impairs phosphorylation or DNA binding. Thirteen genetic disorders conferring MSMD have been described, involving 1 XR, 3 AD (2 genes), and 9 AR traits (4 genes). However, no genetic etiology has yet been identified for about half of all patients with MSMD. We expect to identify new XR and AD causes of MSMD, but new AR etiologies of MSMD are also likely to be discovered. The investigation of children from areas in which consanguineous marriages are common will probably facilitate the description of many more AR traits.
Collapse
Affiliation(s)
- Saleh Al-Muhsen
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
| | | |
Collapse
|
23
|
Bustamante J, Zhang SY, von Bernuth H, Abel L, Casanova JL. From infectious diseases to primary immunodeficiencies. Immunol Allergy Clin North Am 2008; 28:235-58, vii. [PMID: 18424331 DOI: 10.1016/j.iac.2008.01.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The field of primary immunodeficiencies has expanded, thanks to the exploration of novel clinical phenotypes and their connection with morbid genotypes, and the subsequent exploration of new patients who have known primary immunodeficiency-defining clinical phenotypes and their connection with novel morbid genotypes. This two-way process is becoming increasingly active, particularly for patients who have infectious diseases in whom the underlying immunologic and genetic causes remain mostly unexplained. The authors review how the exploration of children who have clinical infectious diseases caused by mycobacteria, pneumococcus, and herpes simplex virus recently led to the description of three new groups of primary immunodeficiencies. These three examples justify the continuation of the genetic exploration of novel infectious phenotypes and novel patients who have infections. This challenging process will eventually reap its rewards, to the benefit of patients and their families.
Collapse
Affiliation(s)
- Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Institut Nationale de la Santé et de la Recherche Médicale, INSERM U550, 75015 Paris, France
| | | | | | | | | |
Collapse
|
24
|
Abstract
Human primary immunodeficiencies (PIDs) are often thought to be confined to a few rare, familial, monogenic, recessive traits impairing the development or function of one or several leucocyte subsets and resulting in multiple, recurrent, opportunistic and fatal infections in infancy. We highlight here the rapidly growing number of exceptions to each of these conventional qualifications. Indeed, bona fide PIDs include common and sporadic illnesses and may present as dominant, or even polygenic traits; their pathogenesis may involve non haematopoietic cells, and they may result in single episode of illness, with a single or multiple morbid phenotypes, some of which may involve infection, in otherwise healthy adults. We need to increase awareness of the multitude of clinical presentations of human PIDs considerably and rapidly in the medical community. Human PIDs should be considered in a wide range of clinical situations.
Collapse
Affiliation(s)
- Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Institut National de la Santé et de la Recherche Médicale, Paris, France.
| | | | | | | |
Collapse
|