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Salinas SA, Mace EM, Conte MI, Park CS, Li Y, Rosario-Sepulveda JI, Mahapatra S, Moore EK, Hernandez ER, Chinn IK, Reed AE, Lee BJ, Frumovitz A, Gibbs RA, Posey JE, Forbes Satter LR, Thatayatikom A, Allenspach EJ, Wensel TG, Lupski JR, Lacorazza HD, Orange JS. An ELF4 hypomorphic variant results in NK cell deficiency. JCI Insight 2022; 7:155481. [PMID: 36477361 PMCID: PMC9746917 DOI: 10.1172/jci.insight.155481] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/13/2022] [Indexed: 12/12/2022] Open
Abstract
NK cell deficiencies (NKD) are a type of primary immune deficiency in which the major immunologic abnormality affects NK cell number, maturity, or function. Since NK cells contribute to immune defense against virally infected cells, patients with NKD experience higher susceptibility to chronic, recurrent, and fatal viral infections. An individual with recurrent viral infections and mild hypogammaglobulinemia was identified to have an X-linked damaging variant in the transcription factor gene ELF4. The variant does not decrease expression but disrupts ELF4 protein interactions and DNA binding, reducing transcriptional activation of target genes and selectively impairing ELF4 function. Corroborating previous murine models of ELF4 deficiency (Elf4-/-) and using a knockdown human NK cell line, we determined that ELF4 is necessary for normal NK cell development, terminal maturation, and function. Through characterization of the NK cells of the proband, expression of the proband's variant in Elf4-/- mouse hematopoietic precursor cells, and a human in vitro NK cell maturation model, we established this ELF4 variant as a potentially novel cause of NKD.
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Affiliation(s)
- Sandra Andrea Salinas
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Emily M. Mace
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Matilde I. Conte
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Yu Li
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Sanjana Mahapatra
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Emily K. Moore
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Evelyn R. Hernandez
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ivan K. Chinn
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Abigail E. Reed
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Barclay J. Lee
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Alexander Frumovitz
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA.,Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Richard A. Gibbs
- Department of Molecular and Human Genetics, and,Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Lisa R. Forbes Satter
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Akaluck Thatayatikom
- Division of Pediatric Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of Florida, Shands Children’s Hospital, Gainesville, Florida, USA
| | - Eric J. Allenspach
- Division of Immunology, Seattle Children’s Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | | | - James R. Lupski
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA.,Department of Molecular and Human Genetics, and,Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Jordan S. Orange
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
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