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Common variable immunodeficiency in two kindreds with heterogeneous phenotypes caused by novel heterozygous NFKB1 mutations

Authors: Frederik Staels; Frederik Staels; Kerstin De Keukeleere; Kerstin De Keukeleere; Matias Kinnunen; Salla Keskitalo; Flaminia Lorenzetti; +23 Authors

Common variable immunodeficiency in two kindreds with heterogeneous phenotypes caused by novel heterozygous NFKB1 mutations

Abstract

NFKB1 haploinsufficiengcy was first described in 2015 in three families with common variable immunodeficiency (CVID), presenting heterogeneously with symptoms of increased infectious susceptibility, skin lesions, malignant lymphoproliferation and autoimmunity. The described mutations all led to a rapid degradation of the mutant protein, resulting in a p50 haploinsufficient state. Since then, more than 50 other mutations have been reported, located throughout different domains of NFKB1 with the majority situated in the N-terminal Rel homology domain (RHD). The clinical spectrum has also expanded with possible disease manifestations in almost any organ system. In silico prediction tools are often used to estimate the pathogenicity of NFKB1 variants but to prove causality between disease and genetic findings, further downstream functional validation is required. In this report, we studied 2 families with CVID and two novel variants in NFKB1 (c.1638-2A>G and c.787G>C). Both mutations affected mRNA and/or protein expression of NFKB1 and resulted in excessive NLRP3 inflammasome activation in patient macrophages and upregulated interferon stimulated gene expression. Protein-protein interaction analysis demonstrated a loss of interaction with NFKB1 interaction partners for the p.V263L mutation. In conclusion, we proved pathogenicity of two novel variants in NFKB1 in two families with CVID characterized by variable and incomplete penetrance.

Countries
Finland, Belgium
Keywords

3101 Biochemistry and cell biology, Inflammasomes, NF-KAPPA-B, Immunology, primary immunodeficiency, functional validation, 3105 Genetics, 1108 Medical Microbiology, NLR Family, Pyrin Domain-Containing 3 Protein, Immunology and Allergy, Humans, RNA, Messenger, Science & Technology, ERN-RITA, NF-kappa B p50 Subunit, NF-KAPPA-B1, RC581-607, HYDROXYLATION, General medicine, internal medicine and other clinical medicine, Jeffrey Modell foundatio, haploinsufficiency, 3204 Immunology, Common Variable Immunodeficiency, Phenotype, 1107 Immunology, Nfkb1 (p50), Mutation, Mutant Proteins, Interferons, novel mutation, Immunologic diseases. Allergy, Life Sciences & Biomedicine

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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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    influence
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    Top 10%
    impulse
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    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Top 10%
Top 10%
Green
gold