Deleterious Mutations in LRBA Are Associated with a Syndrome of Immune Deficiency and Autoimmunity

作者:Lopez Herrera Gabriela; Tampella Giacomo; Pan Hammarstrom Qiang; Herholz Peer; Trujillo Vargas Claudia M; Phadwal Kanchan; Simon Anna Katharina; Moutschen Michel; Etzioni Amos; Mory Adi; Srugo Izhak; Melamed Doron; Hultenby Kjell; Liu Chonghai; Baronio Manuela; Vitali Massimiliano; Philippet Pierre; Dideberg Vinciane; Aghamohammadi Asghar; Rezaei Nima; Enright Victoria; Du Likun; Salzer Ulrich; Eibel Hermann; Pfeifer Dietmar; Veelken Hendrik; Stauss Hans
来源:American Journal of Human Genetics, 2012, 90(6): 986-1001.
DOI:10.1016/j.ajhg.2012.04.015

摘要

Most autosomal genetic causes of childhood-onset hypogammaglobulinemia are currently not well understood. Most affected individuals are simplex cases, but both autosomal-dominant and autosomal-recessive inheritance have been described. We performed genetic linkage analysis in consanguineous families affected by hypogammaglobulinemia. Four consanguineous families with childhood-onset humoral immune deficiency and features of autoimmunity shared genotype evidence for a linkage interval on chromosome 4q. Sequencing of positional candidate genes revealed that in each family, affected individuals had a distinct homozygous mutation in LRBA (lipopolysaccharide responsive beige-like anchor protein). All LRBA mutations segregated with the disease because homozygous individuals showed hypogammaglobulinemia and autoimmunity, whereas heterozygous individuals were healthy. These mutations were absent in healthy controls. Individuals with homozygous LRBA mutations had no LRBA, had disturbed B cell development, defective in vitro B cell activation, plasmablast formation, and immunoglobulin secretion, and had low proliferative responses. We conclude that mutations in LRBA cause an immune deficiency characterized by defects in B cell activation and autophagy and by susceptibility to apoptosis, all of which are associated with a clinical phenotype of hypogammaglobulinemia and autoimmunity.