Severe invasive infections linked to IRAK2 immune variants

• Published in: International journal of infectious diseases Vol. 148; p. 107245
• Main Authors: Amali, Aseervatham Anusha, Paramasivam, Kathirvel, Ravikumar, Sharada, Tan, Zhaohong, Loong, Shaun Seh Ern, Chong, Kelvin Han Chung, Ang, Alicia, Zhu, Jin, Rao, Suma Sathyanarayana, Chai, Louis Yi Ann
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.11.2024; Elsevier
• Subjects: Bacteremia - microbiology; Candida; Candidiasis - immunology; Candidiasis - microbiology; Exome sequencing; Female; Herpes Simplex - immunology; Herpes Simplex - virology; Humans; Immunodeficiency; Interleukin-1 Receptor-Associated Kinases - genetics; Interleukin-1 Receptor-Associated Kinases - metabolism; Lymphohistiocytosis, Hemophagocytic - genetics; Lymphohistiocytosis, Hemophagocytic - immunology; Male; Mutation; Pneumococcal Infections - immunology; Pneumococcal Infections - microbiology; Pyogenic bacteria; Streptococcus pneumoniae - genetics; Streptococcus pneumoniae - immunology; Tuberculosis - immunology; Tuberculosis - microbiology; Tumor Necrosis Factor-alpha - metabolism; Tumour necrosis factor alpha; Pyogenic bacteria; Tumour necrosis factor alpha; Candida; Immunodeficiency; Exome sequencing
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2024.107245

•Interleukin-1 receptor-associated kinase (IRAK) transmits signal of invading microbes.•We elicited novel IRAK2 mutations in two patients with sequential invasive infections.•These patients had viral, bacterial, and fungal infections but could not produce tumor necrosis factor α.•The identified IRAK2 mutants L78P and R506W could not modify tumor necrosis factor receptor-associated factor 6, a signal adaptor. In subjects with peculiar susceptibility to severe infections by common pyogenic bacteria, mutations of interleukin-1 receptor-associated kinase proteins (IRAK)1 and IRAK4 had been identified. The IRAK kinases function as downstream signal transductors following the activation of pathogen recognition receptors. In two patients with sequential or repeated invasive infections: herpes simplex virus-triggered hemophagocytic lymphohistiocytosis with tuberculosis, and Streptococcus pneumoniae bacteremia with candidemia respectively, novel mutations of IRAK2 were identified. These mutations compromised the capacity to ubiquinate (or functionally modify) the signal adaptor tumor necrosis factor receptor-associated factor 6. The result is impairment of the cytokine tumor necrosis factor-alpha production. This susceptibility to a varied range of pathogens underlines a potential central role played by IRAK2 in mediating host defense in infectious diseases.