A Novel Homozygous Stop Mutation in IL23R Causes Mendelian Susceptibility to Mycobacterial Disease
Purpose Mendelian susceptibility to mycobacterial disease (MSMD) is caused by inborn errors of IFN-γ immunity. The most frequent genetic defects are found in IL12 or a subunit of its receptor. IL23R deficiency in MSMD has only been reported once, in two pediatric patients from the same kindred with...
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Published in | Journal of clinical immunology Vol. 42; no. 8; pp. 1638 - 1652 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.11.2022
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Purpose
Mendelian susceptibility to mycobacterial disease (MSMD) is caused by inborn errors of IFN-γ immunity. The most frequent genetic defects are found in
IL12
or a subunit of its receptor. IL23R deficiency in MSMD has only been reported once, in two pediatric patients from the same kindred with isolated disseminated Bacille Calmette-Guérin disease. We evaluated the impact of a homozygous stop mutation in
IL23R
(R381X), identified by whole exome sequencing, in an adult patient with disseminated non-tuberculous mycobacterial disease.
Methods
We performed functional validation of the R381X mutation by evaluating IL23R expression and IL-23 signaling (STAT3 phosphorylation, IFN-γ production) in primary cells (PBMCs, EBV-B cells) and cell lines (HeLa) with or without back-complementation of wild-type IL23R.
Results
We report on a 48-year-old male with disseminated non-tuberculous mycobacterial disease. We identified and characterized a homozygous loss-of-function stop mutation underlying IL23R deficiency, resulting in near absent expression of membrane bound IL23R. IL23R deficiency was characterized by impaired IL-23-mediated IFN-γ secretion in CD4
+
, CD8
+
T, and mucosal-associated invariant T (MAIT) cells, and low frequencies of circulating Th17 (CD3
+
CD45RA
−
CCR4
+
CXCR3
−
RORγT
+
), Th1* (CD45RA
−
CCR4
−
CXCR3
+
RORγT
+
), and MAIT (CD3
+
CD8
+
Vα7.2
+
CD161
+
) cells. Although the patient did not have a history of recurrent fungal infections, impaired Th17 differentiation and blunted IL-23-mediated IL-17 secretion in PBMCs were observed.
Conclusion
We demonstrate that impaired IL-23 immunity caused by a homozygous R381X mutation in
IL23R
underlies MSMD, corroborating earlier findings with a homozygous p.C115Y IL23R mutation. Our report further supports a model of redundant contribution of IL-23- to IL-17-mediated anti-fungal immunity.1 |
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Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 |
ISSN: | 0271-9142 1573-2592 |
DOI: | 10.1007/s10875-022-01320-7 |