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2013 ; 25
(6
): 708-14
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Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) and
IPEX-related disorders: an evolving web of heritable autoimmune diseases
#MMPMID24240290
Verbsky JW
; Chatila TA
Curr Opin Pediatr
2013[Dec]; 25
(6
): 708-14
PMID24240290
show ga
PURPOSE OF REVIEW: To summarize recent progress in our understanding of immune
dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) and IPEX-related
disorders. RECENT FINDINGS: A number of Mendelian disorders of immune
dysregulation and autoimmunity have been noted to result from defects in T
regulatory cell, development and function. The best characterized of these is
IPEX, resulting from mutations affecting FOXP3. A number of other gene defects
that affect T regulatory cell function also give rise to IPEX-related phenotypes,
including loss-of-function mutations in CD25, STAT5b and ITCH. Recent progress
includes the identification of gain-of-function mutations in STAT1 as a cause of
an IPEX-like disease, emerging FOXP3?genotype/phenotype relationships in IPEX,
and the elucidation of a role for the microbiota in the immune dysregulation
associated with regulatory T cell deficiency. SUMMARY: An expanding spectrum of
genetic defects that compromise T regulatory cell function underlies human
disorders of immune dysregulation and autoimmunity. Collectively, these disorders
offer novel insights into pathways of peripheral tolerance and their disruption
in autoimmunity.