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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Allergy+Clin+Immunol 2015 ; 135 (6): 1578-1588.e5 Nephropedia Template TP
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PRKDC mutations associated with immunodeficiency, granuloma, and autoimmune regulator?dependent autoimmunity #MMPMID25842288
Mathieu AL; Verronese E; Rice GI; Fouyssac F; Bertrand Y; Picard C; Chansel M; Walter JE; Notarangelo LD; Butte MJ; Nadeau KC; Csomos K; Chen DJ; Chen K; Delgado A; Rigal C; Bardin C; Schuetz C; Moshous D; Reumaux H; Plenat F; Phan A; Zabot MT; Balme B; Viel S; Bienvenu J; Cochat P; van der Burg M; Caux C; Kemp EH; Rouvet I; Malcus C; Méritet JF; Lim A; Crow YJ; Fabien N; Ménétrier-Caux C; De Villartay JP; Walzer T; Belot A
J Allergy Clin Immunol 2015[Jun]; 135 (6): 1578-1588.e5 PMID25842288show ga
Background: PRKDC encodes for DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a kinase that forms part of a complex (DNA-dependent protein kinase [DNA-PK]) crucial for DNA double-strand break repair and V(D)J recombination. In mice DNA-PK also interacts with the transcription factor autoimmune regulator (AIRE) to promote central T-cell tolerance. Objective: We sought to understand the causes of an inflammatory disease with granuloma and autoimmunity associated with decreasing T- and B-cell counts over time that had been diagnosed in 2 unrelated patients. Methods: Genetic, molecular, and functional analyses were performed to characterize an inflammatory disease evocative of a combined immunodeficiency. Results: We identified PRKDC mutations in both patients. These patients exhibited a defect in DNA double-strand break repair and V(D)J recombination. Whole-blood mRNA analysis revealed a strong interferon signature. On activation, memory T cells displayed a skewed cytokine response typical of TH2 and TH1 but not TH17. Moreover, mutated DNA-PKcs did not promote AIRE-dependent transcription of peripheral tissue antigens in vitro. The latter defect correlated in vivo with production of anti?calcium-sensing receptor autoantibodies, which are typically found in AIRE-deficient patients. In addition, 9 months after bone marrow transplantation, patient 1 had Hashimoto thyroiditis, suggesting that organ-specific autoimmunity might be linked to nonhematopoietic cells, such as AIRE-expressing thymic epithelial cells. Conclusion: Deficiency of DNA-PKcs, a key AIRE partner, can present as an inflammatory disease with organ-specific autoimmunity, suggesting a role for DNA-PKcs in regulating autoimmune responses and maintaining AIRE-dependent tolerance in human subjects.