An immunocompetent patient with a nonsense mutation in NHEJ1 gene.

Autoimmune hemolytic Anemia Genetic disorders Immunologic deficiency syndromes Nonhomologous end-joining factor 1, human Severe combined immunodeficiency

Journal

BMC medical genetics
ISSN: 1471-2350
Titre abrégé: BMC Med Genet
Pays: England
ID NLM: 100968552

Informations de publication

Date de publication:
21 03 2019
Historique:
received: 25 12 2018
accepted: 13 03 2019
entrez: 23 3 2019
pubmed: 23 3 2019
medline: 21 8 2019
Statut: epublish

Résumé

DNA double-strand breaks (DSBs) are among the most deleterious types of DNA damage. DSBs are repaired by homologous recombination or non-homologous end-joining (NHEJ). NHEJ, which is central to the process of V(D)J recombination is the principle pathway for DSB repair in higher eukaryotes. Mutations in NHEJ1 gene have been associated with severe combined immunodeficiency. The patient was a 3.5-year-old girl, a product of consanguineous first-degree cousin marriage, who was homozygous for a nonsense mutation in NHEJ1 gene. She had initially presented with failure to thrive, proportional microcephaly as well as autoimmune hemolytic anemia (AIHA), which responded well to treatment with prednisolone. However, the patient was immunocompetent despite having this pathogenic mutation. Herein, we report on a patient who was clinically immunocompetent despite having a pathogenic mutation in NHEJ1 gene. Our findings provided evidence for the importance of other end-joining auxiliary pathways that would function in maintaining genetic stability. Clinicians should therefore be aware that pathogenic mutations in NHEJ pathway are not necessarily associated with clinical immunodeficiency.

Sections du résumé

BACKGROUND
DNA double-strand breaks (DSBs) are among the most deleterious types of DNA damage. DSBs are repaired by homologous recombination or non-homologous end-joining (NHEJ). NHEJ, which is central to the process of V(D)J recombination is the principle pathway for DSB repair in higher eukaryotes. Mutations in NHEJ1 gene have been associated with severe combined immunodeficiency.
CASE PRESENTATION
The patient was a 3.5-year-old girl, a product of consanguineous first-degree cousin marriage, who was homozygous for a nonsense mutation in NHEJ1 gene. She had initially presented with failure to thrive, proportional microcephaly as well as autoimmune hemolytic anemia (AIHA), which responded well to treatment with prednisolone. However, the patient was immunocompetent despite having this pathogenic mutation.
CONCLUSIONS
Herein, we report on a patient who was clinically immunocompetent despite having a pathogenic mutation in NHEJ1 gene. Our findings provided evidence for the importance of other end-joining auxiliary pathways that would function in maintaining genetic stability. Clinicians should therefore be aware that pathogenic mutations in NHEJ pathway are not necessarily associated with clinical immunodeficiency.

Identifiants

pubmed: 30898087
doi: 10.1186/s12881-019-0784-0
pii: 10.1186/s12881-019-0784-0
pmc: PMC6429708
doi:

Substances chimiques

Codon, Nonsense 0
DNA-Binding Proteins 0
NHEJ1 protein, human 0
DNA Repair Enzymes EC 6.5.1.-

Types de publication

Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Pagination

45

Subventions

Organisme : NINDS NIH HHS
ID : R01 NS081208
Pays : United States

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Auteurs

Hossein Esmaeilzadeh (H)

Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Mohammad Reza Bordbar (MR)

Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Zahra Hojaji (Z)

Department of Allergy and Clinical Immunology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Parham Habibzadeh (P)

Persian BayanGene Research and Training Center, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Dorna Afshinfar (D)

Persian BayanGene Research and Training Center, Shiraz, Iran.

Mohammad Miryounesi (M)

Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Majid Fardaei (M)

Comprehensive Medical Genetic Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Medical Genetics, Shiraz University of Medical Sciences, Shiraz, Iran.

Mohammad Ali Faghihi (MA)

Persian BayanGene Research and Training Center, Shiraz, Iran. MFaghihi@med.miami.edu.
Center for Therapeutic Innovation, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA. MFaghihi@med.miami.edu.

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