The phenotypical implications of immune dysregulation in fragile X syndrome.


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
03 2020
Historique:
received: 17 09 2019
accepted: 19 12 2019
pubmed: 19 1 2020
medline: 25 3 2021
entrez: 19 1 2020
Statut: ppublish

Résumé

Immune system dysfunction and inflammatory dysregulation have been shown in several animal models of fragile X syndrome (FXS). However, the phenotypical implications of this dysregulation have not been systematically evaluated in a large patient cohort. Five thousand seven hundred thirty-six FXS patients from a nationwide health insurance database were identified and compared to 573 600 age- and sex-matched controls. The phenome-wide association studies codes of FXS patients and those without FXS were compared and the false discovery rate was controlled at 0.05 using the Benjamini-Hochberg procedure. In addition to the commonly reported comorbidities of FXS, an over-representation of infectious diseases, including otitis media, cellulitis and abscess of fingers or toes, viral enteritis, candidiasis and pneumonia, was discovered. In addition, there was an under-representation of autoimmune disorders in FXS patients. Our systematic comorbidity analyses identified immunologically-based phenotypes associated with FXS. Our findings align with previous observations of compromised immunity and phagocytic defects in animal models of FXS. These results suggest the importance of immune-related pathways in FXS patients and their relevance to the FMR1 gene.

Sections du résumé

BACKGROUND AND PURPOSE
Immune system dysfunction and inflammatory dysregulation have been shown in several animal models of fragile X syndrome (FXS). However, the phenotypical implications of this dysregulation have not been systematically evaluated in a large patient cohort.
METHODS
Five thousand seven hundred thirty-six FXS patients from a nationwide health insurance database were identified and compared to 573 600 age- and sex-matched controls. The phenome-wide association studies codes of FXS patients and those without FXS were compared and the false discovery rate was controlled at 0.05 using the Benjamini-Hochberg procedure.
RESULTS
In addition to the commonly reported comorbidities of FXS, an over-representation of infectious diseases, including otitis media, cellulitis and abscess of fingers or toes, viral enteritis, candidiasis and pneumonia, was discovered. In addition, there was an under-representation of autoimmune disorders in FXS patients.
CONCLUSIONS
Our systematic comorbidity analyses identified immunologically-based phenotypes associated with FXS. Our findings align with previous observations of compromised immunity and phagocytic defects in animal models of FXS. These results suggest the importance of immune-related pathways in FXS patients and their relevance to the FMR1 gene.

Identifiants

pubmed: 31953887
doi: 10.1111/ene.14146
doi:

Substances chimiques

FMR1 protein, human 0
Fragile X Mental Retardation Protein 139135-51-6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

590-593

Subventions

Organisme : Boston Children's Hospital
Pays : International
Organisme : Harvard University
Pays : International

Informations de copyright

© 2019 European Academy of Neurology.

Références

Hagerman RJ, Berry-Kravis E, Hazlett HC, et al. Fragile X syndrome. Nat Rev Dis Primers 2017; 3: 17065.
Bhakar AL, Dölen G, Bear MF. The pathophysiology of fragile X (and what it teaches us about synapses). Annu Rev Neurosci 2012; 35: 417-443.
Darnell JC, Klann E. The translation of translational control by FMRP: therapeutic targets for FXS. Nat Neurosci 2013; 16: 1530.
O’Connor RM, Stone EF, Wayne CR, et al. A Drosophila model of fragile X syndrome exhibits defects in phagocytosis by innate immune cells. J Cell Biol 2017; 216: 595-605.
Prilutsky D, Kho AT, Palmer NP, et al. Gene expression analysis in Fmr1 KO mice identifies an immunological signature in brain tissue and mGluR5-related signaling in primary neuronal cultures. Mol Autism 2015; 6: 66.
Logan MA. Fragile phagocytes: FMRP positively regulates engulfment activity. J Cell Biol 2017; 216: 531-533.
Denny JC, Ritchie MD, Basford MA, et al. PheWAS: demonstrating the feasibility of a phenome-wide scan to discover gene-disease associations. Bioinformatics 2010; 26: 1205-1210.
Yu KH, Miron O, Palmer N, et al. Data-driven analyses revealed the comorbidity landscape of tuberous sclerosis complex. Neurology 2018; 91: 974-976.
Estes ML, McAllister AK. Immune mediators in the brain and peripheral tissues in autism spectrum disorder. Nat Rev Neurosci 2015; 16: 469.
Gupta S, Ellis SE, Ashar FN, et al. Transcriptome analysis reveals dysregulation of innate immune response genes and neuronal activity-dependent genes in autism. Nat Commun 2014; 5: 5748.
Suzuki K, Sugihara G, Ouchi Y, et al. Microglial activation in young adults with autism spectrum disorder. JAMA Psychiatry 2013; 70: 49-58.
Bagni C, Greenough WT. From mRNP trafficking to spine dysmorphogenesis: the roots of fragile X syndrome. Nat Rev Neurosci 2005; 6: 376-387.
Hagerman RJ, Altshul-Stark D, McBogg P. Recurrent otitis media in the fragile X syndrome. Am J Dis Child 1987; 141: 184-187.
Kidd SA, Lachiewicz A, Barbouth D, et al. Fragile X syndrome: a review of associated medical problems. Pediatrics 2014; 134: 995-1005.

Auteurs

K-H Yu (KH)

Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.

N Palmer (N)

Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.

K Fox (K)

Aetna Inc., Hartford, Connecticut, USA.

L Prock (L)

Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

K D Mandl (KD)

Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.
Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.

I S Kohane (IS)

Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.
Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.

D Prilutsky (D)

Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.

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