Human DNA-dependent protein kinase catalytic subunit deficiency: a comprehensive review and update.

DNA-dependent protein kinase catalytic subunit Inborn errors of immunity autoimmunity granuloma radiosensitivity severe combined immunodeficiency

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
06 Jul 2024
Historique:
received: 22 09 2023
revised: 24 06 2024
accepted: 28 06 2024
medline: 9 7 2024
pubmed: 9 7 2024
entrez: 8 7 2024
Statut: aheadofprint

Résumé

DNA-dependent protein kinase catalytic subunit (DNA-PKcs) has an essential role in the non-homologous end-joining pathway that repairs DNA double-strand breaks in V(D)J recombination involved in the expression of T- and B-cell receptors. Whereas homozygous mutations in PRKDC define the scid mouse, a model that has been widely used in biology, human mutations in PRKDC are extremely rare and the disease spectrum has not been described so far. To provide an update on the genetics, clinical spectrum, immunological profile, and therapy of DNA-PKcs deficiency in human. The clinical, biological, and treatment data from the 6 cases published to date and from 1 new patient were obtained and analyzed. Rubella PCR was performed on available granuloma material. We report on 7 patients; Six patients displayed the autosomal recessive p.L3062R mutation in PRKDC gene encoding DNA-PKcs. Atypical severe combined immunodeficiency with inflammatory lesions, granulomas, and autoimmunity was the predominant clinical manifestation (n=5/7). Rubella viral strain was detected in the granuloma of 1 patient over the 2 tested. T-cell counts, including naïve CD4 DNA-PKcs deficiency mainly manifests as an inflammatory disease with granuloma and autoimmune features, along with severe infections.

Sections du résumé

BACKGROUND BACKGROUND
DNA-dependent protein kinase catalytic subunit (DNA-PKcs) has an essential role in the non-homologous end-joining pathway that repairs DNA double-strand breaks in V(D)J recombination involved in the expression of T- and B-cell receptors. Whereas homozygous mutations in PRKDC define the scid mouse, a model that has been widely used in biology, human mutations in PRKDC are extremely rare and the disease spectrum has not been described so far.
OBJECTIVE OBJECTIVE
To provide an update on the genetics, clinical spectrum, immunological profile, and therapy of DNA-PKcs deficiency in human.
METHODS METHODS
The clinical, biological, and treatment data from the 6 cases published to date and from 1 new patient were obtained and analyzed. Rubella PCR was performed on available granuloma material.
RESULTS RESULTS
We report on 7 patients; Six patients displayed the autosomal recessive p.L3062R mutation in PRKDC gene encoding DNA-PKcs. Atypical severe combined immunodeficiency with inflammatory lesions, granulomas, and autoimmunity was the predominant clinical manifestation (n=5/7). Rubella viral strain was detected in the granuloma of 1 patient over the 2 tested. T-cell counts, including naïve CD4
CONCLUSION CONCLUSIONS
DNA-PKcs deficiency mainly manifests as an inflammatory disease with granuloma and autoimmune features, along with severe infections.

Identifiants

pubmed: 38977084
pii: S0091-6749(24)00677-8
doi: 10.1016/j.jaci.2024.06.018
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Jihane Adelon (J)

Department of Pediatric Immunology and Hematology, Institut d'Hématologie et d'Oncologie Pédiatrique, Université Claude Bernard, Lyon, France; Hospices civils de Lyon, Lyon, France. Electronic address: jihane.adelon@gmail.com.

Hassan Abolhassani (H)

Department of Laboratory Medicine, Karolinska Institute at the Karolinska University Hospital Huddinge, Stockholm, Sweden; Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden; Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Science, Tehran, Iran.

Saliha Esenboga (S)

Department of Pediatric Immunology, Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey.

Fanny Fouyssac (F)

Department of Pediatric Oncology, Children's Hospital, Nancy, France.

Deniz Cagdas (D)

Department of Pediatric Immunology, Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey.

Ilhan Tezcan (I)

Department of Pediatric Immunology, Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey.

Barıs Kuskonmaz (B)

Department of Pediatric Hematology, Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey.

Duygu Cetinkaya (D)

Department of Pediatric Hematology, Hacettepe University, Ihsan Dogramacı Children's Hospital, Ankara, Turkey.

Felipe Suarez (F)

Department of Hematology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique des Hôpitaux de Paris, Paris, France; INSERM UMR1163 and CNRS ERL 8254, Imagine Institut, Sorbonne Paris Cité, Paris, France; Descartes University, Paris, France.

Seyed Alireza Mahdaviani (SA)

Pediatric Respiratory Diseases Research Centre, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Samira Plassart (S)

Centre de Références Maladies Rares, Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l'Enfant RAISE, Department of Pediatrics Nephrology- Rheumatology and Dermatology, Hôpital Femme-Mère-Enfant, Bron, France.

Anne-Laure Mathieu (AL)

CIRI, INSERM U1111, Lyon, France.

Nicole Fabien (N)

Department of Immunology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Christophe Malcus (C)

Department of Immunology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.

Florence Morfin-Sherpa (F)

Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France; Université Lyon, Virpath, CIRI, INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, 69008, Lyon, France.

Geneviève Billaud (G)

Laboratoire de Virologie, Institut des Agents Infectieux, Hospices Civils de Lyon, Groupement Hospitalier Nord, 69004, Lyon, France.

Maud Tusseau (M)

Hospices civils de Lyon, Lyon, France; CIRI, INSERM U1111, Lyon, France; Service de Génétique, Groupe Hospitalier Est, Hopices Civils de Lyon, 69677 Bron, France.

Sarah Benezech (S)

Department of Pediatric Immunology and Hematology, Institut d'Hématologie et d'Oncologie Pédiatrique, Université Claude Bernard, Lyon, France; CIRI, INSERM U1111, Lyon, France.

Thierry Walzer (T)

CIRI, INSERM U1111, Lyon, France.

J P De Villartay (JP)

INSERM UMR1163, Imagine Institut, Sorbonne Paris Cité, Paris, France.

Yves Bertrand (Y)

Department of Pediatric Immunology and Hematology, Institut d'Hématologie et d'Oncologie Pédiatrique, Université Claude Bernard, Lyon, France; Hospices civils de Lyon, Lyon, France.

Alexandre Belot (A)

Hospices civils de Lyon, Lyon, France; Centre de Références Maladies Rares, Rhumatismes inflammatoires et les maladies Auto-Immunes Systémiques rares de l'Enfant RAISE, Department of Pediatrics Nephrology- Rheumatology and Dermatology, Hôpital Femme-Mère-Enfant, Bron, France; CIRI, INSERM U1111, Lyon, France. Electronic address: alexandre.belot@chu-lyon.fr.

Classifications MeSH