Broad-spectrum Antibodies Against self-antigens and Cytokines in RAG Deficiency

ABSTRACT: Patients with mutations of the recombination-activating genes (RAG) present with diverse clinical phenotypes, including severe combined immune deficiency (SCID), autoimmunity, and inflammation. However, the incidence and extent of immune dysregulation in RAG-dependent immunodeficiency have not been studied in detail. Here, we have demonstrated that patients with hypomorphic RAG mutations, especially those with delayed-onset combined immune deficiency and granulomatous/autoimmune manifestations (CID-G/AI), produce a broad spectrum of autoantibodies. Neutralizing anti–IFN-α or anti–IFN-ω antibodies were present at detectable levels in patients with CID-G/AI who had a history of severe viral infections. As this autoantibody profile is not observed in a wide range of other primary immunodeficiencies, we hypothesized that recurrent or chronic viral infections may precipitate or aggravate immune dysregulation in RAG-deficient hosts. We repeatedly challenged Rag1S723C/S723C mice, which serve as a model of leaky SCID, with agonists of the virus-recognizing receptors TLR3/MDA5, TLR7/-8, and TLR9 and found that this treatment elicits autoantibody production. Altogether, our data demonstrate that immune dysregulation is an integral aspect of RAG-associated immunodeficiency and indicate that environmental triggers may modulate the phenotypic expression of autoimmune manifestations.

• Autores: Franco Restrepo, José Luis; Walter, Jolan E.; Rosen, Lindsey B.; Csomos, Krisztian; Rosenberg, Jacob M.; Mathew, Divij; Keszei, Marton; Ujhazi, Boglarka; Chen, Karin; Lee, Yu Nee; Tirosh, Irit; Dobbs, Kerry; Al-Herz, Waleed; Cowan, Morton J.; Puck, Jennifer; Bleesing, Jack J.; Grimley, Michael S.; Malech, Harry; De Ravin, Suk See; Gennery, Andrew R.; Abraham, Roshini S.; Joshi, Avni Y.; Boyce, Thomas G.; Butte, Manish J.; Nadeau, Kari C.; Balboni, Imelda; Sullivan, Kathleen E.; Akhter, Javeed; Adeli, Mehdi; El-Feky, Reem A.; El-Ghoneimy, Dalia H.; Dbaibo, Ghassan; Wakim, Rima; Azzari, Chiara; Palma, Paolo; Cancrini, Caterina; Capuder, Kelly; Condino Neto, Antonio; Costa Carvalho, Beatriz T.; Bosco Oliveira, Joao Bosco; Roifman, Chaim; Buchbinder, David; Kumanovics, Attila; Niehues, Tim; Niehues, Tim; Schuetz, Catharina; Kuijpers, Taco; Yee, Christina; Chou, Janet; Masaad, Michel J.; Geha, Raif; Uzel, Gulbu; Gelman, Rebecca; Holland, Steven M.; Recher, Mike; Utz, Paul J.; Browne, Sarah K.; Notarangelo, Luigi D.
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2015
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/34627
• Acceso en línea: https://hdl.handle.net/10495/34627
• Palabra clave: Broadly Neutralizing Antibodies; Anticuerpos ampliamente neutralizantes; Autoantigens; Autoantígenos; Cytokines; Citocinas; Autoimmunity; Autoinmunidad; Severe Combined Immunodeficiency; Inmunodeficiencia Combinada Grave
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc-nd/2.5/co/