Abstract
Common variable immunodeficiency (CVID) is heterogeneous, clinically, immunologically and genetically. The majority of genetic mechanisms leading to CVID remain elusive. We studied a Greek Cypriot family of non-consanguineous parents. Two children were diagnosed with CVID at an early age. Whole exome sequencing revealed 8bp deletion in the C-terminal part of NFKB2 gene associated with disease. The mutation leads to a frameshift (p.Asp865Valfs*17) altering 17 C-terminal amino acids from residue 865, and creating a premature stop-codon resulting in a truncated protein, 19 amino acids shorter than wild type (p100Δ19). We validated the results with Dye-termination sequencing and Western blot, and confirmed that the conserved residue at 866 is mutated from serine to arginine in p100Δ19, leaving the mutant protein unphosphorylated at this critical regulatory position. Consequently, NFKB2/p100 processing and nuclear translocation were abrogated. Using flow cytometry, we further demonstrated that there was a reduction in B cells (CD19+), switched memory B cells (CD27+IgD−) and T follicular helper (Tfh) cells (both CD4+CXCR5+ and CD4+CXCR5Hi) in a CVID patient with NFKB2/p100Δ19, compared to healthy controls. These data support the notion that the non-canonical NFκB pathway plays an important role in B cell differentiation and the development of Tfh cells, and may pave the way for better understanding of the pathology of CVID.
Abbreviations
- aa:
-
Amino acids
- ACTH:
-
Adrenocorticotrophic hormone
- AIRE:
-
Autoimmune regulator
- BAFFR:
-
B cell-activating factor receptor
- CAML:
-
Calcium Modulating Cyclophilin Ligand
- CVID:
-
Common variable immunodeficiency
- ICOS:
-
Inducible T cell costimulator
- IκB Kinase-alpha:
-
Inhibitor of nuclear factor kappa-B kinase subunit alpha
- ITP:
-
Idiopathic thrombocytopenic purpura
- NA:
-
Not available
- NFKB2:
-
Nuclear factor of kappa light polypeptide gene enhancer in B cells subunit 2
- TACI:
-
Transmembrane Activator and CAML Interactor
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Funding
This work was supported by the Clinical Immunology Research Fund of King’s College Hospital Charitable Trust, a kind donation in memory of Andreas, Viapath and King’s College Hospital.
Summary
A novel heterozygous mutation of the key noncanonical NF kappa B signalling molecule, NFKB2, is associated with deficient T follicular helper cells and early onset severe common variable immunodeficiency with autoimmunity.
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Liu, Y., Hanson, S., Gurugama, P. et al. Novel NFKB2 Mutation in Early-Onset CVID. J Clin Immunol 34, 686–690 (2014). https://doi.org/10.1007/s10875-014-0064-x
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DOI: https://doi.org/10.1007/s10875-014-0064-x