Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Department of Biology, College of Science, UAE University, Al Ain, United Arab Emirates.
PLoS One. 2021 Jan 22;16(1):e0245888. doi: 10.1371/journal.pone.0245888. eCollection 2021.
OBJECTIVES: Inborn errors of immunity (IEI) are prevalent in tribal cultures due to frequent consanguineous marriages. Many of these disorders are autosomal recessive, resulting from founder mutations; hence they are amenable to prevention. The primary objective of this study was to evaluate the pathogenicity of novel variants of IEI found among Emiratis. METHODS: This retrospective data collection study reports novel variants of IEI detected by diagnostic exome sequencing. Pathogenicity prediction was based on scoring tools, amino acid alignment, and Jensen-Shannon divergence values. RESULTS: Twenty-one novel variants were identified; nine were frameshift, three nonsense, four intronic (one pathogenic), and five missense (two pathogenic). Fifteen variants were likely pathogenic, of which 13 were autosomal recessive and two uncertain inheritance. Their clinical spectra included combined immunodeficiency, antibody deficiency, immune dysregulation, defects in intrinsic/innate immunity, and bone marrow failure. CONCLUSION: The described novel pathogenic variants are core to a planned national screening program that aims toward IEI prevention. Future studies, however, are needed to confirm their natural history in individual patients and estimate their prevalence in the community.
目的:由于频繁的近亲结婚,部落文化中普遍存在先天性免疫缺陷(IEI)。许多此类疾病为常染色体隐性遗传,由起始突变引起;因此,它们是可以预防的。本研究的主要目的是评估在阿联酋人中发现的 IEI 新变异的致病性。
方法:本回顾性数据收集研究报告了通过诊断外显子组测序检测到的 IEI 新变异。致病性预测基于评分工具、氨基酸比对和 Jensen-Shannon 离散值。
结果:鉴定出 21 种新型变异,其中 9 种为移码,3 种为无义,4 种为内含子(1 种致病性),5 种为错义(2 种致病性)。15 种变异可能具有致病性,其中 13 种为常染色体隐性遗传,2 种遗传方式不确定。它们的临床表型包括联合免疫缺陷、抗体缺陷、免疫失调、固有/先天免疫缺陷和骨髓衰竭。
结论:所描述的新型致病性变异是计划中的国家筛查计划的核心,旨在预防 IEI。然而,未来还需要研究来确认这些变异在个体患者中的自然病史,并估计其在社区中的患病率。
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