Lien Nguyen Thi Kim, Van Anh Nguyen Thi, Chi Le Quynh, Le Nguyen Ngoc Quynh, Huyen Thuc Thanh, Mai Nguyen Thi Phuong, Van Tung Nguyen, Hoang Nguyen Huy
Institute of Genome Research, Vietnam Academy of Science and Technology, 18 - Hoang Quoc Viet str., Caugiay, Hanoi, Vietnam.
Allergy, Immunology and Rheumatology Department, Vietnam National Hospital Pediatrics, 18/879 La Thanh str., Dongda, Hanoi, Vietnam.
Clin Exp Med. 2023 Feb;23(1):157-161. doi: 10.1007/s10238-021-00774-0. Epub 2021 Nov 29.
The X-linked hyper IgM syndrome is a primary immunodeficiency disorder (PID) due to mutations in the CD40LG gene. Hyper IgM syndrome is characterized by the absence or decreased levels of IgG and IgA and normal or elevated IgM levels in serum. Affected patients become susceptible to infections such as pneumonia, diarrhea, and skin ulcer types. Hematopoietic stem cell transplantation is the only treatment currently available and ideally performed before the age of 10 years. Early, accurate diagnosis will contribute to the effective treatment for patients with hyper IgM. The patients from different Vietnamese families who have been diagnosed with hyper IgM at The Allergy, Immunology and Rheumatology Department, Vietnam National Hospital Pediatrics, were performed a genetic analysis using whole exome sequencing. The mutations were confirmed by the Sanger sequencing method in patients and their families. The influence of the mutations was predicted with the in silico analysis tools: PROVEAN, SIFT, PolyPhen-2, and MutationTaster. In this study, two novel mutations (p.Thr254fs and p.Leu138Phe) in the CD40LG gene were found in Vietnamese patients with X-linked hyper IgM syndrome. Our results contribute to the general understanding of the etiology of the disease and can help diagnose the different forms of PID.
X连锁高IgM综合征是一种原发性免疫缺陷疾病(PID),由CD40LG基因突变引起。高IgM综合征的特征是血清中IgG和IgA水平缺失或降低,而IgM水平正常或升高。受影响的患者易患肺炎、腹泻和皮肤溃疡等类型的感染。造血干细胞移植是目前唯一可用的治疗方法,理想情况下应在10岁之前进行。早期、准确的诊断将有助于高IgM患者的有效治疗。对越南国家儿童医院过敏、免疫和风湿病科诊断为高IgM的不同越南家庭的患者,使用全外显子测序进行了基因分析。通过Sanger测序法在患者及其家族中确认了突变。使用计算机分析工具PROVEAN、SIFT、PolyPhen-2和MutationTaster预测了突变的影响。在本研究中,在越南X连锁高IgM综合征患者中发现了CD40LG基因的两个新突变(p.Thr254fs和p.Leu138Phe)。我们的结果有助于对该疾病病因的总体理解,并有助于诊断不同形式的PID。