Department of Immunology, University Hospital, 12 de Octubre, Avda. de Andalucía S/N, 28041, Madrid, Spain.
Research Institute Hospital, 12 Octubre (imas12), Madrid, Spain.
J Clin Immunol. 2024 Feb 16;44(3):61. doi: 10.1007/s10875-024-01664-2.
Human inborn errors of immunity (IEI) comprise a group of diseases resulting from molecular variants that compromise innate and adaptive immunity. Clinical features of IEI patients are dominated by susceptibility to a spectrum of infectious diseases, as well as autoimmune, autoinflammatory, allergic, and malignant phenotypes that usually appear in childhood, which is when the diagnosis is typically made. However, some IEI patients are identified in adulthood due to symptomatic delay of the disease or other reasons that prevent the request for a molecular study. The application of next-generation sequencing (NGS) as a diagnostic technique has given rise to an ever-increasing identification of IEI-monogenic causes, thus improving the diagnostic yield and facilitating the possibility of personalized treatment. This work was a retrospective study of 173 adults with IEI suspicion that were sequenced between 2005 and 2023. Sanger, targeted gene-panel, and whole exome sequencing were used for molecular diagnosis. Disease-causing variants were identified in 44 of 173 (25.43%) patients. The clinical phenotype of these 44 patients was mostly related to infection susceptibility (63.64%). An enrichment of immune dysregulation diseases was found when cohorts with molecular diagnosis were compared to those without. Immune dysregulation disorders, group 4 from the International Union of Immunological Societies Expert Committee (IUIS), were the most prevalent among these adult patients. Immune dysregulation as a new item in the Jeffrey Model Foundation warning signs for adults significantly increases the sensitivity for the identification of patients with an IEI-producing molecular defect.
人类先天性免疫缺陷(IEI)是一组由分子变异引起的疾病,这些变异会影响固有和适应性免疫。IEI 患者的临床特征主要表现为易患各种感染性疾病,以及自身免疫、自身炎症、过敏和恶性表型,这些通常在儿童时期出现,此时通常会做出诊断。然而,由于疾病的症状延迟或其他原因导致无法进行分子研究,一些 IEI 患者在成年后才被发现。下一代测序(NGS)作为一种诊断技术的应用,使得越来越多的 IEI-单基因病因被识别,从而提高了诊断率,并为个性化治疗提供了可能。本研究是对 2005 年至 2023 年间接受测序的 173 名 IEI 疑似成人患者进行的回顾性研究。采用 Sanger、靶向基因panel 和全外显子组测序进行分子诊断。在 173 名患者中的 44 名(25.43%)患者中鉴定出致病变异。这些 44 名患者的临床表型主要与感染易感性有关(63.64%)。与未进行分子诊断的患者相比,发现具有分子诊断的患者队列中免疫失调疾病更为富集。免疫失调疾病,国际免疫学会联合会(IUIS)专家委员会第 4 组,是这些成年患者中最常见的。将免疫失调作为成人 Jeffrey 模型基金会预警信号的新条目,显著提高了识别具有 IEI 产生分子缺陷患者的敏感性。
J Clin Immunol. 2024-2-16
Clin Rev Allergy Immunol. 2022-8
Front Immunol. 2024-12-19
BMC Genom Data. 2023-8-17
J Clin Immunol. 2020-1
J Clin Immunol. 2025-2-20
J Allergy Clin Immunol Glob. 2025-1-9
J Allergy Clin Immunol Pract. 2023-1
J Clin Immunol. 2022-10