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AICDA 基因中的一种新型杂合变异可损害人 B 细胞中的 Ig 类别转换和体细胞超突变,与常染色体显性遗传高 IgM 血症 2 型(HIGM2)综合征相关。

A Novel Heterozygous Variant in AICDA Impairs Ig Class Switching and Somatic Hypermutation in Human B Cells and is Associated with Autosomal Dominant HIGM2 Syndrome.

机构信息

Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW, 2010, Australia.

School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.

出版信息

J Clin Immunol. 2024 Feb 16;44(3):66. doi: 10.1007/s10875-024-01665-1.

Abstract

B cells and their secreted antibodies are fundamental for host-defense against pathogens. The generation of high-affinity class switched antibodies results from both somatic hypermutation (SHM) of the immunoglobulin (Ig) variable region genes of the B-cell receptor and class switch recombination (CSR) which alters the Ig heavy chain constant region. Both of these processes are initiated by the enzyme activation-induced cytidine deaminase (AID), encoded by AICDA. Deleterious variants in AICDA are causal of hyper-IgM syndrome type 2 (HIGM2), a B-cell intrinsic primary immunodeficiency characterised by recurrent infections and low serum IgG and IgA levels. Biallelic variants affecting exons 2, 3 or 4 of AICDA have been identified that impair both CSR and SHM in patients with autosomal recessive HIGM2. Interestingly, B cells from patients with autosomal dominant HIGM2, caused by heterozygous variants (V186X, R190X) located in AICDA exon 5 encoding the nuclear export signal (NES) domain, show abolished CSR but variable SHM. We herein report the immunological and functional phenotype of two related patients presenting with common variable immunodeficiency who were found to have a novel heterozygous variant in AICDA (L189X). This variant led to a truncated AID protein lacking the last 10 amino acids of the NES at the C-terminal domain. Interestingly, patients' B cells carrying the L189X variant exhibited not only greatly impaired CSR but also SHM in vivo, as well as CSR and production of IgG and IgA in vitro. Our findings demonstrate that the NES domain of AID can be essential for SHM, as well as for CSR, thereby refining the correlation between AICDA genotype and SHM phenotype as well as broadening our understanding of the pathophysiology of HIGM disorders.

摘要

B 细胞及其分泌的抗体是宿主防御病原体的基础。高亲和力类别转换抗体的产生源于 B 细胞受体免疫球蛋白(Ig)可变区基因的体细胞高频突变(SHM)和改变 Ig 重链恒定区的类别转换重组(CSR)。这两个过程都是由酶激活诱导胞嘧啶脱氨酶(AID)启动的,该酶由 AICDA 编码。AICDA 中的有害变异是导致高 IgM 综合征 2 型(HIGM2)的原因,这是一种 B 细胞内在的原发性免疫缺陷,其特征是反复感染和血清 IgG 和 IgA 水平低。已经鉴定出影响 AICDA 外显子 2、3 或 4 的双等位基因变异,这些变异会损害常染色体隐性遗传 HIGM2 患者的 CSR 和 SHM。有趣的是,由 AICDA 外显子 5 编码核输出信号(NES)结构域的杂合变异(V186X、R190X)引起的常染色体显性遗传 HIGM2 的 B 细胞表现出 CSR 完全缺失但 SHM 可变。我们在此报告了两名表现为普通可变免疫缺陷的相关患者的免疫学和功能表型,他们被发现 AICDA 中存在一种新的杂合变异(L189X)。该变体导致 AID 蛋白截短,缺失 C 末端 NES 结构域的最后 10 个氨基酸。有趣的是,携带 L189X 变异的患者 B 细胞不仅 CSR 严重受损,而且体内 SHM 也受损,体外 CSR 和 IgG、IgA 的产生也受损。我们的发现表明 AID 的 NES 结构域对于 SHM 以及 CSR 都是必不可少的,从而细化了 AICDA 基因型与 SHM 表型之间的相关性,并拓宽了我们对 HIGM 疾病病理生理学的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85f0/10873450/1975132595a0/10875_2024_1665_Fig1_HTML.jpg

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