Progressive Immunodeficiency with Gradual Depletion of B and CD4+ T Cells in Immunodeficiency, Centromeric Instability and Facial Anomalies Syndrome 2 (ICF2)

Diseases

ReinholdE. Schmidt¹  Natalia Dubrowinskaja¹  Diana Ernst¹  Georgios Sogkas¹  Faranaz Atschekzei¹  Alexandra Jablonka¹  Jana Lentes²  AnkeK. Bergmann²  Tim Ripperger²  Ulrich Baumann³  Robert Geffers⁴  Mykola Fedchenko⁵ 

[1] Department of Clinical Immunology and Rheumatology, Hannover Medical School, 30625 Hannover, Germany;Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany;Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, 30625 Hannover, Germany;Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany;Institute of Pathology, Hannover Medical School, 30625 Hannover, Germany;

关键词: ICF syndrome;    B cell immunodeficiency;    T cell immunodeficiency;    combined immunodeficiency;    ICF2;    ZBTB24;   

DOI  :  10.3390/diseases7020034

来源: DOAJ

【 摘 要 】

Immunodeficiency, centromeric instability and facial anomalies syndrome 2 (ICF2) is a rare autosomal recessive primary immunodeficiency disorder. So far, 27 patients have been reported. Here, we present three siblings with ICF2 due to a homozygous ZBTB24 gene mutation (c.1222 T>G, p. (Cys408Gly)). Immune deficiency in these patients ranged from late-onset combined immunodeficiency (CID) with severe respiratory tract infections and recurrent shingles to asymptomatic selective antibody deficiency. Evident clinical heterogeneity manifested despite a common genetic background, suggesting the pathogenic relevance of epigenetic modification. Immunological follow-up reveals a previously unidentified gradual depletion of B and CD4⁺ T cells in all three presented patients with transition of a common variable immunodeficiency (CVID)-like disease to late-onset-CID in one of them. Considering all previously published cases with ICF2, we identify inadequate antibody responses to vaccines and reduction in CD27⁺ memory B cells as prevalent immunological traits. High mortality among ICF2 patients (20%) together with the progressive course of immunodeficiency suggest that hematopoietic stem cell transplantation (HSCT) should be considered as a treatment option in due time.

【 授权许可】

Unknown