Loss-of-function mutations in the IL-21 receptor gene cause a primary immunodeficiency syndrome

J Exp Med. 2013 Mar 11;210(3):433-43. doi: 10.1084/jem.20111229. Epub 2013 Feb 25.

Abstract

Primary immunodeficiencies (PIDs) represent exquisite models for studying mechanisms of human host defense. In this study, we report on two unrelated kindreds, with two patients each, who had cryptosporidial infections associated with chronic cholangitis and liver disease. Using exome and candidate gene sequencing, we identified two distinct homozygous loss-of-function mutations in the interleukin-21 receptor gene (IL21R; c.G602T, p.Arg201Leu and c.240_245delCTGCCA, p.C81_H82del). The IL-21R(Arg201Leu) mutation causes aberrant trafficking of the IL-21R to the plasma membrane, abrogates IL-21 ligand binding, and leads to defective phosphorylation of signal transducer and activator of transcription 1 (STAT1), STAT3, and STAT5. We observed impaired IL-21-induced proliferation and immunoglobulin class-switching in B cells, cytokine production in T cells, and NK cell cytotoxicity. Our study indicates that human IL-21R deficiency causes an immunodeficiency and highlights the need for early diagnosis and allogeneic hematopoietic stem cell transplantation in affected children.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immunologic Deficiency Syndromes / etiology
  • Immunologic Deficiency Syndromes / genetics*
  • Immunologic Deficiency Syndromes / immunology
  • Interleukin-21 Receptor alpha Subunit / chemistry
  • Interleukin-21 Receptor alpha Subunit / genetics*
  • Interleukin-21 Receptor alpha Subunit / physiology
  • Killer Cells, Natural / immunology
  • Male
  • Mutation*
  • Phosphorylation
  • STAT3 Transcription Factor / metabolism
  • Signal Transduction

Substances

  • IL21R protein, human
  • Interleukin-21 Receptor alpha Subunit
  • STAT3 Transcription Factor
  • STAT3 protein, human