A kindred with mutant IKAROS and autoimmunity

J Allergy Clin Immunol. 2018 Aug;142(2):699-702.e12. doi: 10.1016/j.jaci.2018.04.008. Epub 2018 Apr 27.

Abstract

IKAROS (encoded by IKZF1) is an important hematopoietic transcription factor critical for early B cell differentiation, with major defects known to lead to low B cell numbers and hypogammaglobulinemia. More perplexing is the link between IKZF1 variants and autoimmunity, including polymorphisms associated with susceptibility to SLE, and recently, rare variants driving monogenic autoimmunity. We identified a novel p.L188V mutation in IKZF1 in the index patient and her father and found this mutation to lead to loss of DNA binding. Peripheral B cells lacking a full complement of IKAROS function show upregulation of molecules accentuating B cell activation, while CD22, a key negative feedback circuit, is suppressed. The resulting hyperresponsiveness of peripheral B cells, in combination with elevated follicular helper T cell (Tfh) numbers, provides a putative mechanistic explanation for the association of IKZF1 variants with the emergence of autoimmune manifestations in this kindred.

Publication types

  • Case Reports
  • Letter
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies, Antinuclear / metabolism
  • Autoimmunity / genetics
  • B-Lymphocytes / pathology*
  • Cell Differentiation / genetics
  • Child
  • Female
  • Gene Frequency
  • Humans
  • Ikaros Transcription Factor / genetics*
  • Lupus Coagulation Inhibitor / metabolism
  • Lupus Erythematosus, Systemic / diagnosis*
  • Lupus Erythematosus, Systemic / genetics
  • Mice
  • Mutation / genetics*
  • NIH 3T3 Cells
  • Pedigree
  • Polymorphism, Genetic
  • Sialic Acid Binding Ig-like Lectin 2 / metabolism

Substances

  • Antibodies, Antinuclear
  • IKZF1 protein, human
  • Lupus Coagulation Inhibitor
  • Sialic Acid Binding Ig-like Lectin 2
  • Ikaros Transcription Factor