Dominant activating RAC2 mutation with lymphopenia, immunodeficiency, and cytoskeletal defects

Blood. 2019 May 2;133(18):1977-1988. doi: 10.1182/blood-2018-11-886028. Epub 2019 Feb 5.

Abstract

Ras-related C3 botulinum toxin substrate 2 (RAC2), through interactions with reduced NAD phosphate oxidase component p67 phox , activates neutrophil superoxide production, whereas interactions with p21-activated kinase are necessary for fMLF-induced actin remodeling. We identified 3 patients with de novo RAC2[E62K] mutations resulting in severe T- and B-cell lymphopenia, myeloid dysfunction, and recurrent respiratory infections. Neutrophils from RAC2[E62K] patients exhibited excessive superoxide production, impaired fMLF-directed chemotaxis, and abnormal macropinocytosis. Cell lines transfected with RAC2[E62K] displayed characteristics of active guanosine triphosphate (GTP)-bound RAC2 including enhanced superoxide production and increased membrane ruffling. Biochemical studies demonstrated that RAC2[E62K] retains intrinsic GTP hydrolysis; however, GTPase-activating protein failed to accelerate hydrolysis resulting in prolonged active GTP-bound RAC2. Rac2+/E62K mice phenocopy the T- and B-cell lymphopenia, increased neutrophil F-actin, and excessive superoxide production seen in patients. This gain-of-function mutation highlights a specific, nonredundant role for RAC2 in hematopoietic cells that discriminates RAC2 from the related, ubiquitous RAC1.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Child, Preschool
  • Cytoskeleton / pathology
  • Female
  • Gain of Function Mutation
  • Humans
  • Immunologic Deficiency Syndromes / genetics*
  • Infant
  • Infant, Newborn
  • Lymphopenia / genetics
  • Mice
  • Mice, Inbred C57BL
  • Pedigree
  • RAC2 GTP-Binding Protein
  • rac GTP-Binding Proteins / genetics*
  • rac GTP-Binding Proteins / immunology

Substances

  • rac GTP-Binding Proteins