Compound heterozygous TYK2 mutations underlie primary immunodeficiency with T-cell lymphopenia

Sci Rep. 2018 May 3;8(1):6956. doi: 10.1038/s41598-018-25260-8.

Abstract

Complete tyrosine kinase 2 (TYK2) deficiency has been previously described in patients with primary immunodeficiency diseases. The patients were infected with various pathogens, including mycobacteria and/or viruses, and one of the patients developed hyper-IgE syndrome. A detailed immunological investigation of these patients revealed impaired responses to type I IFN, IL-10, IL-12 and IL-23, which are associated with increased susceptibility to mycobacterial and/or viral infections. Herein, we report a recessive partial TYK2 deficiency in two siblings who presented with T-cell lymphopenia characterized by low naïve CD4+ T-cell counts and who developed Epstein-Barr virus (EBV)-associated B-cell lymphoma. Targeted exome-sequencing of the siblings' genomes demonstrated that both patients carried novel compound heterozygous mutations (c.209_212delGCTT/c.691C > T, p.Cys70Serfs*21/p.Arg231Trp) in the TYK2. The TYK2 protein levels were reduced by 35% in the T cells of the patient. Unlike the response under complete TYK2 deficiency, the patient's T cells responded normally to type I IFN, IL-6, IL-10 and IL-12, whereas the cells displayed an impaired response to IL-23. Furthermore, the level of STAT1 was low in the cells of the patient. These studies reveal a new clinical entity of a primary immunodeficiency with T-cell lymphopenia that is associated with compound heterozygous TYK2 mutations in the patients.

Publication types

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

MeSH terms

  • Adolescent
  • Epstein-Barr Virus Infections / complications
  • Epstein-Barr Virus Infections / genetics
  • Epstein-Barr Virus Infections / pathology
  • Female
  • Herpesvirus 4, Human / isolation & purification
  • Heterozygote
  • Humans
  • Immunologic Deficiency Syndromes / complications
  • Immunologic Deficiency Syndromes / genetics*
  • Immunologic Deficiency Syndromes / pathology
  • Job Syndrome / complications
  • Job Syndrome / genetics*
  • Job Syndrome / pathology
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / genetics
  • Lymphoma, B-Cell / pathology
  • Lymphopenia / complications
  • Lymphopenia / genetics*
  • Lymphopenia / pathology
  • Male
  • Mutation*
  • Primary Immunodeficiency Diseases
  • Siblings
  • T-Lymphocytes / pathology
  • TYK2 Kinase / deficiency*
  • TYK2 Kinase / genetics

Substances

  • TYK2 Kinase
  • TYK2 protein, human

Supplementary concepts

  • T cell immunodeficiency primary
  • Tyrosine Kinase 2 Deficiency