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PRKDC mutations associated with immunodeficiency, granuloma and aire-dependent autoimmunity
Pediatric Rheumatology volume 12, Article number: P42 (2014)
PRKDC encodes for DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a kinase that forms part of a complex (DNA-PK) crucial for DNA double-strand break (DSB) repair and V(D)J recombination. In mice, DNA-PK also interacts with the transcription factor AIRE (autoimmune regulator) to promote central T cell tolerance.
We sought to understand the causes of an inflammatory disease with granuloma and autoimmunity, associated to decreasing T and B cell counts over time diagnosed in two unrelated patients.
Genetic, molecular, and functional analyses were performed to characterize an inflammatory disease evocative of a combined immunodeficiency.
We identified PRKDC mutations in both patients. These patients exhibited a defect in DNA DSB repair and V(D)J recombination. Circulating T cells had a skewed cytokine response typical of Th1 and Th2 profiles. Moreover, mutated DNA-PKcs failed to promote AIRE-dependent transcription of peripheral tissue antigens in vitro. The latter defect correlated in vivo, with the production of anti-Calcium Sensing Receptor (anti-CaSR) autoantibodies, which are usually found in AIRE-deficient patients.
Deficiency of DNA-PKcs, a key AIRE partner, can present as an inflammatory disease with organ-specific autoantibodies and these findings highlight the essential role of DNA-PKcs in regulating autoimmune responses and maintaining AIRE-dependent tolerance in human.
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Belot, A., Mathieu, AL., Veronese, E. et al. PRKDC mutations associated with immunodeficiency, granuloma and aire-dependent autoimmunity. Pediatr Rheumatol 12, P42 (2014). https://doi.org/10.1186/1546-0096-12-S1-P42
- Inflammatory Disease
- Catalytic Subunit
- Autoimmune Response
- Cell Tolerance
- Unrelated Patient