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1.
J Allergy Clin Immunol ; 146(4): 901-911, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32278790

RESUMO

BACKGROUND: An increasing number of NFKB1 variants are being identified in patients with heterogeneous immunologic phenotypes. OBJECTIVE: To characterize the clinical and cellular phenotype as well as the management of patients with heterozygous NFKB1 mutations. METHODS: In a worldwide collaborative effort, we evaluated 231 individuals harboring 105 distinct heterozygous NFKB1 variants. To provide evidence for pathogenicity, each variant was assessed in silico; in addition, 32 variants were assessed by functional in vitro testing of nuclear factor of kappa light polypeptide gene enhancer in B cells (NF-κB) signaling. RESULTS: We classified 56 of the 105 distinct NFKB1 variants in 157 individuals from 68 unrelated families as pathogenic. Incomplete clinical penetrance (70%) and age-dependent severity of NFKB1-related phenotypes were observed. The phenotype included hypogammaglobulinemia (88.9%), reduced switched memory B cells (60.3%), and respiratory (83%) and gastrointestinal (28.6%) infections, thus characterizing the disorder as primary immunodeficiency. However, the high frequency of autoimmunity (57.4%), lymphoproliferation (52.4%), noninfectious enteropathy (23.1%), opportunistic infections (15.7%), autoinflammation (29.6%), and malignancy (16.8%) identified NF-κB1-related disease as an inborn error of immunity with immune dysregulation, rather than a mere primary immunodeficiency. Current treatment includes immunoglobulin replacement and immunosuppressive agents. CONCLUSIONS: We present a comprehensive clinical overview of the NF-κB1-related phenotype, which includes immunodeficiency, autoimmunity, autoinflammation, and cancer. Because of its multisystem involvement, clinicians from each and every medical discipline need to be made aware of this autosomal-dominant disease. Hematopoietic stem cell transplantation and NF-κB1 pathway-targeted therapeutic strategies should be considered in the future.


Assuntos
Estudos de Associação Genética , Predisposição Genética para Doença , Heterozigoto , Mutação , Subunidade p50 de NF-kappa B/genética , Fenótipo , Adulto , Idoso , Autoimunidade/genética , Variação Biológica da População , Biomarcadores , Gerenciamento Clínico , Feminino , Imunofluorescência , Estudos de Associação Genética/métodos , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X
2.
HLA ; 93(2-3): 124-125, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30614660

RESUMO

The novel allele HLA-C*02:151 showed a single-nucleotide difference to C*02:02:02:01 at codon -23 (CGG/CCG).


Assuntos
Alelos , Medula Óssea/metabolismo , Antígenos HLA-C/genética , Doadores de Tecidos , Éxons/genética , Teste de Histocompatibilidade , Humanos , Federação Russa
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