Mechanistic associations of a mild phenotype of immunodysregulation, polyendocrinopathy, enteropathy, x-linked syndrome
| Autor: | Flaminia Muratori, Alberto G. Ugazio, Elisabetta Cortis, Rita De Vito, Antonella Diamanti, Roberto Cusano, Fabrizio De Benedetti, Rita Carsetti, Antonella Insalaco, Manuela Gambarara, Massimo Castro, Andrea Lamioni, Lucia Perroni, Gian Franco Bottazzo |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Protein-Losing Enteropathies DNA Mutational Analysis chemical and pharmacologic phenomena Autoimmune enteropathy medicine.disease_cause Severity of Illness Index Rare Diseases medicine Humans Enteropathy Genetic Predisposition to Disease IL-2 receptor Functional ability Intestinal Mucosa Polyendocrinopathies Autoimmune Mutation Hepatology business.industry Biopsy Needle Gastroenterology FOXP3 hemic and immune systems Forkhead Transcription Factors Genetic Diseases X-Linked Syndrome IPEX syndrome medicine.disease Prognosis Phenotype Immunohistochemistry Gene Expression Regulation Child Preschool Immunology business |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 4(5) |
| ISSN: | 1542-3565 |
| Popis: | Background & Aims: The syndrome of immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) is a rare disorder resulting in the expression of multiple autoimmune and allergic features. Early onset enteropathy and type 1 diabetes (T1D) are the most common clinical features. The IPEX syndrome is caused by mutations of the FOXP3 gene, which is essential for the development of regulatory T cells (Treg). We describe 2 unrelated patients with IPEX syndrome with a mild clinical phenotype and with novel FOXP3 mutations and the phenotypic and functional characterization of their Treg cells. Methods: The FOXP3 gene was analyzed by sequencing amplimers from genomic DNA. Treg cells were characterized by evaluating the number of CD4+CD25+ T cells and their functional ability to suppress the proliferation of autologous CD4+CD25− effector T cells stimulated with anti-CD3 and anti-CD28 antibodies. Results: A 7-year-old boy and a 24-year-old man presented with autoimmune enteropathy characterized by early onset persistent diarrhea not associated with T1D or other endocrinopathies. These 2 patients carry novel FOXP3 mutations that do not abrogate the function of the forkhead domain. They have normal numbers of CD4+CD25+ T lymphocytes, however, these show severely defective suppressive function in vitro. Conclusions: Our 2 patients show that IPEX patients may present with early onset enteropathy and long-term survival without T1D or other endocrinopathies. This milder phenotype may be associated with FOXP3 mutations that do not abrogate the function of the forkhead domain. |
| Databáze: | OpenAIRE |
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