Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation

In hyper-IgE syndromes (HIES), a group of primary immunodeficiencies clinically overlapping with atopic dermatitis, early diagnosis is crucial to initiate appropriate therapy and prevent irreversible complications. Identification of underlying gene defects such as in DOCK8 and STAT3 and correspondin...

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Autores: Hagl, Beate, Spielberger, Benedikt D., Thoene, Silvia, Bonnal, Sophie, Mertes, Christian, Winter, Christof, Nijman, Isaac J., Verduin, Shira, Eberherr, Andreas C., Puel, Anne, Schindler, Detlev, Ruland, Jürgen, Meitinger, Thomas, Gagneur, Julien, Orange, Jordan S., van Gijn, Marielle E., Renner, Ellen D.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/43117
Acceso en línea:http://hdl.handle.net/10230/43117
http://dx.doi.org/10.1038/s41598-018-34953-z
Access Level:acceso abierto
Palabra clave:Disease genetics
Genetic testing
Immunological deficiency syndromes
Primary immunodeficiency disorders
RNA splicing
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spelling Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutationHagl, BeateSpielberger, Benedikt D.Thoene, SilviaBonnal, SophieMertes, ChristianWinter, ChristofNijman, Isaac J.Verduin, ShiraEberherr, Andreas C.Puel, AnneSchindler, DetlevRuland, JürgenMeitinger, ThomasGagneur, JulienOrange, Jordan S.van Gijn, Marielle E.Renner, Ellen D.Disease geneticsGenetic testingImmunological deficiency syndromesPrimary immunodeficiency disordersRNA splicingIn hyper-IgE syndromes (HIES), a group of primary immunodeficiencies clinically overlapping with atopic dermatitis, early diagnosis is crucial to initiate appropriate therapy and prevent irreversible complications. Identification of underlying gene defects such as in DOCK8 and STAT3 and corresponding molecular testing has improved diagnosis. Yet, in a child and her newborn sibling with HIES phenotype molecular diagnosis was misleading. Extensive analyses driven by the clinical phenotype identified an intronic homozygous DOCK8 variant c.4626 + 76 A > G creating a novel splice site as disease-causing. While the affected newborn carrying the homozygous variant had no expression of DOCK8 protein, in the index patient molecular diagnosis was compromised due to expression of altered and wildtype DOCK8 transcripts and DOCK8 protein as well as defective STAT3 signaling. Sanger sequencing of lymphocyte subsets revealed that somatic alterations and reversions revoked the predominance of the novel over the canonical splice site in the index patient explaining DOCK8 protein expression, whereas defective STAT3 responses in the index patient were explained by a T cell phenotype skewed towards central and effector memory T cells. Hence, somatic alterations and skewed immune cell phenotypes due to selective pressure may compromise molecular diagnosis and need to be considered with unexpected clinical and molecular findings.This work was supported by the Wilhelm-Sander foundation (2013.015.2), the German Research Foundation (DFG RE2799/6-1), the Fritz-Bender foundation (all to E.D.R.), the EU Horizon2020 Collaborative Research Project SOUND (633974) (to J.G.), and the Spanish Ministry of Economy and Competitiveness, Centro de Excelencia Severo Ochoa, and to the EMBL partnership and of the CERCA Programme/Generalitat de Catalunya. Data included in this publication are part of a medical thesis at the School of Medicine, LMU Munich (B.D.S.).Nature Research201920192018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/43117http://dx.doi.org/10.1038/s41598-018-34953-zreponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésScientific Reports. 2018;8(1):16719info:eu-repo/grantAgreement/EC/H2020/633974© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/431172026-05-29T05:05:01Z
dc.title.none.fl_str_mv Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
title Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
spellingShingle Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
Hagl, Beate
Disease genetics
Genetic testing
Immunological deficiency syndromes
Primary immunodeficiency disorders
RNA splicing
title_short Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
title_full Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
title_fullStr Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
title_full_unstemmed Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
title_sort Somatic alterations compromised molecular diagnosis of DOCK8 hyper-IgE syndrome caused by a novel intronic splice site mutation
dc.creator.none.fl_str_mv Hagl, Beate
Spielberger, Benedikt D.
Thoene, Silvia
Bonnal, Sophie
Mertes, Christian
Winter, Christof
Nijman, Isaac J.
Verduin, Shira
Eberherr, Andreas C.
Puel, Anne
Schindler, Detlev
Ruland, Jürgen
Meitinger, Thomas
Gagneur, Julien
Orange, Jordan S.
van Gijn, Marielle E.
Renner, Ellen D.
author Hagl, Beate
author_facet Hagl, Beate
Spielberger, Benedikt D.
Thoene, Silvia
Bonnal, Sophie
Mertes, Christian
Winter, Christof
Nijman, Isaac J.
Verduin, Shira
Eberherr, Andreas C.
Puel, Anne
Schindler, Detlev
Ruland, Jürgen
Meitinger, Thomas
Gagneur, Julien
Orange, Jordan S.
van Gijn, Marielle E.
Renner, Ellen D.
author_role author
author2 Spielberger, Benedikt D.
Thoene, Silvia
Bonnal, Sophie
Mertes, Christian
Winter, Christof
Nijman, Isaac J.
Verduin, Shira
Eberherr, Andreas C.
Puel, Anne
Schindler, Detlev
Ruland, Jürgen
Meitinger, Thomas
Gagneur, Julien
Orange, Jordan S.
van Gijn, Marielle E.
Renner, Ellen D.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Disease genetics
Genetic testing
Immunological deficiency syndromes
Primary immunodeficiency disorders
RNA splicing
topic Disease genetics
Genetic testing
Immunological deficiency syndromes
Primary immunodeficiency disorders
RNA splicing
description In hyper-IgE syndromes (HIES), a group of primary immunodeficiencies clinically overlapping with atopic dermatitis, early diagnosis is crucial to initiate appropriate therapy and prevent irreversible complications. Identification of underlying gene defects such as in DOCK8 and STAT3 and corresponding molecular testing has improved diagnosis. Yet, in a child and her newborn sibling with HIES phenotype molecular diagnosis was misleading. Extensive analyses driven by the clinical phenotype identified an intronic homozygous DOCK8 variant c.4626 + 76 A > G creating a novel splice site as disease-causing. While the affected newborn carrying the homozygous variant had no expression of DOCK8 protein, in the index patient molecular diagnosis was compromised due to expression of altered and wildtype DOCK8 transcripts and DOCK8 protein as well as defective STAT3 signaling. Sanger sequencing of lymphocyte subsets revealed that somatic alterations and reversions revoked the predominance of the novel over the canonical splice site in the index patient explaining DOCK8 protein expression, whereas defective STAT3 responses in the index patient were explained by a T cell phenotype skewed towards central and effector memory T cells. Hence, somatic alterations and skewed immune cell phenotypes due to selective pressure may compromise molecular diagnosis and need to be considered with unexpected clinical and molecular findings.
publishDate 2018
dc.date.none.fl_str_mv 2018
2019
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/43117
http://dx.doi.org/10.1038/s41598-018-34953-z
url http://hdl.handle.net/10230/43117
http://dx.doi.org/10.1038/s41598-018-34953-z
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Scientific Reports. 2018;8(1):16719
info:eu-repo/grantAgreement/EC/H2020/633974
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Nature Research
publisher.none.fl_str_mv Nature Research
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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