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Germline mutations in NFKB2 implicate the noncanonical NF-κB pathway in the pathogenesis of common variable immunodeficiency.

American journal of human genetics | 2013

Common variable immunodeficiency (CVID) is a heterogeneous disorder characterized by antibody deficiency, poor humoral response to antigens, and recurrent infections. To investigate the molecular cause of CVID, we carried out exome sequence analysis of a family diagnosed with CVID and identified a heterozygous frameshift mutation, c.2564delA (p.Lys855Serfs(∗)7), in NFKB2 affecting the C terminus of NF-κB2 (also known as p100/p52 or p100/p49). Subsequent screening of NFKB2 in 33 unrelated CVID-affected individuals uncovered a second heterozygous nonsense mutation, c.2557C>T (p.Arg853(∗)), in one simplex case. Affected individuals in both families presented with an unusual combination of childhood-onset hypogammaglobulinemia with recurrent infections, autoimmune features, and adrenal insufficiency. NF-κB2 is the principal protein involved in the noncanonical NF-κB pathway, is evolutionarily conserved, and functions in peripheral lymphoid organ development, B cell development, and antibody production. In addition, Nfkb2 mouse models demonstrate a CVID-like phenotype with hypogammaglobulinemia and poor humoral response to antigens. Immunoblot analysis and immunofluorescence microscopy of transformed B cells from affected individuals show that the NFKB2 mutations affect phosphorylation and proteasomal processing of p100 and, ultimately, p52 nuclear translocation. These findings describe germline mutations in NFKB2 and establish the noncanonical NF-κB signaling pathway as a genetic etiology for this primary immunodeficiency syndrome.

Pubmed ID: 24140114 RIS Download

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Associated grants

  • Agency: NHLBI NIH HHS, United States
    Id: U54 HL112311
  • Agency: NICHD NIH HHS, United States
    Id: 5K12HD001410-10
  • Agency: NIGMS NIH HHS, United States
    Id: R01 GM104390
  • Agency: NIGMS NIH HHS, United States
    Id: R01 GM059290
  • Agency: NIAID NIH HHS, United States
    Id: 1R21AI094004-01
  • Agency: NIAID NIH HHS, United States
    Id: R21 AI094004
  • Agency: NIGMS NIH HHS, United States
    Id: GM59290
  • Agency: NHLBI NIH HHS, United States
    Id: U54HL112311-01
  • Agency: NHLBI NIH HHS, United States
    Id: R37HL6044525
  • Agency: NICHD NIH HHS, United States
    Id: K12 HD001410

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