Autoimmune versus Non-autoimmune Cutaneous Features in Monogenic Patients with Inborn Errors of Immunity
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Method
2.1. Patients
2.2. Data Collection
2.3. Genetic Analysis
2.4. Statistical Analysis
3. Results
3.1. Population Characteristics
3.2. Cutaneous Involvements in the IEI Cohort
3.3. Dermatologic Characteristics of Different IEI Entities
3.4. Autoimmune Cutaneous Manifestations in the IEI Cohort
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Phenotypical Classifications | Presenting as a Primary Manifestation | Presenting as a Secondary Manifestation |
---|---|---|
Non-syndromic combined immunodeficiencies, n (%), (n = 55) | 29 (52.7%) | 26 (43.7%) |
Syndromic combined immunodeficiencies, n (%), (n = 48) | 21 (45.7%) | 25 (54.3%) |
Predominantly antibody deficiencies, n (%), (n = 16) | 4 (25%) | 12 (75%) |
Diseases of immune dysregulation, n (%), (n = 33) | 5 (15.6%) | 27 (84.4%) |
Congenital defects of phagocytes (number, function, or both), n (%), (n = 8) | 4 (50%) | 4 (50%) |
Defects in intrinsic or innate immunity, n (%), (n = 5) | 3 (60%) | 2 (40%) |
Cutaneous Manifestations | Total (n = 227) | Non-Syndromic Combined Immunodeficiencies (n = 55) | Syndromic Combined Immunodeficiencies (n = 106) | Predominantly Antibody Deficiencies (n = 16) | Diseases of Immune Dysregulation (n = 37) | Congenital Defects of Phagocytes (Number, Function, or Both), (n = 8) | Defects in Intrinsic or Innate Immunity (n = 5) | p-Value |
---|---|---|---|---|---|---|---|---|
Infectious, n (%) | 129 (56.8%) | 45 (81.8%) | 42 (39.6%) | 7 (43.8%) | 23 (62.2%) | 8 (100%) | 4 (80%) | <0.001 |
Fungal infection, n | 35 | 19 | 4 | 1 | 8 | 1 | 2 | <0.001 |
Viral infection, n | 16 | 3 | 4 | 0 | 7 | 2 | 0 | |
Bacterial infection, n | 44 | 13 | 15 | 4 | 6 | 4 | 2 | |
Non-infectious, n (%) | 188 (82.8%) | 41 (74.5%) | 101 (95.3%) | 11 (68.8%) | 30 (81.1%) | 3 (37.5%) | 2 (40%) | <0.001 |
Eczema α, n (%) | 57 (33.5%) | 23 (41.8%) | 20 (40.8%) | 0 | 12 (32.4%) | 1 (12.5%) | 1 (20%) | 0.009 |
Vitiligo β, n (%) | 7 (4.1%) | 2 (3.6%) | 1 (2%) | 1 (6.3%) | 3 (8.1%) | 0 | 0 | 0.686 |
Systemic lupus erythematous, n (%) | 3 (1.8%) | 1 (1.8%) | 1 (2%) | 1 (6.3%) | 0 | 0 | 0 | 0.634 |
Alopecia, n (%) | 10 (5.8%) | 0 | 1 (2%) | 1 (6.3%) | 8 (21.6%) | 0 | 0 | 0.001 |
Psoriasis, n (%) | 5 (2.9%) | 0 | 1 (2%) | 2 (12.5%) | 1 (2.7%) | 0 | 1 (20%) | 0.031 |
Ulcer, n (%) | 4 (2.4%) | 2 (3.6%) | 2 (4.1%) | 0 | 0 | 0 | 0 | 0.795 |
Hyperpigmentation, n (%) | 7 (4.1%) | 3 (5.5%) | 4 (8.2%) | 0 | 0 | 0 | 0 | 0.504 |
Hypopigmentation β, n (%) | 6 (3.5%) | 0 | 0 | 0 | 6 (16.2%) | 0 | 0 | 0.003 |
Vascular-related lesion, n (%) | 77 (33.9%) | 2 (3.6%) | 74 (70.9%) | 0 | 2 (5.4%) | 0 | 0 | <0.001 |
Atopic dermatitis α, n (%) | 13 (7.9%) | 3 (5.5%) | 5 (10.2%) | 0 | 5 (13.5%) | 0 | 0 | 0.570 |
Blister, n (%) | 3 (1.8%) | 1 (1.8%) | 2 (4.1%) | 0 | 0 | 0 | 0 | 0.786 |
Urticaria, n (%) | 5 (2.9%) | 0 | 1 (2%) | 1 (6.3%) | 1 (2.7%) | 2 (25%) | 0 | 0.020 |
Undefined skin disorders ɣ | 56 (32.9%) | 14 (25.5%) | 25 (51%) | 5 (31.3%) | 9 (24.3%) | 2 (25%) | 1 (20%) | 0.068 |
Phenotypical IEI Classifications | Total Number of Patients | Patients with Cutaneous Involvement | Skin Infections | Skin Atopic Manifestations | Skin Autoimmune Manifestations | Other Skin Manifestations |
---|---|---|---|---|---|---|
Non-syndromic combined immunodeficiencies | 126 | 55 (44%) | 45 (81.8%) | 25 (45.5%) | 2 (3.6%) | 17 (30.9%) |
T-B− SCID | ||||||
RAG1/RAG2 deficiency | 21 | 9 (42.8%) | 9 | 1 | 0 | 6 |
ADA deficiency | 8 | 5 (62.5%) | 5 | 1 | 0 | 2 |
Artemis deficiency | 7 | 1 (14.2%) | 1 | 0 | 0 | 1 |
Cernnunos/XLF deficiency | 2 | 1 (50%) | 1 | 0 | 0 | 0 |
T-B+ SCID | ||||||
No γδ T cells [CD3E(6), CD3D(1)] | 7 | 3 (42.8%)(CD3E, CD3D) | 3 | 1 | 0 | 0 |
JAK-3 deficiency | 6 | 3 (50%) | 3 | 3 | 0 | 0 |
gc deficiency | 5 | 3 (60%) | 2 | 0 | 0 | 1 |
Normal γδ T cells (PTPRC) | 1 | 1 (100%) | 1 | 0 | 0 | - |
Others | ||||||
CD40 ligand deficiency | 26 | 3 (11.5%) | 2 | 0 | 1 | 0 |
DOCK8 deficiency | 25 | 21 (84%) | 14 | 17 | 1 | 5 |
MHC class II deficiency [RFX5(2), RFXAP(1), RFXANK(4), CIITA(1)] | 8 | 3 (37.5%)(RFXANK, RFXAP, RFX5) | 3 | 1 | 0 | 1 |
IL-21R deficiency | 2 | 0 | - | - | - | - |
IKBKB deficiency | 2 | 1 (50%) | 0 | 1 | 0 | 0 |
ZAP-70 deficiency | 1 | 0 | - | - | - | - |
ICOS deficiency | 1 | 0 | - | - | - | - |
CARD11 deficiency | 1 | 0 | - | - | - | - |
DOCK2 deficiency | 1 | 0 | - | - | - | - |
ITK deficiency | 1 | 0 | - | - | - | - |
MALT1 deficiency | 1 | 1 (100%) | 1 | 0 | 0 | 1 |
Predominantly antibody deficiencies | 108 | 16 (15%) | 7 (43.8%) | 1 (6.3%) | 4 (25%) | 5 (31.2%) |
BTK deficiency (x-linked agammaglobulinemia) | 70 | 7 (of 69 cases with data, 10.1%) | 4 | 1 | 0 | 2 |
IGHM deficiency (Mu heavy chain deficiency) | 13 | 3 (23.1%) | 1 | 0 | 2 | 0 |
AID deficiency | 9 | 0 | - | - | - | - |
PIK3R1 deficiency | 5 | 1 (20%) | 1 | 0 | 0 | 0 |
NFKB1 deficiency | 3 | 1 (33.3%) | 0 | 0 | 0 | 1 |
BAFF receptor deficiency | 3 | 3 (100%) | 1 | 0 | 1 | 2 |
BLNK deficiency | 2 | 1 (50%) | 0 | 0 | 1 | 0 |
Igα deficiency (CD79A) | 2 | 0 | - | - | - | - |
TACI deficiency | 1 | 0 | ||||
Syndromic combined immunodeficiencies | 131 | 106 (80.9%) | 42 (39.6%) | 22 (20.7%) | 3 (2.9%) | 86 (83.5%) |
ATM deficiency (ataxia telangiectasia) | 78 | 74 (94.9%) | 17 | 4 | 2 | 72 |
STAT3 deficiency (hyper IgE syndrome) | 20 | 17 (85%) | 14 | 12 | 1 | 7 |
DNMT3B | 11 | 3 (27.2%) | 2 | 0 | 0 | 1 |
ZBTBT24 | 6 | 3 (50%) | 1 | 0 | 0 | 3 |
WAS deficiency (Wiskott-Aldrich syndrome) | 11 | 7 (63.6%) | 7 | 5 | 0 | 1 |
ARPC1B deficiency | 2 | 1 (50%) | 1 | 1 | 0 | 1 |
TTC7A deficiency (IEI with multiple intestinal atresias) | 1 | 0 | - | - | - | - |
Purine nucleoside phosphorylase deficiency | 1 | 0 | - | - | - | - |
IKBKG deficiency(NEMO deficiency) | 1 | 1 (100%) | 0 | 0 | 0 | 1 |
Diseases of immune dysregulation | 107 | 38 (35.5%) | 23 (60.5%) | 14 (36.8%) | 12 (31.5%) | 13 (34.2%) |
LRBA deficiency | 42 | 12 (28.5%) | 5 | 3 | 4 | 3 |
IL-10RB deficiency | 13 | 3 (of 12 cases with data, 25%) | 3 | 1 | 0 | 0 |
CD27 deficiency | 9 | 2 (22.2%) | 2 | 2 | 0 | 1 |
RAB27A deficiency (Griscelli Sd type 2) | 6 | 3 (of 3 cases with data, 33.3%) | 1 | 1 | 0 | 3 |
CD70 deficiency | 5 | 2 (40%) | 2 | 0 | 1 | 0 |
AIRE deficiency (APS-1) | 4 | 4 (100%) | 3 | 0 | 2 | 0 |
FOXP3 deficiency (immune dysregulation, polyendocrinopathy, enteropathy X-linked) | 3 | 2 (of 2 cases with data, 100%) | 2 | 2 | 1 | 1 |
CTLA4 deficiency | 3 | 1 (33.3%) | 1 | 0 | 1 | 0 |
XIAP deficiency (XLP2) | 3 | 2 (66.6%) | 1 | 1 | 2 | 1 |
AP3B1 deficiency (Hermansky Pudlak syndrome type 2) | 2 | 2 | 0 | 0 | 0 | 2 |
STAT3 gain of function mutation | 2 | 0 | 0 | 0 | 0 | 0 |
TNFRSF6 deficiency (ALPS syndrome) | 2 | 1 (50%) | 1 | 1 | 0 | 0 |
STXBP2 or Munc18-2 deficiency | 1 | 0 | - | - | - | - |
SH2D1A deficiency (XLP1) | 1 | 1 (100%) | 0 | 1 | 1 | 0 |
UNC13D or Munc13-4 deficiency | 1 | 0 | - | - | - | - |
ITCH deficiency | 1 | 1 (100%) | 1 | 1 | 0 | 1 |
PRF1 or perforin deficiency | 1 | 0 | - | - | - | - |
PRKCD deficiency | 1 | 0 | - | - | - | - |
RLTPR or CARMIL2 deficiency | 1 | 1 (100%) | 1 | 1 | 0 | 0 |
RASGRP1 deficiency | 1 | 0 | - | - | - | - |
RIPK1 deficiency | 1 | - | - | - | - | - |
TPP2 or tripeptidyl-peptidase II deficiency | 2 | 0 | - | - | - | - |
LYST deficiency (Chediak-Higashi syndrome) | 1 | 1 | 0 | 0 | 0 | 1 |
CD25 deficiency | 1 | 0 | ||||
Congenital defects of phagocyte number, function or both | 22 | 8 (38.1%) | 8 (100%) | 2 (25%) | 0 | 2 (25%) |
CGD [CYBA(1), NCF1(2), NCF2(1)] | 4 | 1 (25%)(CYBA) | 1 | 0 | 0 | 0 |
Elastase deficiency | 4 | 1 (25%) | 1 | 0 | 0 | 0 |
Kostmann disease | 4 | 1 (25%) | 1 | 0 | 0 | 1 |
Rac 2 deficiency | 3 | 2 (66.6%) | 2 | 2 | 0 | 1 |
Leukocyte adhesion deficiency I | 2 | 1 (50%) | 1 | 0 | 0 | 0 |
G-CSF receptor deficiency | 1 | 0 | - | - | - | - |
VPS45 deficiency | 1 | 1 (100%) | 1 | 0 | 0 | 0 |
GFI 1 deficiency | 1 | 0 | - | - | - | - |
G6PD deficiency | 1 | 1 (100%) | 1 | 0 | 0 | 0 |
Glycogen storage disease type 1b | 1 | 0 | - | - | - | - |
Defects in intrinsic and innate immunity | 23 | 5 (21.7%) | 4 (80%) | 1 (20%) | 1 (20%) | 1 (20%) |
IL-12RB1 deficiency | 19 | 3 (15.7%) | 2 | 1 | 1 | 1 |
STAT1 deficiency | 2 | 2 (100%) | 2 | 0 | 0 | 0 |
TYK2 deficiency | 1 | 0 | - | - | - | - |
IL-17RA deficiency | 2 | 0 | - | - | - | - |
Autoinflammatory disorders | 3 | 0 | - | - | - | - |
NLRP1 deficiency | 1 | 0 | - | - | - | - |
PLCG2 deficiency (familial cold autoinflammatory syndrome) | 1 | 0 | - | - | - | - |
MVK or mevalonate kinase deficiency | 1 | 0 | - | - | - | - |
Complement deficiencies | 1 | 0 | - | - | - | - |
FCN3 or ficolin 3 deficiency | 1 | 0 | - | - | - | - |
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Sharifinejad, N.; Azizi, G.; Rasouli, S.E.; Chavoshzadeh, Z.; Mahdaviani, S.A.; Tavakol, M.; Sadri, H.; Nabavi, M.; Ebrahimi, S.S.; Shirkani, A.; et al. Autoimmune versus Non-autoimmune Cutaneous Features in Monogenic Patients with Inborn Errors of Immunity. Biology 2023, 12, 644. https://doi.org/10.3390/biology12050644
Sharifinejad N, Azizi G, Rasouli SE, Chavoshzadeh Z, Mahdaviani SA, Tavakol M, Sadri H, Nabavi M, Ebrahimi SS, Shirkani A, et al. Autoimmune versus Non-autoimmune Cutaneous Features in Monogenic Patients with Inborn Errors of Immunity. Biology. 2023; 12(5):644. https://doi.org/10.3390/biology12050644
Chicago/Turabian StyleSharifinejad, Niusha, Gholamreza Azizi, Seyed Erfan Rasouli, Zahra Chavoshzadeh, Seyed Alireza Mahdaviani, Marzieh Tavakol, Homa Sadri, Mohammad Nabavi, Sareh Sadat Ebrahimi, Afshin Shirkani, and et al. 2023. "Autoimmune versus Non-autoimmune Cutaneous Features in Monogenic Patients with Inborn Errors of Immunity" Biology 12, no. 5: 644. https://doi.org/10.3390/biology12050644