학술논문

Dominant-negative NFKBIA mutation promotes IL-1β production causing hepatic disease with severe immunodeficiency.
Document Type
Journal Article
Source
Journal of Clinical Investigation. Nov2020, Vol. 130 Issue 11, p5817-5832. 16p. 3 Color Photographs, 1 Diagram, 2 Graphs.
Subject
*HEMATOPOIETIC stem cell transplantation
*IMMUNOLOGIC diseases
*GENETIC disorders
*IMMUNODEFICIENCY
*MISSENSE mutation
*LIVER disease treatment
*GENETIC mutation
*HOMOGRAFTS
*ANIMAL experimentation
*INTERLEUKIN-1
*SEVERE combined immunodeficiency
*NEUTROPENIA
*LIVER diseases
*CELLULAR signal transduction
*GENES
*EPITHELIAL cells
*MICE
Language
ISSN
0021-9738
Abstract
Although IKK-β has previously been shown as a negative regulator of IL-1β secretion in mice, this role has not been proven in humans. Genetic studies of NF-κB signaling in humans with inherited diseases of the immune system have not demonstrated the relevance of the NF-κB pathway in suppressing IL-1β expression. Here, we report an infant with a clinical pathology comprising neutrophil-mediated autoinflammation and recurrent bacterial infections. Whole-exome sequencing revealed a de novo heterozygous missense mutation of NFKBIA, resulting in a L34P IκBα variant that severely repressed NF-κB activation and downstream cytokine production. Paradoxically, IL-1β secretion was elevated in the patient's stimulated leukocytes, in her induced pluripotent stem cell-derived macrophages, and in murine bone marrow-derived macrophages containing the L34P mutation. The patient's hypersecretion of IL-1β correlated with activated neutrophilia and liver fibrosis with neutrophil accumulation. Hematopoietic stem cell transplantation reversed neutrophilia, restored a resting state in neutrophils, and normalized IL-1β release from stimulated leukocytes. Additional therapeutic blockade of IL-1 ameliorated liver damage, while decreasing neutrophil activation and associated IL-1β secretion. Our studies reveal a previously unrecognized role of human IκBα as an essential regulator of canonical NF-κB signaling in the prevention of neutrophil-dependent autoinflammatory diseases. These findings also highlight the therapeutic potential of IL-1 inhibitors in treating complications arising from systemic NF-κB inhibition. [ABSTRACT FROM AUTHOR]