학술논문

Heterozygous FOXN1 Variants Cause Low TRECs and Severe T Cell Lymphopenia, Revealing a Crucial Role of FOXN1 in Supporting Early Thymopoiesis
Document Type
article
Source
American Journal of Human Genetics. 105(3)
Subject
Biomedical and Clinical Sciences
Immunology
Rare Diseases
Biotechnology
Genetics
Prevention
Vaccine Related
Biodefense
2.1 Biological and endogenous factors
Aetiology
Adult
Aged
Animals
Child
Preschool
Female
Forkhead Transcription Factors
Heterozygote
Humans
Infant
Infant
Newborn
Lymphopenia
Male
Mice
Mice
SCID
Middle Aged
T-Lymphocytes
Thymus Gland
Young Adult
FOXN1
SCID
T cell receptor excision circles
T lymphocytes
newborn screening
thymopoiesis
thymus
Biological Sciences
Medical and Health Sciences
Genetics & Heredity
Biological sciences
Biomedical and clinical sciences
Health sciences
Language
Abstract
FOXN1 is the master regulatory gene of thymic epithelium development. FOXN1 deficiency leads to thymic aplasia, alopecia, and nail dystrophy, accounting for the nude/severe combined immunodeficiency (nu/SCID) phenotype in humans and mice. We identified several newborns with low levels of T cell receptor excision circles (TRECs) and T cell lymphopenia at birth, who carried heterozygous loss-of-function FOXN1 variants. Longitudinal analysis showed persistent T cell lymphopenia during infancy, often associated with nail dystrophy. Adult individuals with heterozygous FOXN1 variants had in most cases normal CD4+ but lower than normal CD8+ cell counts. We hypothesized a FOXN1 gene dosage effect on the function of thymic epithelial cells (TECs) and thymopoiesis and postulated that these effects would be more prominent early in life. To test this hypothesis, we analyzed TEC subset frequency and phenotype, early thymic progenitor (ETP) cell count, and expression of FOXN1 target genes (Ccl25, Cxcl12, Dll4, Scf, Psmb11, Prss16, and Cd83) in Foxn1nu/+ (nu/+) mice and age-matched wild-type (+/+) littermate controls. Both the frequency and the absolute count of ETP were significantly reduced in nu/+ mice up to 3 weeks of age. Analysis of the TEC compartment showed reduced expression of FOXN1 target genes and delayed maturation of the medullary TEC compartment in nu/+ mice. These observations establish a FOXN1 gene dosage effect on thymic function and identify FOXN1 haploinsufficiency as an important genetic determinant of T cell lymphopenia at birth.