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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7945711PMC
http://dx.doi.org/10.46497/ArchRheumatol.2020.7798DOI Listing

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The Rapidly Expanding Genetic Spectrum of Common Variable Immunodeficiency-Like Disorders.

J Allergy Clin Immunol Pract

June 2023

Department of Immunology, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia; Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, VIC, Australia.

Article Synopsis
  • The understanding of Common Variable Immunodeficiency Disorders (CVID) is evolving, with new diagnostic criteria enabling more precise identification of the disorder.
  • Next-generation sequencing (NGS) has revealed that many patients exhibit a genetic variant causing their symptoms, leading to a distinction between CVID and CVID-like disorders.
  • In consanguineous populations, a high percentage of severe hypogammaglobulinemia cases are linked to inherited immunity disorders, while in others, about 20-30% of patients have pathogenic genetic mutations, adding complexity to disease severity and diagnosis.
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Background: Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare inborn error of immunity caused by mutations in the forkhead box P3 (FOXP3) gene.

Objective: In this study, we conducted a systematic review of patients with IPEX and IPEX-like syndrome to delineate differences in these 2 major groups.

Methods: The literature search was performed in PubMed, Web of Science, and Scopus databases, and demographic, clinical, immunologic, and molecular data were compared between the IPEX and IPEX-like groups.

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Mutations in the gene encoding Bruton's tyrosine kinase (BTK) interfere with B cell proliferation and lead to an X-linked immunodeficiency in mice characterized by reduced B cell numbers. Recent studies have established that BTK transmits signals from the B cell antigen receptor (BCR) to transcription factor NF-kappaB, which in turn reprograms a set of genes required for normal B cell growth. We now demonstrate that induction of NF-kappaB via this pathway requires the intermediate action of the -gamma2 isoform of phospholipase C (PLC-gamma2), a potential phosphorylation substrate of BTK.

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