Inherited human ITK deficiency impairs IFN-γ immunity and underlies tuberculosis.

Inherited human ITK deficiency impairs IFN-γ immunity and underlies tuberculosis.
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DOI:
10.1084/jem.20220484
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发表时间:
2023-01-02
期刊:
The Journal of experimental medicine
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其他
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遗传性ITK缺陷显示严重EBV疾病的不完全转移,并且由于先天性适应性(Vδ2+ γδ T和MAIT)和纯适应性αβ T淋巴细胞产生的IFN-γ不足,可能是严重结核病的基础。IFN-γ免疫的先天性缺陷可能是结核病(TB)的基础。我们报告了三名来自两个kindeles的患者,他们没有EBV病毒血症或疾病,但患有严重的结核病和遗传性完全ITK缺乏症,这种疾病与严重的EBV疾病有关,使免疫学研究具有挑战性。他们患有CD 4 + αβ T淋巴细胞减少症,伴随着CD 4 − CD 8 −双阴性(DN)αβ和Vδ2− γδ T淋巴细胞的扩增,两者均表现出独特的CD 38 + CD 45 RA +T-bet+EOMES−表型。Itk缺陷小鼠分别在胸腺和脾脏中重现了γδ T和DN αβ T淋巴细胞群的扩增。此外,患者的T淋巴细胞分泌少量IFN-γ以响应TCR交联、促分裂剂或与自体B淋巴细胞的强制突触形成。最后,患者的总淋巴细胞分泌少量的IFN-γ,并且CD 4+、CD 8+、DN αβ T、Vδ2+ γδ T和MAIT细胞显示响应于BCG的IFN-γ产生受损。遗传性ITK缺陷破坏各种产生IFN-γ的T细胞亚群的发育和功能,从而成为TB的基础。
Inherited ITK deficiency shows incomplete penetrance for severe EBV disease and can underlie severe tuberculosis due to insufficient IFN-γ production by innate-like adaptive (Vδ2+ γδ T and MAIT) and purely adaptive αβ T lymphocytes. Inborn errors of IFN-γ immunity can underlie tuberculosis (TB). We report three patients from two kindreds without EBV viremia or disease but with severe TB and inherited complete ITK deficiency, a condition associated with severe EBV disease that renders immunological studies challenging. They have CD4+ αβ T lymphocytopenia with a concomitant expansion of CD4−CD8− double-negative (DN) αβ and Vδ2− γδ T lymphocytes, both displaying a unique CD38+CD45RA+T-bet+EOMES− phenotype. Itk-deficient mice recapitulated an expansion of the γδ T and DN αβ T lymphocyte populations in the thymus and spleen, respectively. Moreover, the patients’ T lymphocytes secrete small amounts of IFN-γ in response to TCR crosslinking, mitogens, or forced synapse formation with autologous B lymphocytes. Finally, the patients’ total lymphocytes secrete small amounts of IFN-γ, and CD4+, CD8+, DN αβ T, Vδ2+ γδ T, and MAIT cells display impaired IFN-γ production in response to BCG. Inherited ITK deficiency undermines the development and function of various IFN-γ–producing T cell subsets, thereby underlying TB.
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