Low Density Granulocytes and Dysregulated Neutrophils Driving Autoinflammatory Manifestations in NEMO Deficiency

2022-01-01
Yilmaz, Naz Surucu
Eltan, Sevgi Bilgic
Kayaoğlu, Başak
Geckin, Busranur
Heredia, Raul Jimenez
Sefer, Asena Pinar
KIYKIM, AYÇA
Nain, Ercan
Kasap, Nurhan
DOĞRU, ÖMER
YÜCELTEN, AYŞE DENİZ
Cinel, Leyla
Karasu, Gulsun
Yesilipek, Akif
Sozeri, Betul
Kaya, Goksu Gokberk
Yılmaz, İsmail Cem
Baydemir, Ilayda
Aydin, Yagmur
Kahraman, Deniz Cansen
Haimel, Matthias
Boztug, Kaan
Karakoc-Aydiner, Elif
GÜRSEL, İHSAN
Ozen, Ahmet
BARIŞ, SAFA
Gürsel, Mayda
NF-kappa B essential modulator (NEMO, IKK-gamma) deficiency is a rare combined immunodeficiency caused by mutations in the IKBKG gene. Conventionally, patients are afflicted with life threatening recurrent microbial infections. Paradoxically, the spectrum of clinical manifestations includes severe inflammatory disorders. The mechanisms leading to autoinflammation in NEMO deficiency are currently unknown. Herein, we sought to investigate the underlying mechanisms of clinical autoinflammatory manifestations in a 12-years old male NEMO deficiency (EDA-ID, OMIM #300,291) patient by comparing the immune profile of the patient before and after hematopoietic stem cell transplantation (HSCT). Response to NF-kB activators were measured by cytokine ELISA. Neutrophil and low-density granulocyte (LDG) populations were analyzed by flow cytometry. Peripheral blood mononuclear cells (PBMC) transcriptome before and after HSCT and transcriptome of sorted normal-density neutrophils and LDGs were determined using the NanoString nCounter gene expression panels. ISG15 expression and protein ISGylation was based on Immunoblotting. Consistent with the immune deficiency, PBMCs of the patient were unresponsive to toll-like and T cell receptor-activators. Paradoxically, LDGs comprised 35% of patient PBMCs and elevated expression of genes such as MMP9, LTF, and LCN2 in the granulocytic lineage, high levels of IP-10 in the patient's plasma, spontaneous ISG15 expression and protein ISGylation indicative of a spontaneous type I interferon (IFN) signature were observed, all of which normalized after HSCT. Collectively, our results suggest that type I IFN signature observed in the patient, dysregulated LDGs and spontaneously activated neutrophils, potentially contribute to tissue damage in NEMO deficiency.
JOURNAL OF CLINICAL IMMUNOLOGY

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Citation Formats
N. S. Yilmaz et al., “Low Density Granulocytes and Dysregulated Neutrophils Driving Autoinflammatory Manifestations in NEMO Deficiency,” JOURNAL OF CLINICAL IMMUNOLOGY, pp. 0–0, 2022, Accessed: 00, 2022. [Online]. Available: https://hdl.handle.net/11511/95313.