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  • NFKB2 haploinsufficiency id...
    Bodansky, Aaron; Vazquez, Sara E.; Chou, Janet; Novak, Tanya; Al-Musa, Amer; Young, Cameron; Newhams, Margaret; Kucukak, Suden; Zambrano, Laura D.; Mitchell, Anthea; Wang, Chung-Yu; Moffitt, Kristin; Halasa, Natasha B.; Loftis, Laura L.; Schwartz, Stephanie P.; Walker, Tracie C.; Mack, Elizabeth H.; Fitzgerald, Julie C.; Gertz, Shira J.; Rowan, Courtney M.; Irby, Katherine; Sanders, Ronald C.; Kong, Michele; Schuster, Jennifer E.; Staat, Mary A.; Zinter, Matt S.; Cvijanovich, Natalie Z.; Tarquinio, Keiko M.; Coates, Bria M.; Flori, Heidi R.; Dahmer, Mary K.; Crandall, Hillary; Cullimore, Melissa L.; Levy, Emily R.; Chatani, Brandon; Nofziger, Ryan; Kong, Michele; Sanders, Ronald C.; Yates, Masson; Smith, Chelsea; Cvijanovich, Natalie Z.; Zinter, MattS; McLaughlin, Gwenn; Tarquinio, Keiko M.; Coates, Bria M.; Rowan, Courtney M.; Randolph, Adrienne G.; Newhams, Margaret M.; Kucukak, Suden; Novak, Tanya; Moon, Hye Kyung; Kobayashi, Takuma; Melo, Jeni; Young, Cameron; Chen, Sabrina R.; Chou, Janet; Flori, Heidi R.; Dahmer, Mary K.; Levy, Emily R.; Behl, Supriya; Drapeau, Noelle M.; Schuster, Jennifer E.; Cullimore, Melissa L.; McCulloh, Russell J.; Gertz, Shira J.; Schwartz, Stephanie P.; Walker, Tracie C.; Nofziger, Ryan A.; Staat, Mary Allen; Rohlfs, Chelsea C.; Fitzgerald, Julie C.; Mack, Elizabeth H.; Reed, Nelson; Halasa, Natasha B.; Loftis, Laura L.; Crandall, Hillary; Geha, Raif S.; DeRisi, Joseph; Campbell, Angela P.; Anderson, Mark; Randolph, Adrienne G.

    Journal of allergy and clinical immunology, 04/2023, Letnik: 151, Številka: 4
    Journal Article

    Autoantibodies against type I IFNs occur in approximately 10% of adults with life-threatening coronavirus disease 2019 (COVID-19). The frequency of anti-IFN autoantibodies in children with severe sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unknown. We quantified anti–type I IFN autoantibodies in a multicenter cohort of children with severe COVID-19, multisystem inflammatory syndrome in children (MIS-C), and mild SARS-CoV-2 infections. Circulating anti–IFN-α2 antibodies were measured by a radioligand binding assay. Whole-exome sequencing, RNA sequencing, and functional studies of peripheral blood mononuclear cells were used to study any patients with levels of anti–IFN-α2 autoantibodies exceeding the assay’s positive control. Among 168 patients with severe COVID-19, 199 with MIS-C, and 45 with mild SARS-CoV-2 infections, only 1 had high levels of anti–IFN-α2 antibodies. Anti–IFN-α2 autoantibodies were not detected in patients treated with intravenous immunoglobulin before sample collection. Whole-exome sequencing identified a missense variant in the ankyrin domain of NFKB2, encoding the p100 subunit of nuclear factor kappa–light-chain enhancer of activated B cells, aka NF-κB, essential for noncanonical NF-κB signaling. The patient’s peripheral blood mononuclear cells exhibited impaired cleavage of p100 characteristic of NFKB2 haploinsufficiency, an inborn error of immunity with a high prevalence of autoimmunity. High levels of anti–IFN-α2 autoantibodies in children and adolescents with MIS-C, severe COVID-19, and mild SARS-CoV-2 infections are rare but can occur in patients with inborn errors of immunity.