Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8721298 | Clinical Immunology | 2018 | 25 Pages |
Abstract
We describe a four-year-old boy with typical but slightly delayed-onset of IPEX with autoimmune diabetes mellitus, enteropathy, hepatitis and skin disease. We found the unreported FOXP3 splice site mutation c.816+2T>A that leads to the loss of leucine-zipper coding exon 7. RNA-Seq revealed that FOXP3Î7 leads to differential expression of FOXP3 regulated genes. After myeloablative conditioning the patient underwent allogeneic HSCT from a matched unrelated donor. HSCT led to the resolution of all IPEX symptoms including insulin requirement despite persisting autoantibody levels. After initial full donor engraftment nearly complete autologous reconstitution was documented, but donor-derived TReg cells persisted with a lineage-specific chimerism of >70% and the patient remained in clinical remission.
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Authors
Thomas Magg, Volker Wiebking, Raffaele Conca, Stefan Krebs, Stefan Arens, Irene Schmid, Christoph Klein, Michael H. Albert, Fabian Hauck,