Thiếu hụt MKL1 dẫn đến khiếm khuyết nghiêm trọng về tính di động của bạch cầu trung tính do rối loạn polymer hóa actin

Blood - Tập 135 - Trang 2171-2181 - 2020
Evelien G.G. Sprenkeler1,2, Stefanie S.V. Henriet3, Anton T.J. Tool1, Iris C. Kreft4, Ivo van der Bijl1, Cathelijn E.M. Aarts1, Michel van Houdt1, Paul J.J.H. Verkuijlen1, Koen van Aerde3, Gerald Jaspers5, Arno van Heijst6, Wouter Koole7, Thatjana Gardeitchik7, Judy Geissler1, Martin de Boer1, Simon Tol8, Christine W. Bruggeman1, Floris P.J. van Alphen8, Han J.M.P. Verhagen9, Emile van den Akker9
1Department of Blood Cell Research, Sanquin Research, Amsterdam University Medical Center (AUMC), University of Amsterdam, Amsterdam, The Netherlands
2Department of Pediatric Immunology, Rheumatology, and Infectious Diseases, Emma Children's Hospital, AUMC, University of Amsterdam, Amsterdam, The Netherlands
3Department of Pediatric Infectious Diseases and Immunology, Amalia Children's Hospital, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
4Department of Molecular and Cellular Hemostasis, Sanquin Research, Amsterdam, The Netherlands
5Department of Pediatric Intensive Care, Nijmegen, The Netherlands
6Department of Neonatology, Amalia Children's Hospital, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
7Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
8Department of Research Facilities, Amsterdam, The Netherlands
9Department of Hematopoiesis, Sanquin Research, Amsterdam, the Netherlands

Tóm tắt

Tóm tắtBệnh bạch cầu megakaryoblastic 1 (MKL1) thúc đẩy điều tiết các quá trình tế bào thiết yếu, bao gồm động lực của bộ khung tế bào actin, thông qua việc đồng hoạt hóa yếu tố đáp ứng huyết thanh. Gần đây, bệnh nhân người đầu tiên bị thiếu hụt MKL1, dẫn đến một loại suy giảm miễn dịch nguyên phát mới, đã được phát hiện. Chúng tôi báo cáo về một gia đình thứ hai với 2 anh chị em có đột biến khung đồng hợp tử trong gen MKL1. Trường hợp chỉ số đã tử vong khi còn là trẻ sơ sinh do viêm phổi tiến triển và nặng nề gây ra bởi Pseudomonas aeruginosa và việc lành vết thương kém. Em trai nhỏ hơn đã được ghép tạng dự phòng ngay sau khi sinh. Sự suy giảm miễn dịch được đặc trưng bởi rối loạn polymer hóa actin rõ rệt và phản ứng di động cũng như hóa hướng động bị giảm sút mạnh ở bạch cầu trung tính thiếu MKL1. Ngoài việc thiếu MKL1, các phân tích proteomic và transcriptomic tiếp theo từ bạch cầu trung tính của bệnh nhân cho thấy actin và một số protein liên quan đến actin bị giảm điều hòa, khẳng định vai trò của MKL1 như một đồng điều chỉnh phiên mã. Quá trình giải phóng hạt được tăng cường sau khi kích hoạt bạch cầu trung tính không tối ưu, trong khi sản xuất các loài oxy phản ứng vẫn là bình thường. Sự bám dính của bạch cầu trung tính vẫn nguyên vẹn nhưng không diễn ra việc trải rộng đúng cách. Điều này có thể giải thích cho sự thất bại quan sát thấy trong việc bám dính chắc và di cư xuyên nội mạch dưới điều kiện chảy. Không tìm thấy khiếm khuyết rõ ràng nào trong quá trình thực bào hoặc tiêu diệt vi khuẩn. Ngoài ra, đại thực bào có nguồn gốc từ tế bào mono cũng cho thấy quá trình thực bào nguyên vẹn, và số lượng tế bào lympho cũng như khả năng phân bào là bình thường. Các nguyên bào sợi không huyết học cho thấy sự phân hóa kém vào myofibroblast nhưng di động và hàm lượng F-actin bình thường, rất có thể do các cơ chế bù trừ của MKL2, không được biểu hiện trong bạch cầu trung tính. Những phát hiện của chúng tôi mở rộng hiểu biết hiện tại về rối loạn miễn dịch nghiêm trọng trong thiếu hụt MKL1, với rối loạn bộ khung tế bào và rối loạn sự thoát mạch của bạch cầu trung tính là những đặc điểm nổi bật nhất.

Từ khóa


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