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Genetically determined susceptibility to mycobacterial infection
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Genetically determined susceptibility to mycobacterial infection
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Journal Article
Genetically determined susceptibility to mycobacterial infection
2008
Overview
Individuals with impaired cell mediated immunity exhibit increased susceptibility to infections caused by poorly pathogenic mycobacteria (non-tuberculous mycobacteria and BCG), as well as salmonella species. However, these infections may also occur in a disseminated, fatal form, sometimes with a familial distribution, in the absence of any recognised primary or secondary immunodeficiency. Genetic analysis of affected families has defined mutations in seven different genes participating in the interleukin 12 (IL12) dependent, high output interferon γ (IFNγ) pathway. The first category of defect is mutations in the IFNγR1 or R2 genes, resulting in defective expression or function of the IFNγ receptor. The second category of mutations abrogates the cell surface expression IL12Rβ1gene, resulting in the inability to respond to IL12. The third category of defect is the inability to produce IL12, due to deletion within the gene coding for the inducible chain of IL12 (IL12-p40). Patients with X-linked recessive mutations of the gene encoding the NFκB essential modulator may also develop mycobacterial infections, although they usually have a more complex phenotype and are susceptible to a broad spectrum of pathogens. Mutations of the gene encoding the signal transducing molecule STAT1, which impairs the ability to respond to IFNγ, and mutations of the gene encoding TYK2 (which is associated with a failure to respond to IL12), are both rare genetic defects predisposing to mycobacterial infections. This review summarises the clinical spectrum seen in this group of patients and indicates a strategy for the identification of putative genetic defects in the type-1 cytokine pathway.
Publisher
BMJ Publishing Group Ltd and Association of Clinical Pathologists,BMJ,BMJ Publishing Group LTD
Subject
/ Biological and medical sciences
/ Defects
/ Genes
/ Genetic Predisposition to Disease
/ Genotype
/ Humans
/ Interleukin-12 Subunit p40 - deficiency
/ Interleukin-12 Subunit p40 - genetics
/ Investigative techniques, diagnostic techniques (general aspects)
/ Kinases
/ Ligands
/ Mutation
/ Mycobacterium bovis - immunology
/ Mycobacterium Infections, Nontuberculous - genetics
/ Mycobacterium Infections, Nontuberculous - immunology
/ Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
/ Receptors, Interferon - genetics
/ Receptors, Interleukin-12 - genetics
/ Rodents
/ STAT1 Transcription Factor - deficiency
/ STAT1 Transcription Factor - genetics
