Simon Urschel, Daniel Suez, Hans D. Ochs, Sanja Ugrinovic, Stephanie Jennings, Lennart Hammarström, Hans-Hartmut Peter, Tina Hagena, Alessandro Plebani, Are Martin Holm, Bodo Grimbacher, Tatiana C. Lawrence, Andrew McLean-Tooke, Chiara Bacchelli, Sylvie Buckridge, Alejandro A. Schäffer, A. David B. Webster, Stephanie Anover-Sombke, H. Bobby Gaspar, Qiang Pan-Hammarström, Dinakantha S. Kumararatne, Gavin P. Spickett, Helen Chapel, Bernd H. Belohradsky, Adrian J. Thrasher, Astrid Bergbreiter, Pascal Schneider, E. Michael Gertz, Jennifer Birmelin, Ulrich Salzer, Vassilis Lougaris, José Luis Franco, Ilka Schulze, Univ Hosp Freiburg, Inst Child Hlth, Karolinska Univ Hosp Huddinge, Univ Brescia, Spedali Civil Brescia, Royal Free Hosp, UCL, Allergy Asthma & Immunol Clin, Oxford Radcliffe Hosp, Royal Victoria Infirm, Univ Washington, Childrens Hosp, Univ Munich, Addenbrookes Hosp, Universidade Federal de São Paulo (UNIFESP), Univ Oslo, Univ Antioquia, Charite Humboldt Univ, Univ Lausanne, and Natl Lib Med
Deutsche Forschungsgemeinschaft (Bonn, Germany) European Commission (Brussels, Belgium) National Institutes of Health/National Institute of Allergy and Infectious Diseases Primary Immunodeficiency Association (PIA; London, United Kingdom) Medical Research Council (MRC; London, United Kingdom) The Wellcome Trust (London, United Kingdom) Swedish Research Council (Stockholm, Sweden) Fondazione C. Golgi (Brescia, Italy) Swiss National Science Foundation (Bern, Switzerland) Grant Colciencias (Bogota, Colombia) NIH Jeffrey Modell Foundation (New York, NY) Intramural Research Program of the National Institutes of Health, National Library of Medicine TNFRSF13B encodes transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI), a B cell specific tumor necrosis factor (TNF) receptor superfamily member. Both biallelic and monoallelic TNFRSF13B mutations were identified in patients with common variable immunodeficiency disorders. the genetic complexity and variable clinical presentation of TACI deficiency prompted us to evaluate the genetic, immunologic, and clinical condition in 50 individuals with TNFRSF13B alterations, following screening of 564 unrelated patients with hypogammaglobulinemia. We identified 13 new sequence variants. the most frequent TNFRSF13B variants (C104R and A181E; n = 39; 6.9%) were also present in a heterozygous state in 2% of 675 controls. All patients with biallelic mutations had hypogammaglobulinemia and nearly all showed impaired binding to a proliferation-inducing ligand (APRIL). However, the majority (n = 41; 82%) of the patients carried monoallelic changes in TNFRSF13B. Presence of a heterozygous mutation was associated with antibody deficiency (P < .001, relative risk 3.6). Heterozygosity for the most common mutation, C104R, was associated with disease (P < .001, relative risk 4.2). Furthermore, heterozygosity for C104R was associated with low numbers of IgD(-)CD27(+) B cells (P = .019), benign lymphoproliferation (P < .001), and autoimmune complications (P = .001). These associations indicate that C104R heterozygosity increases the risk for common variable immunodeficiency disorders and influences clinical presentation. (Blood. 2009; 113: 1967-1976) Univ Hosp Freiburg, Dept Rheumatol & Clin Immunol, Freiburg, Germany Inst Child Hlth, Mol Immunol Unit, London, England Karolinska Univ Hosp Huddinge, Karolinska Inst, Div Clin Immunol, Stockholm, Sweden Univ Brescia, Pediat Clin, Brescia, Italy Spedali Civil Brescia, Ist Med Mol Angelo Nocivelli, I-25125 Brescia, Italy Royal Free Hosp, Dept Immunol & Mol Pathol, London NW3 2QG, England UCL, London, England Allergy Asthma & Immunol Clin, Irving, TX USA Oxford Radcliffe Hosp, Nuffield Dept Med, Oxford, England Royal Victoria Infirm, Dept Immunol, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England Univ Washington, Reg Med Ctr, Seattle, WA 98195 USA Childrens Hosp, Seattle, WA USA Univ Munich, Div Infect Dis & Immunol, Univ Childrens Hosp, Munich, Germany Addenbrookes Hosp, Dept Clin Immunol, Cambridge, England Universidade Federal de São Paulo, Dept Pediat, São Paulo, Brazil Univ Oslo, Natl Hosp, Internal Med Res Inst, Oslo, Norway Univ Antioquia, Grp Immunodeficiencias Primarias, Medellin, Colombia Charite Humboldt Univ, Dept Paediat Pneumol & Immunol, Berlin, Germany Univ Lausanne, Dept Biochem, Lausanne, Switzerland Natl Lib Med, Natl Ctr Biotechnol Informat, NIH, US Dept HHS, Bethesda, MD 20894 USA Universidade Federal de São Paulo, Dept Pediat, São Paulo, Brazil Deutsche Forschungsgemeinschaft (Bonn, Germany): GR1617/3 Deutsche Forschungsgemeinschaft (Bonn, Germany): SFB620/C2 Deutsche Forschungsgemeinschaft (Bonn, Germany): SFB620/Z1 Deutsche Forschungsgemeinschaft (Bonn, Germany): SFB620/C1 European Commission (Brussels, Belgium): SP23-CT-2005-006411 European Commission (Brussels, Belgium): MEXT-CT-2006-042316 European Commission (Brussels, Belgium): HEALTH-F2-2008-201549 National Institutes of Health/National Institute of Allergy and Infectious Diseases: NO1-A130070 Fondazione C. Golgi (Brescia, Italy): PRIN2006 Grant Colciencias (Bogota, Colombia): 1115-05-16784 NIH: HD 37091 Web of Science