Abstract
Background: Investigating and documenting novel mutations
within inborn errors of immunity (IEIs) has demonstrably enriched our
comprehension of disease causation. This encompasses elucidating the
clinical and immunological presentations linked to specific gene
alterations, ultimately leading to refined classification precision and,
optimistically, improved treatment modalities. The present study aims to
the profiles of patients within the Iranian IEI registry exhibiting
mutations within the NFKB signaling pathway. Methods:
Peripheral blood mononuclear cells were utilized for immunophenotyping
of B and T lymphocyte subsets, and proliferation assays. Immunoblotting
was employed to assess the expression levels of the corresponding
protein in each patient harboring the respective variant.
Results: The study cohort encompassed 17 patients: 8 with
NFKB1 mutations, 5 with NFKB2 mutations, 3 with
IKBKB mutations, and 1 with an IKBKG mutation. All
NFKB1 and NFKB2 mutations presented as heterozygous,
whereas IKBKB mutations were homozygous and the IKBKG
mutation was hemizygous. The predominant clinical features included
hypogammaglobulinemia and B cell subset disturbances, with T cell
subsets and proliferation being normal in most, though not all, cases.
Protein expression in patients generally mirrored healthy controls,
except for two individuals harboring NFKB2 mutations.
Conclusions: These findings provide novel IEI cases linked to
NFKB pathway mutations. Comprehensive evaluation and functional analysis
of novel mutations, confirming potential impacts on disease
manifestation, also highlight the need for specialized care and further
research within immunodeficiency disorders.