Infectious diseases in patients with IRAK-4, MyD88, NEMO, or IκBα deficiency

C Picard, JL Casanova, A Puel - Clinical microbiology reviews, 2011 - Am Soc Microbiol
C Picard, JL Casanova, A Puel
Clinical microbiology reviews, 2011Am Soc Microbiol
Autosomal recessive IRAK-4 and MyD88 deficiencies predispose affected patients to
recurrent invasive pyogenic bacterial infection. Both defects result in the selective
impairment of cellular responses to Toll-like receptors (TLRs) other than TLR3 and of
cellular responses to most interleukin-1 receptors (IL-1Rs), including IL-1R, IL-18R, and IL-
33R. Hypomorphic mutations in the X-linked NEMO gene and hypermorphic mutations in the
autosomal IKBA gene cause X-linked recessive and autosomal dominant anhidrotic …
Summary
Autosomal recessive IRAK-4 and MyD88 deficiencies predispose affected patients to recurrent invasive pyogenic bacterial infection. Both defects result in the selective impairment of cellular responses to Toll-like receptors (TLRs) other than TLR3 and of cellular responses to most interleukin-1 receptors (IL-1Rs), including IL-1R, IL-18R, and IL-33R. Hypomorphic mutations in the X-linked NEMO gene and hypermorphic mutations in the autosomal IKBA gene cause X-linked recessive and autosomal dominant anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID) syndromes. Both of these defects impair NF-κB-mediated cellular responses to multiple receptors, including TLRs, IL-1Rs, and tumor necrosis factor receptors (TNF-Rs). They therefore confer a much broader predisposition to infections than that for IRAK-4 and MyD88 deficiencies. These disorders were initially thought to be rare but have now been diagnosed in over 170 patients worldwide. We review here the infectious diseases affecting patients with inborn errors of NF-κB-dependent TLR and IL-1R immunity.
American Society for Microbiology