[PDF][PDF] Whole-exome-sequencing-based discovery of human FADD deficiency

A Bolze, M Byun, D McDonald, NV Morgan… - The American Journal of …, 2010 - cell.com
A Bolze, M Byun, D McDonald, NV Morgan, A Abhyankar, L Premkumar, A Puel, CM Bacon
The American Journal of Human Genetics, 2010cell.com
Germline mutations in FASL and FAS impair Fas-dependent apoptosis and cause
recessively or dominantly inherited autoimmune lymphoproliferative syndrome (ALPS).
Patients with ALPS typically present with no other clinical phenotype. We investigated a
large, consanguineous, multiplex kindred in which biological features of ALPS were found in
the context of severe bacterial and viral disease, recurrent hepatopathy and
encephalopathy, and cardiac malformations. By a combination of genome-wide linkage and …
Germline mutations in FASL and FAS impair Fas-dependent apoptosis and cause recessively or dominantly inherited autoimmune lymphoproliferative syndrome (ALPS). Patients with ALPS typically present with no other clinical phenotype. We investigated a large, consanguineous, multiplex kindred in which biological features of ALPS were found in the context of severe bacterial and viral disease, recurrent hepatopathy and encephalopathy, and cardiac malformations. By a combination of genome-wide linkage and whole-exome sequencing, we identified a homozygous missense mutation in FADD, encoding the Fas-associated death domain protein (FADD), in the patients. This FADD mutation decreases steady-state protein levels and impairs Fas-dependent apoptosis in vitro, accounting for biological ALPS phenotypes in vivo. It also impairs Fas-independent signaling pathways. The observed bacterial infections result partly from functional hyposplenism, and viral infections result from impaired interferon immunity. We describe here a complex clinical disorder, its genetic basis, and some of the key mechanisms underlying its pathogenesis. Our findings highlight the key role of FADD in Fas-dependent and Fas–independent signaling pathways in humans.
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