[PDF][PDF] Dominant mutations in the autoimmune regulator AIRE are associated with common organ-specific autoimmune diseases

BE Oftedal, A Hellesen, MM Erichsen, E Bratland… - Immunity, 2015 - cell.com
BE Oftedal, A Hellesen, MM Erichsen, E Bratland, A Vardi, J Perheentupa, EH Kemp…
Immunity, 2015cell.com
The autoimmune regulator (AIRE) gene is crucial for establishing central immunological
tolerance and preventing autoimmunity. Mutations in AIRE cause a rare autosomal-
recessive disease, autoimmune polyendocrine syndrome type 1 (APS-1), distinguished by
multi-organ autoimmunity. We have identified multiple cases and families with mono-allelic
mutations in the first plant homeodomain (PHD1) zinc finger of AIRE that followed dominant
inheritance, typically characterized by later onset, milder phenotypes, and reduced …
Summary
The autoimmune regulator (AIRE) gene is crucial for establishing central immunological tolerance and preventing autoimmunity. Mutations in AIRE cause a rare autosomal-recessive disease, autoimmune polyendocrine syndrome type 1 (APS-1), distinguished by multi-organ autoimmunity. We have identified multiple cases and families with mono-allelic mutations in the first plant homeodomain (PHD1) zinc finger of AIRE that followed dominant inheritance, typically characterized by later onset, milder phenotypes, and reduced penetrance compared to classical APS-1. These missense PHD1 mutations suppressed gene expression driven by wild-type AIRE in a dominant-negative manner, unlike CARD or truncated AIRE mutants that lacked such dominant capacity. Exome array analysis revealed that the PHD1 dominant mutants were found with relatively high frequency (>0.0008) in mixed populations. Our results provide insight into the molecular action of AIRE and demonstrate that disease-causing mutations in the AIRE locus are more common than previously appreciated and cause more variable autoimmune phenotypes.
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