Neil Warner, Severine Vermeire, Margarida Guedes, Dirk Foell, John I. Gallin, Vimel Rattina, Dirk Roos, Matías Oleastro, Michel van Houdt, José Luis Franco, Jeanet Serafín López, Eunice Trindade, Paul Verkuijlen, Vritika Batura, Júlia Vasconcelos, Carmen Oleaga-Quintas, Peter D. Arkwright, Matthieu Bouaziz, Taco W. Kuijpers, Harry L. Malech, Esmeralda Neves, Jean-Laurent Casanova, Marcela Moncada-Vélez, Felipe Cabarcas, Andrea Bernasconi, Carlos Garcés, María Esnaola Azcoiti, Timo K. van den Berg, Isabelle Meyts, Alejandro Nieto-Patlán, Laurent Abel, Andrés Augusto Arias, Anniek Corveleyn, Laura Perez, Anton T.J. Tool, Nadine Cerf–Bensussan, Douglas B. Kuhns, Claire Booth, Stephen M. Hughes, Caroline Deswarte, Juan F. Alzate, Kunihiko Moriya, John L. van Hamme, Siobhan O. Burns, Karin van Leeuwen, Patricio Ibañez, Claas Hinze, Aleixo M. Muise, Steven M. Holland, Barbara Boardman, Jacinta Bustamante, Fabienne Charbit-Henrion, Austen Worth, Roel P. Gazendam, Martin de Boer, Mary C. Dinauer, Helmut Wittkowski, Annemarie van de Geer, Carlos Andrés Arango-Franco, Molecular cell biology and Immunology, Pediatric surgery, APH - Aging & Later Life, Amsterdam Reproduction & Development (AR&D), ACS - Pulmonary hypertension & thrombosis, Graduate School, General practice, General Paediatrics, Paediatric Infectious Diseases / Rheumatology / Immunology, and ARD - Amsterdam Reproduction and Development
Biallelic loss-of-function (LOF) mutations of the NCF4 gene, encoding the p40phox subunit of the phagocyte NADPH oxidase, have been described in only 1 patient. We report on 24 p40phox-deficient patients from 12 additional families in 8 countries. These patients display 8 different in-frame or out-of-frame mutations of NCF4 that are homozygous in 11 of the families and compound heterozygous in another. When overexpressed in NB4 neutrophil-like cells and EBV-transformed B cells in vitro, the mutant alleles were found to be LOF, with the exception of the p.R58C and c.120_134del alleles, which were hypomorphic. Particle-induced NADPH oxidase activity was severely impaired in the patients' neutrophils, whereas PMA-induced dihydrorhodamine-1,2,3 (DHR) oxidation, which is widely used as a diagnostic test for chronic granulomatous disease (CGD), was normal or mildly impaired in the patients. Moreover, the NADPH oxidase activity of EBV-transformed B cells was also severely impaired, whereas that of mononuclear phagocytes was normal. Finally, the killing of Candida albicans and Aspergillus fumigatus hyphae by neutrophils was conserved in these patients, unlike in patients with CGD. The patients suffer from hyperinflammation and peripheral infections, but they do not have any of the invasive bacterial or fungal infections seen in CGD. Inherited p40phox deficiency underlies a distinctive condition, resembling a mild, atypical form of CGD. ispartof: JOURNAL OF CLINICAL INVESTIGATION vol:128 issue:9 pages:3957-3975 ispartof: location:United States status: published