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Dominant negative variants in ITPR3 impair T cell Ca2+ dynamics causing combined immunodeficiency
Elena Blanco1, Carme Camps2,3, Sameer Bahal1
1Molecular and Cellular Immunology, Great Ormond Street Institute of Child Health, University College London , London, UK.
Abstract:
The importance of calcium (Ca2+) as a second messenger in T cell signaling is exemplified by genetic deficiencies of STIM1 and ORAI1, which abolish store-operated Ca2+ entry (SOCE) resulting in combined immunodeficiency (CID). We report five unrelated patients with de novo missense variants in ITPR3, encoding a subunit of the inositol 1,4,5-trisphosphate receptor (IP3R), which forms a Ca2+ channel in the endoplasmic reticulum (ER) membrane responsible for the release of ER Ca2+ required to trigger SOCE, and for Ca2+ transfer to other organelles. The patients presented with CID, abnormal T cell Ca2+ homeostasis, incompletely penetrant ectodermal dysplasia, and multisystem disease. Their predominant T cell immunodeficiency is characterized by significant T cell lymphopenia, defects in late stages of thymic T cell development, and impaired function of peripheral T cells, including inadequate NF-κB- and NFAT-mediated, proliferative, and metabolic responses to activation. Pathogenicity is not due to haploinsufficiency, rather ITPR3 protein variants interfere with IP3R channel function leading to depletion of ER Ca2+ stores and blunted SOCE in T cells.
Insights
Genetic variants in ITPR3 cause combined immunodeficiency (CID) by disrupting calcium (Ca2+) signaling in T cells. This impairs T cell development and function, leading to immune system defects and multisystem disease.
Area of Science:
- Immunology
- Cell Biology
- Genetics
Background:
- Calcium (Ca2+) influx via store-operated Ca2+ entry (SOCE) is critical for T cell signaling and immune function.
- Deficiencies in STIM1 and ORAI1, key regulators of SOCE, lead to combined immunodeficiency (CID).
Purpose of the Study:
- To investigate the role of inositol 1,4,5-trisphosphate receptor (IP3R) in T cell signaling and its association with combined immunodeficiency (CID).
Main Methods:
- Genetic analysis of five unrelated patients with de novo missense variants in ITPR3.
- Assessment of T cell calcium homeostasis, development, and function.
- Evaluation of endoplasmic reticulum (ER) Ca2+ stores and SOCE.
Main Results:
- Identified de novo missense variants in ITPR3 in patients presenting with CID, abnormal T cell Ca2+ homeostasis, ectodermal dysplasia, and multisystem disease.
- Observed significant T cell lymphopenia, impaired thymic T cell development, and defective peripheral T cell responses (NF-κB, NFAT, proliferation, metabolism).
- Demonstrated that ITPR3 variants impair IP3R channel function, leading to ER Ca2+ depletion and blunted SOCE in T cells.
Conclusions:
- De novo variants in ITPR3 cause a distinct form of combined immunodeficiency (CID) by disrupting T cell calcium signaling.
- ITPR3 variants lead to impaired T cell development and function through defective ER Ca2+ release and blunted SOCE.
- This study highlights the crucial role of IP3R-mediated calcium release in T cell immunity and overall health.
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