Keywords :
I-kappa B Kinase; NF-kappa B; CHUK protein, human; Humans; Female; Mutation; Agammaglobulinemia/genetics; Agammaglobulinemia/immunology; Protein Domains; Signal Transduction; HEK293 Cells; I-kappa B Kinase/genetics; I-kappa B Kinase/metabolism; NF-kappa B/metabolism; Immunologic Deficiency Syndromes/genetics; Immunologic Deficiency Syndromes/immunology
Abstract :
[en] IKKα, encoded by CHUK, is crucial in the non-canonical NF-κB pathway and part of the IKK complex activating the canonical pathway alongside IKKβ. The absence of IKKα causes fetal encasement syndrome in humans, fatal in utero, while an impaired IKKα-NIK interaction was reported in a single patient and causes combined immunodeficiency. Here, we describe compound heterozygous variants in the kinase domain of IKKα in a female patient with hypogammaglobulinemia, recurrent lung infections, and Hay-Wells syndrome-like features. We showed that both variants were loss-of-function. Non-canonical NF-κB activation was profoundly diminished in stromal and immune cells while the canonical pathway was unexpectedly partially impaired. Reintroducing wt CHUK restored non-canonical NF-κB activation. The patient had neutralizing autoantibodies against type I IFN, akin to non-canonical NF-κB pathway deficiencies. Thus, this is the first case of biallelic CHUK mutations disrupting IKKα kinase function, broadening non-canonical NF-κB defect understanding, and suggesting IKKα's role in canonical NF-κB target gene expression in humans.
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