title: Clinical features, STAT3 gene mutations and Th17 cell analysis in nine children with hyper-IgE syndrome in mainland China.
abstract: Hyper-IgE syndrome (HIES) is a rare primary immunodeficiency disease characterized by eczema, recurrent staphylococcal aureus skin abscesses, pneumonia with pneumatocele formation, remarkably high serum IgE levels, eosinophilia and involvement of skeleton and connective tissues. Heterozygous signal transducer and activator of transcription 3 (STAT3) mutations were shown to be the cause of autosomal dominant HIES (AD-HIES). In this study, we diagnosed nine patients with HIES from 9 unrelated families on the basis of a National Institutes of Health (NIH) score of ≥40 points, sequenced the STAT3 gene of all nine patients, and quantified Th17 cells in peripheral blood of seven patients by flow cytometry in mainland China. All nine patients had characteristic manifestation of HIES with the range of NIH scores 45-77 points. STAT3 hot mutations V637M or R382W/Q were identified in five patients. We identified two novel heterozygous missense mutations (T620S and R609G) located in Src homology 2 (SH2) domain in two patients, respectively. In two other patients, no STAT3 mutations were found. Quantified Th17 cell numbers were markedly decreased or absent (0-0.28% of CD4(+) T cells) in six patients with STAT3 mutations and almost normal (0.53% of CD4(+) T cells) in one wild-type STAT3 patient compared with healthy controls (0.40-2.25% of CD4(+) T cells). These results suggest that not all patients with HIES who had NIH scores over 40 points carry STAT3 mutations, those whose Th17 cell numbers strikingly decreased probably had AD-HIES with STAT3 mutations.
authors: Clinical Immunology Laboratory, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors: L-Y
authors: LY
authors: Zhang
authors: W
authors: W
authors: Tian
authors: L
authors: L
authors: Shu
authors: L-P
authors: LP
authors: Jiang
authors: Y-Z
authors: YZ
authors: Zhan
authors: W
authors: W
authors: Liu
authors: X-D
authors: XD
authors: Zhao
authors: Y-X
authors: YX
authors: Cui
authors: X-M
authors: XM
authors: Tang
authors: M
authors: M
authors: Wang
authors: D-Q
authors: DQ
authors: Wu
authors: X-Q
authors: XQ
authors: Yang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D020662:Guanine Nucleotide Exchange Factors / Q000235:genetics; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D007589:Job Syndrome / Q000235:genetics* / Q000276:immunology* / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D050796:STAT3 Transcription Factor / Q000235:genetics*; D013203:Staphylococcal Infections; D058504:Th17 Cells / Q000276:immunology*
chemical_list: C516591:DOCK8 protein, human; D020662:Guanine Nucleotide Exchange Factors; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human; D007073:Immunoglobulin E