Early-onset pulmonary and cutaneous vasculitis driven by constitutively active SRC-family kinase HCK

Research output: Contribution to journalCase reportContributedpeer-review

Contributors

  • Veronika Kanderova - , Charles University Prague (Author)
  • Tamara Svobodova - , Charles University Prague (Author)
  • Simon Borna - , Czech Academy of Sciences (Author)
  • Martina Fejtkova - , Charles University Prague (Author)
  • Vendula Martinu - , Charles University Prague (Author)
  • Jana Paderova - , Charles University Prague (Author)
  • Michael Svaton - , Charles University Prague (Author)
  • Jarmila Kralova - , Czech Academy of Sciences (Author)
  • Eva Fronkova - , Charles University Prague (Author)
  • Adam Klocperk - , Charles University Prague (Author)
  • Stepanka Pruhova - , Charles University Prague (Author)
  • Min Ae Lee-Kirsch - , Department of Paediatrics (Author)
  • Ludmila Hornofova - , Charles University Prague (Author)
  • Miroslav Koblizek - , Charles University Prague (Author)
  • Petr Novak - , Charles University Prague (Author)
  • Olga Zimmermannova - , Charles University Prague (Author)
  • Zuzana Parackova - , Charles University Prague (Author)
  • Anna Sediva - , Charles University Prague (Author)
  • Tomas Kalina - , Charles University Prague (Author)
  • Ales Janda - , Ulm University (Author)
  • Jana Kayserova - , Horovice Hospital (Author)
  • Marcela Dvorakova - , Charles University Prague (Author)
  • Milan Macek - , Charles University Prague (Author)
  • Petr Pohunek - , Charles University Prague (Author)
  • Petr Sedlacek - , Charles University Prague (Author)
  • Ashleigh Poh - , La Trobe University (Author)
  • Matthias Ernst - , La Trobe University (Author)
  • Tomas Brdicka - , Czech Academy of Sciences (Author)
  • Ondrej Hrusak - , Charles University Prague (Author)
  • Jan Lebl - , Charles University Prague (Author)

Abstract

Background: Inborn errors of immunity are genetic disorders characterized by various degrees of immune dysregulation that can manifest as immune deficiency, autoimmunity, or autoinflammation. The routine use of next-generation sequencing in the clinic has facilitated the identification of an ever-increasing number of inborn errors of immunity, revealing the roles of immunologically important genes in human pathologies. However, despite this progress, treatment is still extremely challenging. Objective: We sought to report a new monogenic autoinflammatory disorder caused by a de novo activating mutation, p.Tyr515∗, in hematopoietic cell kinase (HCK). The disease is characterized by cutaneous vasculitis and chronic pulmonary inflammation that progresses to fibrosis. Methods: Whole-exome sequencing, Sanger sequencing, mass spectrometry, and western blotting were performed to identify and characterize the pathogenic HCK mutation. Dysregulation of mutant HCK was confirmed ex vivo in primary cells and in vitro in transduced cell lines. Results: Mutant HCK lacking the C-terminal inhibitory tyrosine Tyr522 exhibited increased kinase activity and enhanced myeloid cell priming, migration and effector functions, such as production of the inflammatory cytokines IL-1β, IL-6, IL-8, and TNF-α, and production of reactive oxygen species. These aberrant functions were reflected by inflammatory leukocyte infiltration of the lungs and skin. Moreover, an overview of the clinical course of the disease, including therapies, provides evidence for the therapeutic efficacy of the Janus kinase 1/2 inhibitor ruxolitinib in inflammatory lung disease. Conclusions: We propose HCK-driven pulmonary and cutaneous vasculitis as a novel autoinflammatory disorder of inborn errors of immunity.

Details

Original languageEnglish
Pages (from-to)1464-1472.e3
JournalJournal of allergy and clinical immunology
Volume149
Issue number4
Publication statusPublished - Apr 2022
Peer-reviewedYes

External IDs

PubMed 34536415

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • autoinflammation, cutaneous vasculitis, hematopoietic cell kinase, inborn error of immunity, inflammatory cytokines, pulmonary hemorrhage, reactive oxygen species, ruxolitinib, SRC-family kinase