Somatic mutations and T-cell clonality in patients with immunodeficiency

Haematologica. 2020 Dec 1;105(12):2757-2768. doi: 10.3324/haematol.2019.220889.

Abstract

Common variable immunodeficiency and other late-onset immunodeficiencies often co-manifest with autoimmunity and lymphoproliferation. The pathogenesis of most cases is elusive, as only a minor subset harbors known monogenic germline causes. The involvement of both B and T cells is however implicated. To study whether somatic mutations in CD4+ and CD8+ T cells associate with immunodeficiency, we recruited 17 patients and 21 healthy controls. Eight patients had late-onset common variable immunodeficiency and nine patients other immunodeficiency and/or severe autoimmunity. In total, autoimmunity occurred in 94% and lymphoproliferation in 65%. We performed deep sequencing of 2533 immune-associated genes from CD4+ and CD8+ cells. Deep T-cell receptor beta sequencing was used to characterize CD4+ and CD8+ T-cell receptor repertoires. The prevalence of somatic mutations was 65% in all immunodeficiency patients, 75% in common variable immunodeficiency and 48% in controls. Clonal hematopoiesis-associated variants in both CD4+ and CD8+ cells occurred in 24% of immunodeficiency patients. Results demonstrated mutations in known tumor suppressors, oncogenes, and genes that are critical for immune- and proliferative functions, such as STAT5B (two patients), C5AR1 (two patients), KRAS (one patient), and NOD2 (one patient). Additionally, as a marker of T-cell receptor repertoire perturbation, common variable immunodeficiency patients harbored increased frequencies of clones with identical complementarity determining region 3 sequences despite unique nucleotide sequences when compared to controls. In conclusion, somatic mutations in genes implicated for autoimmunity and lymphoproliferation are common in CD4+ and CD8+ cells of patients with immunodeficiency. They may contribute to immune dysregulation in a subset of immunodeficiency patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • CD4-Positive T-Lymphocytes
  • CD8-Positive T-Lymphocytes
  • Complementarity Determining Regions / genetics
  • Humans
  • Immunologic Deficiency Syndromes*
  • Mutation
  • Receptors, Antigen, T-Cell, alpha-beta / genetics

Substances

  • Complementarity Determining Regions
  • Receptors, Antigen, T-Cell, alpha-beta

Grants and funding

Funding: This work was supported by the European Research Council (M-IMM project), the ERAPerMed consortium ‘JAKSTAT-TARGET, Academy of Finland, Finnish special governmental subsidy for health sciences, research and training, the Sigrid Juselius Foundation, the Instrumentarium Science Foundation, the Finnish Cancer Societies, the Finnish Cancer Institute, the Biomedicum Helsinki Foundation, the Finnish Medical Foundation, the Orion Research Foundation, the Juhani Aho Foundation, the K. Albin Johansson Foundation, the Paulo Foundation, and the Foundation for Pediatric Research.