2019
DOI: 10.1084/jem.20191336
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Activated PI3Kδ breaches multiple B cell tolerance checkpoints and causes autoantibody production

Abstract: Antibody-mediated autoimmune diseases are a major health burden. However, our understanding of how self-reactive B cells escape self-tolerance checkpoints to secrete pathogenic autoantibodies remains incomplete. Here, we demonstrate that patients with monogenic immune dysregulation caused by gain-of-function mutations in PIK3CD, encoding the p110δ catalytic subunit of phosphoinositide 3-kinase (PI3K), have highly penetrant secretion of autoreactive IgM antibodies. In mice with the corresponding heterozygous Pi… Show more

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Cited by 38 publications
(51 citation statements)
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“…Another example of a PID with a B cell specific break in self-tolerance are patients with gain-of-function mutations in PIK3CD, encoding the p110δ catalytic subunit of phosphoinositide 3-kinase (PI3K), who present with production of germline autoreactive IgM antibodies ( 119 ). PI3K expression has been shown to be increased in cGvHD patients ( 120 ).…”
Section: The Role Of B Cell Mediated Autoimmunitymentioning
confidence: 99%
“…Another example of a PID with a B cell specific break in self-tolerance are patients with gain-of-function mutations in PIK3CD, encoding the p110δ catalytic subunit of phosphoinositide 3-kinase (PI3K), who present with production of germline autoreactive IgM antibodies ( 119 ). PI3K expression has been shown to be increased in cGvHD patients ( 120 ).…”
Section: The Role Of B Cell Mediated Autoimmunitymentioning
confidence: 99%
“…Most APDS patients present with an increase in circulating transitional B cells, as well as reduced numbers of class-switched B cells. In addition to clear B cell-intrinsic effects of APDS-associated mutations 45 47 , 55 , the defects in humoral immunity could also be due in part to the elevated numbers of Tfh cells and disorganized germinal centers found within the secondary lymphoid organs of APDS patients 56 . Within the germinal center, the signals that drive the Tfh program also initiate the expression of ICOS and migration towards the T-B border zone.…”
Section: Lessons From Activated Pi3kδ Syndromementioning
confidence: 99%
“…Downstream of PI3K activation, FOXO factors are inactivated in developing B cells ( Fruman and Bismuth, 2009 ; Zhang et al, 2011 ). Therefore, RANK-mediated PI3K activation at B cell selection checkpoints could in theory prevent proper FOXO-mediated induction of the proapoptotic molecule Bim, which results in the survival of autoreactive B cells ( Arron et al, 2001 ; Enders et al, 2003 ; Lau et al, 2020 ; Wong et al, 1999 ). This is likely one mechanism by which forced RANK K240E signaling can disrupt B cell tolerance.…”
Section: Discussionmentioning
confidence: 99%