%0 Journal Article %T Inherited IL-12p40 Deficiency Genetic, Immunologic, and Clinical Features of 49 Patients From 30 Kindreds %+ Rockefeller University [New York] %+ CHU Necker - Enfants Malades [AP-HP] %+ Imagine - Institut des maladies génétiques (IMAGINE - U1163) %+ Service d'immuno-hématologie pédiatrique [CHU Necker] %+ King Saud University [Riyadh] (KSU) %+ King Faisal Specialist Hospital and Research Center %+ Institut Pasteur de Tunis %+ Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS) %+ Institut National de la Santé et de la Recherche Médicale (INSERM) %+ Département de Pediatrie %+ Department of Pediatrics %+ Addenbrookes Hospital %+ Shahid Beheshti University %+ Sahloul Hospital %+ Farhat Hached Hospital %+ Department of Pediatrics %+ King Fahad Med City, Dept Pediat %+ Univ Oxford, NIHR Oxford Biomed Res Ctr, Childrens Hosp, Dept Paediat %+ National University of Singapore (NUS) %+ Secur Forces Hosp, Dept Pediat %+ King Fahad Medical City %+ Univ Tehran Med Sci, Pediat Infect Dis Res Ctr %+ Université Paris Descartes - Faculté de Médecine (UPD5 Médecine) %A Prando, Carolina %A Samarina, Arina %A Bustamante, Jacinta %A Boisson-Dupuis, Stephanie %A Cobat, Aurélie %A Picard, Capucine %A Alsum, Zobaida %A Al-Jumaah, Suliman %A Al-Hajjar, Sami %A Frayha, Husn %A Al-Mousa, Hamoud %A Ben-Mustapha, Imen %A Adimi, Parisa %A Feinberg, Jacqueline %A Suremain, Maylis, De %A Janniere, Lucile %A Filipe-Santos, Orchidée %A Mansouri, Nahal %A Stephan, Jean-Louis %A Nallusamy, Revathy %A Kumararatne, Dinakantha S. %A Bloorsaz, Mohamad Reza %A Ben-Ali, Meriem %A Elloumi-Zghal, Houda %A Chemli, Jalel %A Bouguila, Jihène %A Béjaoui, Mohamed %A Alaki, Emadia %A Alfawaz, Tariq S. %A Al Idrissi, Eman %A Elghazali, Gehad %A Pollard, Andrew J. %A Murugasu, Belinda %A Lee, Bee Wah %A Halwani, Rabih %A Al-Zahrani, Mohammed %A Al Shehri, Mohammed A. %A Al-Zahrani, Mofareh %A Bin-Hussain, Ibrahim %A Mahdaviani, Seyed Alireza %A Parvaneh, Nima %A Abel, Laurent %A Mansouri, Davood %A Barbouche, Mohamed-Ridha %A Al-Muhsen, Saleh %A Casanova, Jean-Laurent %Z The Laboratory of Human Genetics of Infectious Diseases is supported by institutional grants to INSERM and The Rockefeller University, and grants from the Agence Nationale de la Recherche (ANR), the European Union HOMITB (E08153KK) and NEOTIM (018736), the St. Giles Foundation, the Thrasher Research Fund, the Jeffrey Modell Foundation, Talecris Biotherapeutics, National Institutes of Health (1R01AI089970-01) %< avec comité de lecture %@ 0025-7974 %J Medicine %I Lippincott, Williams & Wilkins %V 92 %N 2 %P 109-122 %8 2013-03 %D 2013 %R 10.1097/MD.0b013e31828a01f9 %M 23429356 %Z Life Sciences [q-bio] %Z Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism %Z Life Sciences [q-bio]/GeneticsJournal articles %X Autosomal recessive interleukin (IL)-12 p40 (IL-12p40) deficiency is a rare genetic etiology of Mendelian susceptibility to mycobacterial disease (MSMD). We report the genetic, immunologic, and clinical features of 49 patients from 30 kindreds originating from 5 countries (India, Iran, Pakistan, Saudi Arabia, and Tunisia). There are only 9 different mutant alleles of the IL12B gene: 2 small insertions, 3 small deletions, 2 splice site mutations, and 1 large deletion, each causing a frameshift and leading to a premature stop codon, and 1 nonsense mutation. Four of these 9 variants are recurrent, affecting 25 of the 30 reported kindreds, due to founder effects in specific countries. All patients are homozygous and display complete IL-12p40 deficiency. As a result, the patients lack detectable IL-12p70 and IL-12p40 and have low levels of interferon gamma (IFN-gamma). The clinical features are characterized by childhood onset of bacille Calmette-Guerin (attenuated Mycobacterium bovis strain) (BCG) and Salmonella infections, with recurrences of salmonellosis (36.4%) more common than recurrences of mycobacterial disease (25%). BCG vaccination led to BCG disease in 40 of the 41 patients vaccinated (97.5%). Multiple mycobacterial infections were rare, observed in only 3 patients, whereas the association of salmonellosis and mycobacteriosis was observed in 9 patients. A few other infections were diagnosed, including chronic mucocutaneous candidiasis (n = 3), nocardiosis (n = 2), and klebsiellosis (n = 1). IL-12p40 deficiency has a high but incomplete clinical penetrance, with 33.3% of genetically affected relatives of index cases showing no symptoms. However, the prognosis is poor, with mortality rates of up to 28.6%. Overall, the clinical phenotype of IL-12p40 deficiency closely resembles that of interleukin 12 receptor beta 1 (IL-12R beta 1) deficiency. In conclusion, IL-12p40 deficiency is more common than initially thought and should be considered worldwide in patients with MSMD and other intramacrophagic infectious diseases, salmonellosis in particular. (Medicine 2013; 92: 109-122) %G English %L pasteur-01375115 %U https://riip.hal.science/pasteur-01375115 %~ UNIV-ST-ETIENNE %~ UNIV-PARIS5 %~ RIIP %~ APHP %~ RIIP_TUNIS %~ OPENAIRE %~ CHU-UNIV-PARIS5 %~ UDL %~ UNIV-PARIS %~ UP-SANTE