临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (1): 74-.doi: 10.3969/j.issn.1000-3606.2021.01.018

• 继续医学教育 • 上一篇    下一篇

CARD11基因变异所致原发性免疫缺陷病研究进展

胡文慧,黄瑛   

  1. 复旦大学附属儿科医院消化科(上海 201102)
  • 出版日期:2021-01-15 发布日期:2021-01-15

Research progress in primary immunodeficiency disease caused by CARD11 mutation

HU Wenhui, HUANG Ying   

  1. Division of Gastroenterology, Children’s Hospital of Fudan University, Shanghai 201102 , China
  • Online:2021-01-15 Published:2021-01-15

摘要: 半胱天冬酶募集结构域11(CARD11)基因编码一种支架蛋白,在T细胞和B细胞抗原识别受体参与的多条信 号通路中起重要作用,包括核转录因子、c-Jun氨基末端激酶、哺乳动物雷帕霉素靶蛋白信号通路。该基因胚系变异可引起 3种不同的原发性免疫缺陷病,包括重症联合免疫缺陷(双等位基因功能缺失性变异)、NF-κB相关B细胞增殖和T细胞 失能性疾病(杂合功能获得性变异)和严重特应性疾病(杂合显性负性变异)。由于CARD11不同胚系变异所致疾病临床表 现迥然,因此有必要对罕见变异进行功能验证实验以确定其致病性。本文综述CARD 11变异相关疾病的基因型、临床和免 疫表型、治疗等。

关键词: CARD11; 原发性免疫缺陷; 特应性疾病

Abstract: The Caspase activation and recruitment domain 11 (CARD 11 ) encodes a scaffold protein which plays an important role in multiple signaling pathways participated by antigen recognition receptors of T cells and B cells, including nuclear transcription factors, c-Jun N-terminal kinase and mammalian rapamycin target protein signaling pathway. The germline variation of CARD11 causes three different primary immunodeficiency diseases, including profound combined immunodeficiency (biallelic loss-of-function mutations), B-cell expansion with nuclear factor κB and T cell anergy (heterozygous, gain-of-function mutations) and severe atopic disease with diverse immunologic phenotypes (heterozygous, dominant negative mutations). Since the clinical manifestations of diseases caused by different CARD 11 germline variations are diverse, it is necessary to conduct functional verification experiments on rare variations to determine their pathogenicity. This article reviews the genotypes, clinical and immunophenotypes, and treatments of CARD11 variant-related diseases.

Key words: CARD11 ; primary immunodeficiency; atopic disease