EXTL3 mutations cause skeletal dysplasia, immune deficiency, and developmental delay

نویسندگان

  • Stefano Volpi
  • Yasuhiro Yamazaki
  • Patrick M Brauer
  • Ellen van Rooijen
  • Atsuko Hayashida
  • Anne Slavotinek
  • Hye Sun Kuehn
  • Maja Di Rocco
  • Carlo Rivolta
  • Ileana Bortolomai
  • Likun Du
  • Kerstin Felgentreff
  • Lisa Ott de Bruin
  • Kazutaka Hayashida
  • George Freedman
  • Genni Enza Marcovecchio
  • Kelly Capuder
  • Prisni Rath
  • Nicole Luche
  • Elliott J Hagedorn
  • Antonella Buoncompagni
  • Beryl Royer-Bertrand
  • Silvia Giliani
  • Pietro Luigi Poliani
  • Luisa Imberti
  • Kerry Dobbs
  • Fabienne E Poulain
  • Alberto Martini
  • John Manis
  • Robert J Linhardt
  • Marita Bosticardo
  • Sergio Damian Rosenzweig
  • Hane Lee
  • Jennifer M Puck
  • Juan Carlos Zúñiga-Pflücker
  • Leonard Zon
  • Pyong Woo Park
  • Andrea Superti-Furga
  • Luigi D Notarangelo
چکیده

We studied three patients with severe skeletal dysplasia, T cell immunodeficiency, and developmental delay. Whole-exome sequencing revealed homozygous missense mutations affecting exostosin-like 3 (EXTL3), a glycosyltransferase involved in heparan sulfate (HS) biosynthesis. Patient-derived fibroblasts showed abnormal HS composition and altered fibroblast growth factor 2 signaling, which was rescued by overexpression of wild-type EXTL3 cDNA. Interleukin-2-mediated STAT5 phosphorylation in patients' lymphocytes was markedly reduced. Interbreeding of the extl3-mutant zebrafish (box) with Tg(rag2:green fluorescent protein) transgenic zebrafish revealed defective thymopoiesis, which was rescued by injection of wild-type human EXTL3 RNA. Targeted differentiation of patient-derived induced pluripotent stem cells showed a reduced expansion of lymphohematopoietic progenitor cells and defects of thymic epithelial progenitor cell differentiation. These data identify EXTL3 mutations as a novel cause of severe immune deficiency with skeletal dysplasia and developmental delay and underline a crucial role of HS in thymopoiesis and skeletal and brain development.

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عنوان ژورنال:

دوره 214  شماره 

صفحات  -

تاریخ انتشار 2017