Mutations disrupting the kinase domain of IKKα lead to immunodeficiency and immune dysregulation in humans

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Riller, Quentin | Sorin, Boris | Courteille, Charline | Ho-Nhat, Duong | Le Voyer, Tom | Debray, Jean-Christophe | Stolzenberg, Marie-Claude | Schmutz, Muriel | Pellé, Olivier | Becquard, Thomas | Rodrigo Riestra, María | Berteloot, Laureline | Migaud, Mélanie | Delage, Laure | Jeanpierre, Marie | Boussard, Charlotte | Brunaud, Camille | Magérus, Aude | Bretot, Charles | Michel, Victor | Roux, Camille | Picard, Capucine | Masson, Cécile | Bole-Feysot, Christine | Cagnard, Nicolas | Corneau, Aurélien | Meyts, Isabelle | Baud, Véronique | Casanova, Jean-Laurent | Fischer, Alain | Dejardin, Emmanuel | Puel, Anne | Boulanger, Cécile | Neven, Bénédicte | Rieux-Laucat, Frédéric

Edité par CCSD ; Rockefeller University Press -

International audience. IKKα, encoded by CHUK, is crucial in the non-canonical NF-κB pathway and part of the IKK complex activating the canonical pathway alongside IKKβ. The absence of IKKα causes fetal encasement syndrome in humans, fatal in utero, while an impaired IKKα-NIK interaction was reported in a single patient and causes combined immunodeficiency. Here, we describe compound heterozygous variants in the kinase domain of IKKα in a female patient with hypogammaglobulinemia, recurrent lung infections, and Hay–Wells syndrome-like features. We showed that both variants were loss-of-function. Non-canonical NF-κB activation was profoundly diminished in stromal and immune cells while the canonical pathway was unexpectedly partially impaired. Reintroducing wt CHUK restored non-canonical NF-κB activation. The patient had neutralizing autoantibodies against type I IFN, akin to non-canonical NF-κB pathway deficiencies. Thus, this is the first case of biallelic CHUK mutations disrupting IKKα kinase function, broadening non-canonical NF-κB defect understanding, and suggesting IKKα’s role in canonical NF-κB target gene expression in humans.

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