Ectodermal dysplasia with immunodeficiency caused by a branch-point mutation in IKBKG/NEMO Sofie E. Jørgensen, MS, Pernille Bøttger, PhD, Emil Kofod-Olsen,

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Ectodermal dysplasia with immunodeficiency caused by a branch-point mutation in IKBKG/NEMO Sofie E. Jørgensen, MS, Pernille Bøttger, PhD, Emil Kofod-Olsen,

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Ectodermal dysplasia with immunodeficiency caused by a branch-point mutation in IKBKG/NEMO Sofie E. Jørgensen, MS, Pernille Bøttger, PhD, Emil Kofod-Olsen, PhD, Mette Holm, MD, PhD, Nanna Mørk, MD, Torben F. Ørntoft, MD, PhD, Uffe B.S. Sørensen, PhD, Jens Magnus Bernth-Jensen, MD, Troels Herlin, MD, DMSc, Jens Veirum, MD, PhD, Carsten S. Larsen, MD, DMSc, Lars Østergaard, MD, DMSc, Rune Hartmann, PhD, Mette Christiansen, PhD, Trine H. Mogensen, MD, PhD, DMSc Journal of Allergy and Clinical Immunology Volume 138, Issue 6, Pages 1706-1709.e4 (December 2016) DOI: 10.1016/j.jaci.2016.05.030 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Impaired NF-κB activation and inflammatory responses in patient's PBMCs. A, Clinical photos of the patient at age 9 years demonstrating characteristics of the EDA-ID phenotype, including hypothrichosis and hypodontia. B, PBMCs from the patient (P1) and control (C1) were stimulated with TNF-α or LPS for 2 hours, and whole-cell lysates were harvested and analyzed for phospho-IκBα by Luminex technology. C, Full blood from P1 and C1 was stimulated for 1 hour with TLR ligands as shown and leukocytes were stained with antihuman CD62L. D-F, PBMCs were treated with TLR ligands, HSV-1, or S pneumoniae for 16 hours followed by harvest of supernatants and measurement of TNF-α by Luminex technology. HSV-1, Herpes simplex virus type 1; MFI, mean fluorescense intensity; PMA, phorbol 12-myristate 13-acetate; UT, untreated. Journal of Allergy and Clinical Immunology 2016 138, 1706-1709.e4DOI: (10.1016/j.jaci.2016.05.030) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Identification of a novel branch-point variant in intron 4 of the IKBKG/NEMO gene. A, Pedigree demonstrating the index patient, the carrier mother, the healthy father, and 2 sisters of unknown genetic status, as well as Sanger sequencing of the IKBKG/NEMO gene in the patient and parents. B, RT-PCR analysis of NEMO transcripts (exons 2-6) from the patient (P1) and control (C3) treated as indicated. C, RT-qPCR of full-length NEMO transcripts in samples from P1 and C3 PBMCs left untreated or stimulated with Hi (heat-inactivated)-S pneumoniae, HSV-1, and LPS performed with a TaqMan primer-probe set spanning the exon 4 to 5 border. D, Schematic overview of the impact of intron 4 c.519-23A>T variant on splicing of patient pre-mRNA. The IKBKG/NEMO gene harbors nontranslated exons 1D, 1A, 1B, and 1C and coding exons 2 to 10. The intron 4 variant c.519-23A>T is indicated with an asterisk. E, Capillary electrophoresis was used to determine the distribution and fragment length of NEMO-derived transcripts. The size of p2 corresponds to NEMO ΔEx5 transcript (∼617 bp), the sizes of p3 and c3 correspond to the full-length NEMO transcript (∼770 bp), and the size of p7 corresponds to the NEMO transcript harboring unspliced intron (∼2460 bp) 4. For further details, see Table E2. F, Whole-cell lysates from P1 and controls, C1, C2, and C3, were analyzed by Western blotting for the expression of NEMO and β-actin. GAPDH, Glyceraldehyde-3-phospho-dehydrogenase; HSV-1, herpes simplex virus type 1; NTC, negative control; qPCR, quantitative PCR; UT, untreated. *P < .05; **P < .01; ***P < .005. Journal of Allergy and Clinical Immunology 2016 138, 1706-1709.e4DOI: (10.1016/j.jaci.2016.05.030) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions