Clinical, immunological, molecular and therapeutic findings in monogenic immune dysregulation diseases: Middle East and North Africa registry
Mahnaz Jamee 1, Gholamreza Azizi 2, Safa Baris 3, Elif Karakoc-Aydiner 3, Ahmet Ozen 3, Sara Ş Kiliç 4, Hulya Kose 4, Zahra Chavoshzadeh 5, Seyed Alireza Mahdaviani 6, Tooba Momen 7, Bibi Shahin Shamsian 8, Mazdak Fallahi 5, Samin Sharafian 5, Nesrin Gülez 9, Ayşe Aygun 10, Neslihan Edeer Karaca 10, Necil Kutukculer 10, Nashat Al Sukait 11, Tariq Al Farsi 11, Salem Al-Tamemi 12, Nisreen Khalifa 13, Reda Shereen 14, Dalia El-Ghoneimy 14, Rasha El-Owaidy 14, Nesrine Radwan 14, Raed Alzyoud 15, Mohamed-Ridha Barbouche 16, Imen Ben-Mustapha 17, Najla Mekki 17, Afef Rais 17, Rachida Boukari 18, Reda Belbouab 18, Kamel Djenouhat 19, Azzeddine Tahiat 19, Souad Touri 20, Gehad Elghazali 21, Suleiman Al-Hammadi 22, Hiba Mohammed Shendi 23, Amna Alkuwaiti 23, Brahim Belaid 24, Reda Djidjik 24, Hasibe Artac 25, Mehdi Adeli 26, Ali Sobh 27, Marwa H Elnagdy 27, Sara A Bahgat 27, Gulnara Nasrullayeva 28, Janet Chou 29, Nima Rezaei 30, Waleed Al-Herz 31, Raif S Geha 29, Hassan Abolhassani 32; MENA-I. E. I. Study Group
Affiliations
Affiliations
- Immunology and Allergy Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Pediatric Nephrology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: azizi@abzums.ac.ir.
- Marmara University School of Medicine, Division of Allergy and Immunology, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Marmara University School of Medicine, İstanbul, Turkey; Istanbul Jeffrey Modell Foundation Diagnostic Center for Primary Immune Deficiencies, Istanbul, Turkey.
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Uludağ University, Faculty of Medicine, Bursa, Turkey.
- Immunology and Allergy Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Asthma, Allergy and Clinical Immunology, Child Growth and Development Research Center, Research Institute of Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Division of Pediatric Allergy and Immunology, University of Health Sciences, Dr. Behcet Uz Children's Education and Research Hospital, Izmir, Turkey.
- Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey.
- Department of Pediatric Allergy and Clinical Immunology, The Royal Hospital, Muscat, Oman.
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
- NBK Children's Hospital, Kuwait City, Kuwait.
- The pediatric allergy immunology and rheumatology unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- Allergy, Immunology, and Rheumatology, Queen Rania Children's Hospital, Amman, Jordan.
- Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Department of Immunology, Institut Pasteur de Tunis and University Tunis El Manar, Tunis, Tunisia.
- Department of Pediatrics, University Hospital of Mustapha Pacha, Algiers, Algeria.
- Laboratory of Immunology, Department of Medical Biology, Rouiba Hospital, University of Algiers, Algiers, Algeria.
- Department of Pediatrics, University Hospital of Blida, Blida, Algeria.
- Department of Immunology, Sheikh Khalifa Medical City- Union 71/Purehealth, and Faculty of Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.
- College of Medicine, Mohammed Bin Rashid University for Medicine and Health Sciences, Dubai, United Arab Emirates.
- Department of Pediatrics, Tawam Hospital, Al-Ain, United Arab Emirates.
- Department of Medical Immunology, University Hospital Center of Beni Messous, University of Algiers, Algiers, Algeria.
- Division of Immunology and Allergy, Department of Pediatrics, Selcuk University Faculty of Medicine, Konya, Turkey.
- Allergy and Immunology Division, Pediatrics Department, Sidra Medicine, Doha, Qatar.
- Department of Pediatrics, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
- Department Immunology Research Laboratory, Azerbaijan Medical University, Baku, Azerbaijan.
- Division of Immunology, Boston Children's Hospital and Harvard Medical School, 1 Blackfan Circle, Karp, Building, Boston, Massachusetts, USA.
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Pediatrics, Faculty of Medicine, Kuwait University, Safat, Kuwait City, Kuwait; Allergy and Clinical Immunology Unit, Pediatric Department, Al-Sabah Hospital, Kuwait City, Kuwait.
- Immunology and Allergy Department, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden. Electronic address: hassan.abolhassani@ki.se.
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Pediatric Rheumatology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Collaborators
- MENA-I. E. I. Study Group:
Seyed Erfan Rasouli 33, Marzie Esmaeili 30, Reza Yazdani 30, Samaneh Delavari 30, Marzieh Tavakol 33, Homa Sadri 33, Abdollah Karimi 34, Reza Shiari 35, Samin Alavi 8, Delara Babaie 5, Peyman Eshghi 8, Shahnaz Armin 34, Ahmad Vosughimotlagh 36, Sevgi Bilgic Eltan 3, Royala Babayeva 3, Asena Pinar Sefer 3, Burcu Kolukisa 3, Ezgi Yalcin Gungoren 3, Melek Yorgun Altunbas 3, Vafa Mammadova 28
Abstract
Monogenic immune dysregulation diseases (MIDD) are caused by defective immunotolerance. This study was designed to increase knowledge on the prevalence and spectrum of MIDDs, genetic patterns, and outcomes in Middle East and North Africa (MENA). MIDD patients from 11 MENA countries (Iran, Turkey, Kuwait, Oman, Algeria, Egypt, United Arab Emirates, Tunisia, Jordan, Qatar, and Azerbaijan) were retrospectively evaluated. 343 MIDD patients (58% males and 42% female) at a median (IQR) age of 101 (42-192) months were enrolled. The most common defective genes were LRBA (23.9%), LYST (8.2%), and RAB27A (7.9%). The most prevalent initial and overall manifestations were infections (32.2% and 75.1%), autoimmunity (18.6% and 41%), and organomegaly (13.3% and 53.8%), respectively. Treatments included immunoglobulin replacement therapy (53%), hematopoietic stem cell transplantation (HSCT) (14.3%), immunosuppressives (36.7%), and surgery (3.5%). Twenty-nine (59.2%) patients survived HSCT. Along with infectious complications, autoimmunity and organomegaly may be the initial or predominant manifestations of MIDD.
Keywords: Autoimmune disorders; Genetic; Immune dysregulation; Inborn errors of immunity; Lymphoproliferation; Primary immunodeficiency.
Conflict of interest statement
Declaration of Competing Interest The authors have no conflicts of interest to declare that are relevant to the content of this article.
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