An exome sequencing strategy employed to identify pathogenic variants in patients with pediatric-onset systemic lupus or Evans syndrome resulted in the discovery of six novel monoallelic mutations in PTPN2. PTPN2 is a phosphatase that acts as an essential negative regulator of the JAK/STAT pathways. All mutations led to a loss of PTPN2 regulatory function as evidenced by in vitro assays and by hyperproliferation of patients’ T cells. Furthermore, patients exhibited high serum levels of inflammatory cytokines, mimicking the profile observed in individuals with gain-of-function mutations in STAT factors. Flow cytometry analysis of patients’ blood cells revealed typical alterations associated with autoimmunity and all patients presented with autoantibodies. These findings further supported the notion that a loss of function in negative regulators of cytokine pathways can lead to a broad spectrum of autoimmune manifestations and that PTPN2 along with SOCS1 haploinsufficiency constitute a new group of monogenic autoimmune diseases that can benefit from targeted therapy.
Haploinsufficiency in PTPN2 leads to early-onset systemic autoimmunity from Evans syndrome to lupus
M. Jeanpiere and J. Cognard contributed equally to this paper and share first authorship.
F. Rieux-Laucat, A. Belot, and A.-L. Mathieu share last authorship.
Disclosures: E. Crickx reported personal fees from Novartis, Amgen, UCB, and Sanofi outside the submitted work. A. Belot reported grants from Boehringer Ingelheim and personal fees from Abbvie, Kabi, and GlaxoSmithKline during the conduct of the study. No other disclosures were reported.
- Award Id(s): ANR-10-IAHU-01,ANR-18-RHUS-0010,ANR-14-CE14-0026-01,ANR-18-CE17-0001,ANR-22-CE15-0047-02,ANR-21-CE17-0064,ANR-21-RHUS-08
- Award Id(s): EQU202103012670
- Award Id(s): 01057100
Marie Jeanpierre, Jade Cognard, Maud Tusseau, Quentin Riller, Linh-Chi Bui, Jérémy Berthelet, Audrey Laurent, Etienne Crickx, Marianna Parlato, Marie-Claude Stolzenberg, Felipe Suarez, Guy Leverger, Nathalie Aladjidi, Sophie Collardeau-Frachon, Christine Pietrement, Marion Malphettes, Antoine Froissart, Christine Bole-Feysot, Nicolas Cagnard, Fernando Rodrigues Lima, Thierry Walzer, Frédéric Rieux-Laucat, Alexandre Belot, Anne-Laure Mathieu; Haploinsufficiency in PTPN2 leads to early-onset systemic autoimmunity from Evans syndrome to lupus. J Exp Med 2 September 2024; 221 (9): e20232337. doi: https://doi.org/10.1084/jem.20232337
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