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Immunogenetics associated with severe coccidioidomycosis.


ABSTRACT: Disseminated coccidioidomycosis (DCM) is caused by Coccidioides, pathogenic fungi endemic to the Southwestern United States and Mexico. Illness occurs in approximately 30% of those infected, <1% of whom develop disseminated disease. To address why some individuals allow dissemination, we enrolled DCM patients and performed whole-exome sequencing. In an exploratory set of 67 DCM patients, two had haploinsufficient STAT3 mutations, while defects in β-glucan sensing and response were seen in 34/67 (50.7%) cases. Damaging CLEC7A (n=14) and PLCG2 (n=11) variants were associated with impaired production of β-glucan-stimulated TNF-α from peripheral blood mononuclear cells compared to healthy controls (P<0.005). Using ancestry-matched controls, damaging CLEC7A and PLCG2 variants were over-represented in DCM (P=0.0206, P=0.015, respectively) including CLEC7A Y238* (P=0.0105) and PLCG2 R268W (P=0.0025). A validation cohort of 111 DCM patients confirmed PLCG2 R268W (P=0.0276), CLEC7A I223S (P=0.044), and CLEC7A Y238* (P=0.0656). Stimulation with a DECTIN-1 agonist induced DUOX1/DUOXA1-derived H2O2 in transfected cells. Heterozygous DUOX1 or DUOXA1 variants which impaired H2O2 production were overrepresented in discovery and validation cohorts. Patients with DCM have impaired β-glucan sensing or response affecting TNF-α and H2O2 production. Impaired Coccidioides recognition and decreased cellular response are associated with disseminated coccidioidomycosis.

SUBMITTER: Hsu AP 

PROVIDER: S-EPMC9746810 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Immunogenetics associated with severe coccidioidomycosis.

Hsu Amy P AP   Korzeniowska Agnieszka A   Aguilar Cynthia C CC   Gu Jingwen J   Karlins Eric E   Oler Andrew J AJ   Chen Gang G   Reynoso Glennys V GV   Davis Joie J   Chaput Alexandria A   Peng Tao T   Sun Ling L   Lack Justin B JB   Bays Derek J DJ   Stewart Ethan R ER   Waldman Sarah E SE   Powell Daniel A DA   Donovan Fariba M FM   Desai Jigar V JV   Pouladi Nima N   Long Priel Debra A DA   Yamanaka Daisuke D   Rosenzweig Sergio D SD   Niemela Julie E JE   Stoddard Jennifer J   Freeman Alexandra F AF   Zerbe Christa S CS   Kuhns Douglas B DB   Lussier Yves A YA   Olivier Kenneth N KN   Boucher Richard C RC   Hickman Heather D HD   Frelinger Jeffrey J   Fierer Joshua J   Shubitz Lisa F LF   Leto Thomas L TL   Thompson George R GR   Galgiani John N JN   Lionakis Michail S MS   Holland Steven M SM  

JCI insight 20221122 22


Disseminated coccidioidomycosis (DCM) is caused by Coccidioides, pathogenic fungi endemic to the southwestern United States and Mexico. Illness occurs in approximately 30% of those infected, less than 1% of whom develop disseminated disease. To address why some individuals allow dissemination, we enrolled patients with DCM and performed whole-exome sequencing. In an exploratory set of 67 patients with DCM, 2 had haploinsufficient STAT3 mutations, and defects in β-glucan sensing and response were  ...[more]

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