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pubmed-article:21109225pubmed:abstractTextGermline mutations in FASL and FAS impair Fas-dependent apoptosis and cause recessively or dominantly inherited autoimmune lymphoproliferative syndrome (ALPS). Patients with ALPS typically present with no other clinical phenotype. We investigated a large, consanguineous, multiplex kindred in which biological features of ALPS were found in the context of severe bacterial and viral disease, recurrent hepatopathy and encephalopathy, and cardiac malformations. By a combination of genome-wide linkage and whole-exome sequencing, we identified a homozygous missense mutation in FADD, encoding the Fas-associated death domain protein (FADD), in the patients. This FADD mutation decreases steady-state protein levels and impairs Fas-dependent apoptosis in vitro, accounting for biological ALPS phenotypes in vivo. It also impairs Fas-independent signaling pathways. The observed bacterial infections result partly from functional hyposplenism, and viral infections result from impaired interferon immunity. We describe here a complex clinical disorder, its genetic basis, and some of the key mechanisms underlying its pathogenesis. Our findings highlight the key role of FADD in Fas-dependent and Fas-independent signaling pathways in humans.lld:pubmed
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pubmed-article:21109225pubmed:copyrightInfoCopyright © 2010 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.lld:pubmed
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pubmed-article:21109225pubmed:articleTitleWhole-exome-sequencing-based discovery of human FADD deficiency.lld:pubmed
pubmed-article:21109225pubmed:affiliationThe Rockefeller University, New York, NY 10065, USA.lld:pubmed
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