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IUIS classification of defects in intrinsic and innate immunity (category VI inborn errors of immunity)

IUIS classification of defects in intrinsic and innate immunity (category VI inborn errors of immunity)
Disease Genetic defect Inheritance OMIM Affected cells Affected function Associated features
Mendelian susceptibility to mycobacterial disease (MSMD)
IL-12 and IL-23 receptor beta 1 chain deficiency Interleukin 12 receptor subunit beta 1 (IL12RB1) AR 601604 Lymphocytes, NK cells IFN-gamma secretion Susceptibility to mycobacteria and Salmonella
IL-12p40 (IL-12 and IL-23) deficiency Interleukin 12B (IL12B) AR 161561 Monocytes IFN-gamma secretion Susceptibility to mycobacteria and Salmonella
IL-12 receptor beta 2 deficiency Interleukin 12 receptor subunit beta 2 (IL12RB2) AR 601642 Lymphocytes, NK cells IFN-gamma secretion Susceptibility to mycobacteria and Salmonella
IL-23R deficiency Interleukin 23 receptor (IL23R) AR 607562 Lymphocytes, NK cells IFN-gamma secretion Susceptibility to mycobacteria and Salmonella
IFN-gamma receptor 1 deficiency Interferon gamma receptor 1 (IFNGR1) AR 209950 Monocytes, lymphocytes IFN-gamma binding and signaling Susceptibility to mycobacteria and Salmonella
AD 615978 Monocytes, lymphocytes IFN-gamma binding and signaling Susceptibility to mycobacteria and Salmonella
IFN-gamma receptor 2 deficiency Interferon gamma receptor 2 (IFNGR2) AR 147569 Monocytes, lymphocytes IFN-gamma signaling Susceptibility to mycobacteria and Salmonella
STAT1 deficiency Signal transducer and activator of transcription 1 (STAT1) AD LOF 614892 Monocytes, lymphocytes IFN-gamma signaling Susceptibility to mycobacteria and Salmonella
Macrophage gp91 phox deficiency Cytochrome b-245 beta chain (CYBB) XL 300645 Macrophage only Killing (faulty O2+) production Isolated susceptibility to mycobacteria
IRF8 deficiency Interferon regulatory factor 8 (IRF8) AD 614893 Monocytes, lymphocytes Impaired development of cDCs and Th1+ cells Susceptibility to mycobacterial
AR 226990 Monocytes Lack of circulating monocytes and DCs; reduced NK cell numbers and function reported in some patients Susceptibility to mycobacterial and multiple other infectious agents including EBV
SPPL2a deficiency Signal peptide peptidase-like 2A (SPPL2A) AR 608238 Monocytes, lymphocytes Impaired development of cDCs and Th1+ cells Susceptibility to mycobacterial and Salmonella
Tyk2 deficiency Tyrosine kinase 2 (TYK2) AR 611521 Monocytes, lymphocytes Impaired cellular responses to IL-10, IL-12, IL-23, and type I IFNs Susceptibility to intracellular bacteria (mycobacteria, Salmonella) and viruses
P1104A TYK2 homozygosity Tyrosine kinase 2 (TYK2) AR 176941 Lymphocytes Impaired cellular response to IL-23 MSMD or tuberculosis
ISG15 deficiency ISG15 ubiquitin-like modifier (ISG15) AR 147571   IFN-gamma production defect Susceptibility to mycobacteria (BCG), brain calcification
ROR-gamma-t deficiency RAR-related orphan receptor C (RORC) AR 602943 Lymphocytes, NK cells Lack of functional ROR-gamma-T protein; IFN-gamma production defect; complete absence of IL-17A/F-producing T cells Susceptibility to mycobacteria and Candida
JAK1 deficiency Janus kinase 1 (JAK1) AR LOF 147795 Neutrophils, lymphocytes Reduced JAK1 activation to cytokines; reduced IFN-gamma production Susceptibility to mycobacteria and viruses, urothelial carcinoma
T-bet deficiency T-box transcription factor 21 (TBX21) AR 619630 Lymphocytes Decreased IFN-gamma and TNF-alpha production by gamma-delta T cells, MAIT cells, iNKT cells, NK cells, and CD4+ T cells Susceptibility to mycobacteria
IFN-gamma deficiency Interferon gamma (IFNG) AR 618963 Lymphocytes No IFN-gamma production by patient T and NK cells Susceptibility to mycobacteria
Epidermodysplasia verruciformis (HPV)
EVER1 deficiency Transmembrane channel-like 6 (TMC6) AR 605828 Keratinocytes EVER1, EVER2, and CIB1 form a complex in keratinocytes HPV (group B1) infections and cancer of the skin (typical epidermodysplasia verruciformis)
EVER2 deficiency Transmembrane channel-like 8 (TMC8) AR 605829 Keratinocytes EVER1, EVER2, and CIB1 form a complex in keratinocytes HPV (group B1) infections and cancer of the skin (typical epidermodysplasia verruciformis)
CIB1 deficiency Calcium and integrin binding 1 (CIB1) AR 618267 Keratinocytes EVER1, EVER2, and CIB1 form a complex in keratinocytes HPV (group B1) infections and cancer of the skin (typical epidermodysplasia verruciformis)
WHIM (warts, hypogammaglobulinemia, infections, myelokathexis) syndrome C-X-C motif chemokine receptor 4 (CXCR4) AD GOF 162643 Leukocytes Increased response of the CXCR4 chemokine receptor to its ligand CXCL12 (SDF-1) Warts (HPV) infection, neutropenia, low B cell number, hypogammaglobulinemia
Predisposition to severe viral infection
STAT1 deficiency Signal transducer and activator of transcription 1 (STAT1) AR LOF 600555 Leukocytes and other cells STAT1-dependent IFN-alpha/beta, gamma, and delta responses Severe viral infections, mycobacterial infection
STAT2 deficiency Signal transducer and activator of transcription 2 (STAT2) AR 600556 Leukocytes and other cells STAT2-dependent IFN-alpha/beta and delta responses Severe viral infections (disseminated vaccine-strain measles)
IRF9 deficiency Interferon regulatory factor 9 (IRF9) AR 147574 Leukocytes and other cells IRF9- and ISGF3-dependent IFN-alpha/beta and delta responses Severe influenza disease
IRF7 deficiency Interferon regulatory factor 7 (IRF7) AR 605047 Leukocytes, plasmacytoid DCs, nonhematopoietic cells IFN-alpha, beta, and gamma production and IFN-delta production Severe influenza disease
IFNAR1 deficiency Interferon alpha and beta receptor subunit 1 (IFNAR1) AR 107450 Leukocytes and other cells IFNAR1-dependent responses to IFN-alpha/beta Severe disease cause by yellow fever vaccine and measles vaccine
IFNAR2 deficiency Interferon alpha and beta receptor subunit 2 (IFNAR2) AR 602376 Broadly expressed IFNAR2-depnent responses to IFN-alpha/beta Severe viral infections (disseminated vaccine-strain measles, HHV6)
CD16 deficiency Fc gamma receptor IIIa (FCGR3A) AR 146740 NK cells Altered NK cell function Severe herpes virus infections, particularly VZV, EBV, and HPV
MDA5 deficiency Interferon induced with helicase C domain 1 (IFIH1) AR LOF 606951 Broadly expressed Viral recognition and IFN induction Rhinovirus and other RNA viruses
NOS2 deficiency Nitric oxide synthase 2 (NOS2) AR   Myeloid cells Mutant NOS2 failed to induce nitrous oxide Severe (fatal) susceptibility to CMV-induced disease, pneumocystis pneumonia secondary to CMV, intact responses to infection with other herpes virus (EBV, VZV, HSV)
ZNFX1 deficiency Zinc finger NFX1-type containing 1 (ZNFX1) AR 619644 Broadly expressed Increased ISG in response to poly I:C Severe infections by RNA/DNA viruses, mycobacteria; early-onset severe inflammation affecting liver, brain, kidneys, lungs; virally triggered inflammatory episodes; hepatosplenomegaly, lymphadenopathy
RNA polymerase III deficiency RNA polymerase III subunit A (POLR3A) AD 614258 Leukocytes and other cells Impaired viral recognition and IFN induction in response to VZV or poly(I:C) Severe VZV infection
RNA polymerase III subunit C (POLR3C) AD 617454 Leukocytes and other cells Impaired viral recognition and IFN induction in response to VZV or poly(I:C) Severe VZV infection
RNA polymerase III subunit F (POLR3F) AD 617455 Leukocytes and other cells Impaired viral recognition and IFN induction in response to VZV or poly(I:C) Severe VZV infection
Herpes simplex encephalitis (HSE)
TLR3 deficiency Toll-like receptor 3 (TLR3) AD or AR 613002 CNS resident cells and fibroblasts TLR3-dependent IFN-alpha, beta, and gamma response HSV1 encephalitis (incomplete clinical penetrance for all etiologies listed here), severe pulmonary influenza, VZV
UNC93B1 deficiency Unc-93 homolog B1, TLR signaling regulator (UNC93B1) AR 608204 CNS resident cells and fibroblasts UNC93B-dependent IFN-alpha, beta, and gamma response HSV1 encephalitis
TRAF3 deficiency TNF receptor-associated factor 3 (TRAF3) AD 601896 CNS resident cells and fibroblasts TRAF3-dependent IFN-alpha, beta, and gamma response HSV1 encephalitis
TRIF deficiency TIR domain-containing adaptor molecule 1 (TICAM1) AD or AR 607601 CNS resident cells and fibroblasts TRIF-dependent IFN-alpha, beta, and gamma response HSV1 encephalitis
TBK1 deficiency TANK-binding kinase 1 (TBK1) AD 604834 CNS resident cells and fibroblasts TBK1-dependent IFN-alpha, beta, and gamma response HSV1 encephalitis
IRF3 deficiency Interferon regulatory factor 3 (IRF3) AD 616532 CNS resident cells and fibroblasts Low IFN-alpha/beta production in response to HSV1 and decreased IRF3 phosphorylation HSV1 encephalitis
DBR1 deficiency Debranching RNA lariats 1 (DBR1) AR 607024 CNS resident cells and fibroblasts Impaired production of antiviral IFNs HSE of the brainstem, other viral infections of the brainstem
SNORA31 deficiency Small nucleolar RNA, H/ACA box 31 (SNORA31) AD 619396 CNS resident cells and fibroblasts Impaired production of antiviral IFNs Forebrain HSV1 encephalitis
ATG4A deficiency Autophagy-related 4A cysteine peptidase (ATG4A) AD   CNS resident cells and fibroblasts Impaired HSV2-induced autophagy leading to increased viral replication and apoptosis of patient fibroblasts Mollaret meningitis (recurrent lymphocytic meningitis) due to HSV2
MAP1LC3B2 deficiency Microtubule-associated protein 1 light chain 3 beta 2 (MAP1LC3B2) AD   CNS resident cells and fibroblasts Impaired HSV2-induced autophagy leading to increased viral replication and apoptosis of patient fibroblasts Mollaret meningitis (recurrent lymphocytic meningitis) due to HSV2
Predisposition to invasive fungal diseases
CARD9 deficiency Caspase recruitment domain family member 9 (CARD9) AR 607212 Mononuclear phagocytes CARD9 signaling pathway Invasive candidiasis infection, deep dermatophytoses, other invasive fungal infections
Predisposition to mucocutaneous candidiasis
IL-17RA deficiency Interleukin 17 receptor A (IL17RA) AR 605461 Epithelial cells, fibroblasts, mononuclear phagocytes IL-17RA signaling pathway CMC, folliculitis
IL-17RC deficiency Interleukin 17 receptor C (IL17RC) AR 610925 Epithelial cells, fibroblasts, mononuclear phagocytes IL-17RC signaling pathway CMC
IL-17F deficiency Interleukin 17F (IL17F) AD 606496 T cells IL-17F-containing dimers CMC, folliculitis
STAT1 GOF Signal transducer and activator of transcription 1 (STAT1) AD GOF 600555 T cells, B cells, monocytes GOF STAT1 mutations that impair the development of IL-17-producing T cells CMC; various fungal, bacterial, and viral (HSV) infections; autoimmunity (thyroiditis, diabetes, cytopenias); enteropathy
ACT1 deficiency TRAF3 interacting protein 1 (TRAF3IP1) AR 607043 T cells, fibroblasts Fibroblasts fail to response to IL-17A and IL-17F and their T cells to IL-17E CMC, blepharitis, folliculitis and macroglossia
JNK1 haploinsufficiency Mitogen-activated protein kinase 8 (MAPK8) AD   T cells, fibroblasts Decreased Th17 cells ex vivo and in vitro; decreased responses of fibroblasts to IL-17A an IL-17F; decreased c-Jun/ATF2-dependent TGF-beta signalling CMC, connective issue disorder (similar to Ehlers-Danlos syndrome)
TLR signaling pathway deficiency with bacterial susceptibility
IRAK4 deficiency Interleukin 1 receptor-associated kinase 4 (IRAK4) AR 606883 Lymphocytes, granulocytes, monocytes TIR-IRAK4 signaling pathway Bacterial infections (pyogenes)
MyD88 deficiency MYD88 innate immune signal transduction adaptor (MYD88) AR 602170 Lymphocytes, granulocytes, monocytes TIR-MyD88 signaling pathway Bacterial infections (pyogenes)
IRAK1 deficiency Interleukin 1 receptor-associated kinase 1 (IRAK1) XL 300283 Lymphocytes, granulocytes, monocytes TIR-IRAK1 signaling pathway Bacterial infections, XL MECP2 deficiency-related syndrome due to large de novo Xq28 chromosomal deletion encompassing both MECP2 and IRAK1
TIRAP deficiency TIR domain-containing adaptor protein (TIRAP) AR 614382 Lymphocytes, granulocytes, monocytes TIRAP signaling pathway; TLR1/2, TLR2/6, and TLR4 agonists were impaired in the fibroblasts and leukocytes Staphylococcal disease during childhood
TLR7 deficiency Toll-like receptor 7 (TLR7) XL 301051 Lymphocytes, myeloid cells Impaired responses to TLR7 ligands; reduced production of type 1 IFN Severe COVID-19 infection
TLR8 GOF Toll-like receptor 8 (TLR8) XL   Myeloid cells Elevated proinflammatory serum cytokines; increased proinflammatory responses of patient myeloid cells to TLR8 agonists; reduced ability of mutant TLR8 to attenuate TLR7 signaling Early-onset severe cytopenias, hepatosplenomegaly, lymphadenopathy; progressive autoinflammatory disease
Other IEI related to nonhematopoietic tissues
Isolated congenital asplenia (ICA) Ribosomal protein SA (RPSA) AD 271400 No spleen RPSA encodes ribosomal protein SA, a component of the small subunit of the ribosome Bacteremia (encapsulated bacteria)
Heme oxygenase 1 (HMOX) AR 141250 Macrophages HMOX regulates iron recycling, and heme-dependent damage occurs Hemolysis, nephritis, inflammation
Trypanosomiasis Apolipoprotein L1 (APOL1) AD 603743 Somatic Pore-forming serum protein Trypanosomiasis
Acute liver failure due to NBAS deficiency NBAS subunit of NRZ tethering complex (NBAS) AR 608025 Somatic and hematopoietic ER stress Fever induces liver failure
Acute necrotizing encephalopathy RAN-binding protein 2 (RANBP2) AR 601181 Ubiquitous expression Nuclear poor Fever induces acute encephalopathy
Osteopetrosis Chloride voltage-gated channel 7 (CLCN7) AR 602727 Osteoclasts Secretory lysosomes Osteopetrosis with hypocalcemia, neurologic features
Sorting nexin 10 (SNX10) AR 614780 Osteoclasts Secretory lysosomes Osteopetrosis with visual impairment
Osteoclastogenesis-associated transmembrane protein 1 (OSTM1) AR 607649 Osteoclasts Secretory lysosomes Osteopetrosis with hypocalcemia, neurologic features
Pleckstrin homology and RUN domain-containing M1 (PLEKHM1) AR 611466 Osteoclasts Secretory lysosomes Osteopetrosis
T cell immune regulator 1, ATPase H+ transporting V0 subunit a3 (TCIRG1) AR 604592 Osteoclasts Secretory lysosomes Osteopetrosis with hypocalcemia
TNF receptor superfamily member 11a (TNFRSF11A) AR 603499 Osteoclasts Osteoclastogenesis Osteopetrosis
TNF superfamily member 11 (TNFSF11) AR 602642 Stromal Osteoclastogenesis Osteopetrosis with severe growth retardation
Hidradenitis suppurativa Nicastrin (NCSTN) AD 605254 Epidermis Notch signaling/gamma-secretase in hair follicle regulates keratinization Verneuil's disease/hidradenitis suppurativa with acne
Presenilin (PSEN) AD 613737 Epidermis Notch signaling/gamma-secretase in hair follicle regulates keratinization Verneuil's disease/hidradenitis suppurativa with cutaneous hyperpigmentation
Presenilin enhancer, gamma-secretase subunit (PSENEN) AD 613736 Epidermis Notch signaling/gamma-secretase in hair follicle regulates keratinization Verneuil's disease/hidradenitis suppurativa
Other IEI related to leukocytes
IRF4 haploinsufficiency Interferon regulatory factor 4 (IRF4) AD 601900 Lymphocytes, monocytes IRF4 is a pleiotropic transcription factor Whipple's disease
IL-18BP deficiency Interleukin 18 binding protein (IL18BP) AR 604113 Leukocytes and other cells IL-18BP neutralizes secreted IL-18 Fulminant viral hepatitis
Total number of mutant genes in table: 74.
IUIS: International Union of Immunological Societies; IL: interleukin; AR: autosomal recessive; NK: natural killer; IFN: interferon; AD: autosomal dominant; LOF: loss of function; XL: X linked; cDC: conventional dendritic cell; Th1: T helper type 1; EBV: Epstein-Barr virus; BCG: Bacillus Calmette-Guérin; TNF: tumor necrosis factor; MAIT: mucosal-associated invariant T; iNKT: invariant natural killer T; CD: cluster of differentiation; HPV: human papillomavirus; EVER: epidermodysplasia verruciformis; GOF: gain of function; CXCL12: C-X-C motif chemokine ligand 12; SDF-1: stromal cell-derived factor 1; ISGF3: interferon-stimulated gene factor 3 complex; DC: dendritic cell; HHV6: human herpesvirus 6; VZV: varicella zoster virus; MDA5: melanoma differentiation-associated gene 5; RNA: ribonucleic acid; CMV: cytomegalovirus; HSV: herpes simplex virus; ISG: interferon-stimulated gene; DNA: deoxyribonucleic acid; poly(I:C): polyinosinic-polycytidylic acid; CNS: central nervous system; TRIF: TIR domain-containing adaptor-inducing IFN-beta; CMC: chronic mucocutaneous candidiasis; ACT1: nuclear factor kappa B activator 1; JNK1: JUN N-terminal kinase 1; Th17: T helper type 17; TGF: transforming growth factor; ATF2: activating transcription factor 2; TLR: toll-like receptor; TIR: toll and interleukin 1 receptor; MECP2: methyl-CpG binding protein 2; COVID-19: coronavirus disease 2019; IEI: inborn errors of immunity; ER: endoplasmic reticulum.
From: Tangye SG, Al-Herz W, Bousfiha A, et al. Human inborn errors of immunity: 2022 update on the classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol 2022; 42:1473. Copyright © 2022 The Authors. Reproduced under the terms of the Creative Commons Attribution License 4.0.
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