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Impaired lymphocyte function and differentiation in CTPS1-deficient patients result from a hypomorphic homozygous mutation
Emmanuel Martin, Norbert Minet, Anne-Claire Boschat, Sylvia Sanquer, Steicy Sobrino, Christelle Lenoir, Jean Pierre de Villartay, Maria Leite-de-Moraes, Capucine Picard, Claire Soudais, Tim Bourne, Sophie Hambleton, Stephen M. Hughes, Robert F. Wynn, Tracy A. Briggs, Genomics England Research Consortium, Smita Patel, Monica G. Lawrence, Alain Fischer, Peter D. Arkwright, Sylvain Latour
Emmanuel Martin, Norbert Minet, Anne-Claire Boschat, Sylvia Sanquer, Steicy Sobrino, Christelle Lenoir, Jean Pierre de Villartay, Maria Leite-de-Moraes, Capucine Picard, Claire Soudais, Tim Bourne, Sophie Hambleton, Stephen M. Hughes, Robert F. Wynn, Tracy A. Briggs, Genomics England Research Consortium, Smita Patel, Monica G. Lawrence, Alain Fischer, Peter D. Arkwright, Sylvain Latour
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Research Article Immunology

Impaired lymphocyte function and differentiation in CTPS1-deficient patients result from a hypomorphic homozygous mutation

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Abstract

Cytidine triphosphate (CTP) synthetase 1 (CTPS1) deficiency is caused by a unique homozygous frameshift splice mutation (c.1692-1G>C, p.T566Dfs26X). CTPS1-deficient patients display severe bacterial and viral infections. CTPS1 is responsible for CTP nucleotide de novo production involved in DNA/RNA synthesis. Herein, we characterized in depth lymphocyte defects associated with CTPS1 deficiency. Immune phenotyping performed in 7 patients showed absence or low numbers of mucosal-associated T cells, invariant NKT cells, memory B cells, and NK cells, whereas other subsets were normal. Proliferation and IL-2 secretion by T cells in response to TCR activation were markedly decreased in all patients, while other T cell effector functions were preserved. The CTPS1T566Dfs26X mutant protein was found to be hypomorphic, resulting in 80%–90% reduction of protein expression and CTPS activity in cells of patients. Inactivation of CTPS1 in a T cell leukemia fully abolished cell proliferation. Expression of CTPS1T566Dfs26X failed to restore proliferation of CTPS1-deficient leukemia cells to normal, except when forcing its expression to a level comparable to that of WT CTPS1. This indicates that CTPS1T566Dfs26X retained normal CTPS activity, and thus the loss of function of CTPS1T566Dfs26X is completely attributable to protein instability. This study supports that CTPS1 represents an attractive therapeutic target to selectively inhibit pathological T cell proliferation, including lymphoma.

Authors

Emmanuel Martin, Norbert Minet, Anne-Claire Boschat, Sylvia Sanquer, Steicy Sobrino, Christelle Lenoir, Jean Pierre de Villartay, Maria Leite-de-Moraes, Capucine Picard, Claire Soudais, Tim Bourne, Sophie Hambleton, Stephen M. Hughes, Robert F. Wynn, Tracy A. Briggs, Genomics England Research Consortium, Smita Patel, Monica G. Lawrence, Alain Fischer, Peter D. Arkwright, Sylvain Latour

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Figure 4

Analysis of CTPS1 expression in lymphocytes subsets and activated T cells in control individuals.

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Analysis of CTPS1 expression in lymphocytes subsets and activated T cell...
(A) Dot plot graph representing the MFI of CTPS1 expression in αβ T cells (black circle), γδ T cells (blue circle), NK cells (green circle), B cells (red circle), and monocytes (gray circle). PBMCs were stimulated (right) or not (No stim) (left) with PMA plus ionomycin for 48 hours. (B) MFI of CTPS1 expression in T cell subpopulations: MAIT (red circle), iNKT (green circle), naive (circle), memory (square), CD45RA– (up triangle) and CD45RA+ (down triangle), effector memory CD4 (black symbols), or CD8 (blue symbols). T cells were stimulated (middle) or not (upper) with 1 μg/mL of coated anti-CD3 antibody for 48 hours. CTPS1 MFI ratios of unstimulated and anti-CD3–stimulated T cells are represented in the lower panel. (C) Immunoblots for CTPS1, CTPS2, and actin protein expression in Jurkat cells and control T cell blasts stimulated or not with anti-CD3/CD28–coated beads for 48 hours, control (Ctrl), LCLs, primary fibroblast cell lines, SV-40 T antigen–immortalized fibroblast cell lines (SV40 Fibro), and telomerized SV40-transformed fibroblast cell lines (Tel. SV40 Fibro). (D) Immunoblots (upper) and quantitative PCRs (qPCRs) (lower) for CTPS1, CTPS2, and actin protein expression in T cell blasts stimulated with anti-CD3/CD28 beads for different periods. In lower panels, the bar graphs depict relative CTPS1 (left) and CTPS2 (right) mRNA expression normalized on GAPDH mRNA expression. Data were obtained from 3 independent experiments. In A–B, all MFIs were calculated from FACS histogram analysis (data not shown). Each symbol corresponds to an independent biological sample of a healthy individual. The horizontal bars represent the median ± SEM.

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