Background
Coronin-1A (CORO1A) is a regulator of actin dynamics important for T cell homeostasis. CORO1A deficiency causes T−B+NK+ severe combined immunodeficiency or T cell lymphopenia with severe viral infections. However, since all known human mutations in CORO1A abrogate protein expression, the role of the protein’s functional domains in host immunity is unknown.
Objective
To identify the cause of the primary immunodeficiency in two young adult siblings with a history of disseminated varicella, cutaneous warts, and CD4+ T cell lymphopenia.
Methods
We performed immunologic, genetic, and biochemical studies in the patients, family members, and healthy controls.
Results
Both patients had CD4+ T cell lymphopenia and decreased lymphocyte proliferation to mitogens. IgG, IgM, IgA and specific antibody responses were normal. Whole genome sequencing identified a homozygous frameshift mutation in CORO1A disrupting the last two C-terminal domains by replacing 61 a.a. with a novel 91 a.a. sequence. The CORO1AS401fs mutant was expressed in the patients’ lymphocytes at a level comparable with that of wild-type CORO1A in normal lymphocytes, but failed to oligomerize and had impaired cytoskeletal association. CORO1AS401fs was associated with increased F-actin accumulation in T cells, severely defective thymic output, and impaired T cell survival, but normal calcium flux and cytotoxicity, demonstrating the importance of CORO1A oliogomerization and subcellular localization in T cell homeostasis.
Conclusions
We describe a truncating mutation in CORO1A that permits protein expression and survival into young adulthood. Our studies demonstrate the importance of intact CORO1A C-terminal domains in thymic egress and T cell survival as well as in the defense against viral pathogens.