“…Mutations that reduce the expression of HOIL-1 (haem-oxidised IRP2 ubiquitin ligase-1), also called RBCK1 (RING-B-Box-coiled-coil protein interacting with PKC 1 or RANBP2-Type and C3HC4-type zinc finger-containing protein 1) cause both auto-inflammation and immuno-insufficiency in humans (Boisson et al, 2012;Phadke et al, 2020) and immunoinsufficiency in mice (MacDuff et al, 2015;Tokunaga et al, 2009). However, HOIL-1 deficiency in humans also leads to cardiomyopathy and death from heart failure in early adulthood (Boisson et al, 2012;Fanin et al, 2015;Krenn et al, 2018;Nilsson et al, 2013;Phadke et al, 2020;Wang et al, 2013), which is unrelated to the immune defects, and arises from the progressive accumulation of toxic polyglucosan bodies in cardiac muscle and other tissues, such as the brain, with some patients also displaying cognitive impairment (Chen et al, 2021;Phadke et al, 2020). Mice expressing low levels of HOIL-1 (Fujita et al, 2018) also form toxic polyglucosan bodies in cardiac muscle (MacDuff et al, 2015), brain and spinal cord (Sullivan et al, 2018), but it is the brain that is affected predominantly in mice, the animals displaying defects in learning, memory and motor coordination (Sullivan et al, 2018).…”