The cytoskeletal regulator HEM1 governs B cell development and prevents autoimmunity
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HEM1 deficiency causes heritable autoimmunity and immunodeficiency.
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Most HEM1-deficient patients (six out of nine) displayed increased total B cells.
“Most patients (six out of nine) displayed increased total B cells [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
In Results, ‘Aberrant B-cell phenotype in HEM1 deficiency’ (page unavailable), the paper reports that patients’ absolute CD19+ B-cell counts were within the age-matched normal range. It reports increases in particular B-cell subsets, not total B cells, and does not report six of nine patients with increased total B cells. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredOther bacterial infections in HEM1-deficient patients have included cellulitis, septic arthritis, and cholecystitis.
“Other bacterial infections have included cellulitis, septic arthritis, and cholecystitis [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Identification of human HEM1 deficiency” (page unavailable), reports recurrent infections and treatment for assumed or proven bacterial infections in a HEM1-deficient patient. It does not identify cellulitis, septic arthritis, or cholecystitis among those infections. (LLM, conf=0.86)
Experimental — accuracy not yet measuredHEM1-deficient patients may have systemic lupus erythematosus-like disease with positive anti-nuclear antibodies and double-stranded DNA autoantibodies, and associated immune complex glomerulonephritis.
“Patients may have systemic lupus erythematosus–like disease with positive anti-nuclear antibodies (ANA) and double-stranded (ds) DNA autoantibodies, and associated immune complex glomerulonephritis [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
In Results (Identification of human HEM1 deficiency; page unavailable), the paper reports that one HEM1-deficient patient had glomerulonephritis, tested positive for anti-dsDNA antibodies, and was diagnosed with SLE. It does not report a positive ANA test or establish that this patient's glomerulonephritis was immune-complex mediated; the explicit immune-complex glomerulonephritis finding in Results concerns Hem1-deficient mice, not patients. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIncreased proportions of naïve B cells and B cell subsets associated with autoimmunity (innate-like memory B CD19+CD21loCD38lo and CD19+CD21−) were observed less consistently in HEM1-deficient patients.
“Increased proportions of naïve B cells and B cell subsets associated with autoimmunity (innate-like memory B CD19+CD21loCD38lo and CD19+CD21−) were observed less consistently [9, 10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Aberrant B-cell phenotype in HEM1 deficiency” (page unavailable), reports increased innate-like CD19+CD38loCD21lo memory B cells associated with autoimmunity. It says naïve B-cell proportions were within the age-matched normal range, however, and does not report an increase in CD19+CD21− cells. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPathogenic variants in NCKAP1L, a hematopoietically restricted gene encoding the HEM1 protein component of the WRC, define a novel disease involving recurrent bacterial and viral infections, autoimmunity, and excessive inflammation (OMIM 141180).
“Recently, three reports investigating novel mutations in NCKAP1L, a hematopoietically restricted gene encoding the HEM1 protein component of the WAVE regulatory complex (WRC), established how improper actin networks lead to a clinical syndrome involving recurrent bacterial and viral infections and autoimmunity (OMIM 141180) [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
All HEM1-deficient patients suffer from recurrent infections such as otitis media, upper respiratory infections, pneumonia, and abscesses.
“All patients suffer from recurrent infections such as otitis media, upper respiratory infections, pneumonia, and abscesses [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
In Results, ‘Identification of human HEM1 deficiency’ (page not provided), the paper reports recurrent respiratory infections in both patients studied, and ear infections and skin abscesses in one. It does not report pneumonia, and its findings in two patients do not establish that all HEM1-deficient patients have recurrent infections. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSubsets of CD4+ central memory, effector memory, and T effector memory RA+ cells are frequently increased in HEM1-deficient patients.
“In contrast, subsets of CD4+ central memory (CM), effector memory (EM), and T effector memory RA+ (TEMRA) cells are frequently increased [9, 10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Impaired T-cell function in HEM1 deficiency” (page unavailable), reports elevated relative percentages of central memory and exhausted effector memory cells in the patients. It does not report an increase in CD4+ TEMRA cells, and the passage does not specify that both elevated subsets were CD4+. The claim is therefore more specific than this source supports. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHEM1 deficiency was first described in 2019 and has been reported in nine individuals from seven kindreds.
“HEM1 deficiency was first described in 2019 and has been reported in nine individuals from seven kindreds [8–10, 25].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredSiblings of patients from three of the seven kindreds died before 3 years of age from unknown causes or known infections, possibly because of HEM1 deficiency.
“Notably, siblings of patients from three of the seven kindreds died before 3 years of age from unknown causes or known infections, possibly because of HEM1 deficiency [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
In Results, ‘Identification of human HEM1 deficiency’ (page unavailable), the paper reports that an older sister of its two patients died two hours after birth of an unknown cause. It does not report deaths among siblings in three of seven kindreds or deaths from known infections, and it says no tissue was available to investigate whether the deceased sister had HEM1 deficiency. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMost reported pathogenic NCKAP1L variants are biallelic missense variants resulting in destabilizing amino acid substitutions: p.R129W in exon 4, p.V141F in exon 5, p.R258L in exon 7, and p.P359L and p.M371V in exon 11.
“Most are biallelic missense variants resulting in destabilizing amino acid substitutions: p.R129W in exon 4, p.V141F in exon 5, p.R258L in exon 7, and p.P359L and p.M371V in exon 11 [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section (‘Identification of human HEM1 deficiency’; page unavailable) identifies a homozygous NCKAP1L missense variant, p.R129W, in two affected siblings. ‘Defective WRC assembly and stability’ reports reduced HEM1 and WRC-subunit expression in patient cells. Our copy does not establish that most reported pathogenic variants are biallelic missense variants, give p.R129W’s exon, or identify the other four variants and their exon locations. (LLM, conf=0.87)
Experimental — accuracy not yet measuredHEM1-deficient patients with severe autoimmune features display reduced proportions of naïve CD4+ and CD8+ T cell populations.
“Patients with severe autoimmune features display reduced proportions of naïve CD4+ and CD8+ T cell populations [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Impaired T-cell function in HEM1 deficiency” (page unavailable), reports elevated relative percentages of memory T-cell subsets in HEM1-deficient patients, while the Discussion identifies P1 as having severe SLE-like autoimmunity. Our copy does not state that the proportions of naïve CD4+ and naïve CD8+ T cells were reduced; an increase in memory subsets alone does not establish both specific reductions. (LLM, conf=0.78)
Experimental — accuracy not yet measuredFailure to thrive was noted in two HEM1-deficient patients.
“Failure to thrive was noted in two patients [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
In Results, “Identification of human HEM1 deficiency” (page unavailable), the paper reports failure to thrive in patient P1, with height and weight below the third percentile. It describes a second HEM1-deficient patient, P2, but does not report failure to thrive for her. This source therefore supports one patient, not two. (LLM, conf=0.90)
Experimental — accuracy not yet measuredSimilar defects in B cell immune synapses likely underlie poor antibody responses after vaccination or infection in HEM1-deficient patients.
“Similar defects in B cell immune synapses likely underlie poor antibody responses after vaccination or infection [9, 38].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section on B-cell intrinsic survival reports that HEM1-deficient patient B cells spread poorly and form disorganized immunological synapses; the Discussion links these defects to weaker B-cell receptor signaling. The paper does not report poor antibody responses after vaccination or infection, or establish that synapse defects underlie such responses. Searches for vaccination and pathogen-specific antibody responses found no supporting passage. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPatient cells demonstrated reduced mTOR activity in the absence of WRC.
“data from patient cells reliably demonstrated reduced mTOR activity in the absence of WRC [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results sections report severely reduced WRC subunits in patient cells and decreased phosphorylated AKT in patient B cells compared with normal donor B cells. They do not report reduced mTOR activity; a search for mTOR in our copy found no passage establishing that specific claim. (LLM, conf=0.83)
Experimental — accuracy not yet measuredDuring B cell development and BCR editing, defective actin polymerization at immune synapses results in weaker signals, allowing for survival of autoreactive B cells with inherently stronger signals.
“During B cell development and BCR editing, defective actin polymerization at immune synapses results in weaker signals, allowing for survival of autoreactive B cells with inherently stronger signals [9, 39, 40].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Discussion says HEM1-deficient B cells form less effective immune synapses and receive weaker signals. It proposes that stronger signals from autoreactive antigens may then favor autoreactive B-cell survival, but explicitly calls this a hypothesis; the citing sentence presents that mechanism as an established result. The paper discusses receptor adaptation during germinal-center maturation, rather than directly demonstrating the mechanism during BCR editing. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHem1−/− mice have increased serum levels of IFNγ and IL-6.
“corresponding to increased serum levels of IFNγ and IL-6 observed in Hem1−/− mice [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Hem1−/− mice replicate aberrant B-cell development and multifaceted autoimmunity” (page unavailable), reports markedly increased IL-6 and IFNγ in Hem1−/− mice. The passage does not specify that those levels were measured in serum, so it does not establish that part of the claim. (LLM, conf=0.83)
Experimental — accuracy not yet measuredKnockdown of HEM1 in pan-T cells followed by reactivation increased soluble granzymes, IFNγ, IL-4, and IL-6.
“Knockdown of HEM1 in pan-T cells and subsequent reactivation resulted in increased levels of soluble granzymes, interferon gamma (IFNγ), IL-4, and IL-6”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Impaired T-cell function in HEM1 deficiency” (page unavailable), reports a hypersecretory Th1-biased phenotype in HEM1-deficient CD4 T-helper memory cells. It does not report HEM1 knockdown and reactivation of pan-T cells or increased soluble granzymes, IFNγ, IL-4, and IL-6 in those cells. The increased IL-6 and IFNγ reported elsewhere in Results were pro-inflammatory markers in Hem1-deficient mice, not measurements from reactivated pan-T cells. (LLM, conf=0.82)
Experimental — accuracy not yet measuredNumerous Hem1-deficient mouse models demonstrated systemic autoimmunity and inflammation parallel to that seen in patients, including splenomegaly, immune complex lupus glomerulonephritis, elevated proinflammatory markers (IL-6, IFNγ, and MRP8/14), and autoreactive plasmablasts with elevated serum dsDNA autoantibodies.
“Numerous Hem1-deficient mouse models demonstrated systemic autoimmunity and inflammation parallel to that seen in patients, including splenomegaly, immune complex lupus glomerulonephritis, elevated proinflammatory markers (IL-6, IFNγ, and MRP8/14), and autoreactive plasmablasts with elevated serum dsDNA autoantibodies [9, 41].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn HEM1-deficient patients, phosphorylation of AKT at serine 473 in response to various stimuli (CD3/28 TCR stimulation, IgM BCR stimulation, fibronectin, and ICAM-1) is diminished in T and B cells.
“Phosphorylation of AKT at serine 473, a specific target of the mTORC2 kinase complex, in response to various stimuli (CD3/28 TCR stimulation, IgM BCR stimulation, fibronectin, and ICAM-1) was diminished in T and B cells from patients [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section ('Defective B-cell intrinsic survival in murine Hem1-/- B cells'; page unavailable) reports significantly less AKT phosphorylated at Ser473 in patient B cells than in normal donor B cells. It also describes impaired downstream signaling after IgM stimulation, but the passages do not establish reduced Ser473 phosphorylation in patient T cells or after CD3/CD28, fibronectin, or ICAM-1 stimulation. The T-cell Results passage reports impaired proliferation after CD3/CD28 stimulation, not AKT phosphorylation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredHEM1-deficient T cells show reduced CD25 and CD69 upregulation and poor proliferative responses after TCR engagement in vitro.
“This manifests as reduced CD25 and CD69 upregulation and poor proliferative responses in patient cells after TCR engagement in vitro [8, 9].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
Reported viral infections in HEM1-deficient patients have included disseminated herpes simplex virus, Epstein-Barr virus viremia, and gastroenteritis.
“Reported viral infections have included disseminated herpes simplex virus, Epstein-Barr virus viremia, and gastroenteritis [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Identification of human HEM1 deficiency” (page unavailable), reports recurrent respiratory and other infections in two patients but does not identify them as viral. Searches for herpes simplex, EBV viremia, and gastroenteritis found no passage reporting those infections in the patients; the mention of EBV-immortalized cells concerns a laboratory method, not viremia. (LLM, conf=0.76)
Experimental — accuracy not yet measuredNaïve CD8+ T cell populations were low in HEM1-deficient patients, and no consistent pattern has been observed with CD8+ memory cells.
“Naïve CD8+ T cell populations were low, and no consistent pattern has been observed with CD8+ memory cells [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section ('Impaired T-cell function in HEM1 deficiency'; page unavailable) reports normal total CD8+ T-cell numbers and elevated relative percentages of central memory and exhausted effector memory cells. It does not state whether naïve CD8+ cells were low or describe a pattern specifically for CD8+ memory cells. Searches for naïve CD8+ cells and CD8+ memory-cell patterns found no passage settling either point. (LLM, conf=0.70)
Experimental — accuracy not yet measuredAtopic disease in the form of food allergy, allergic rhinitis, and asthma occurs in more than half of the HEM1-deficient patient cohort.
“Atopic disease in the form of food allergy, allergic rhinitis, and asthma occurs in more than half of the patient cohort, highlighting exaggerated atopic inflammatory responses against environmental allergens and irritants [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section, “Identification of human HEM1 deficiency” (page unavailable), describes two affected siblings and their infections and autoimmune symptoms, but does not report food allergy, allergic rhinitis, or asthma. Searches for those conditions and atopic disease found no passage establishing that they occurred in more than half of the HEM1-deficient patients. (LLM, conf=0.76)
Experimental — accuracy not yet measuredNatural killer cells were either normal or decreased across the HEM1-deficient cohort.
“Natural killer (NK) cells were either normal or decreased across the cohort [8–10].”
From HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions (2022) · cites this paper as [9]
The Results section on impaired T-cell function reports that invariant natural killer T (iNKT) cells were very low to absent in both patients, but iNKT cells are not the NK cells named in the claim. Searches for “natural killer cells” and “NK cells” found no passage in our copy reporting whether NK-cell counts were normal or decreased. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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Rakeman, A. S., & Anderson, K. V. (2006) · Development · doi:10.1242/dev.02473 · Cited by 107 · see citing works
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Cited by
Sorted by citations
HEM1 Actin Immunodysregulatory Disorder: Genotypes, Phenotypes, and Future Directions
Cook, S., Lenardo, M. J., & Freeman, A. F. (2022) · Journal of Clinical Immunology · doi:10.1007/s10875-022-01327-0 · Cited by 24 · see citing works
- Authors
- Salzer, E., Zoghi, S., Kiss, M. G., Kage, F., Rashkova, C., Stahnke, S., Haimel, M., Platzer, R., Caldera, M., Ardy, R. C., Hoeger, B., Block, J., Medgyesi, D., Sin, C., Shahkarami, S., Kain, R., Ziaee, V., Hammerl, P., Bock, C., Menche, J., Dupré, L., Huppa, J. B., Sixt, M., Lomakin, A., Rottner, K., Binder, C. J., Stradal, T. E. B., Rezaei, N., & Boztug, K.
- Affiliations
- Austrian Academy of Sciences (AT)
- Helmholtz Centre for Infection Research (DE)
- Medical University of Vienna (AT)
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.
- Universal Scientific Education and Research Network (IR)
- Rheumatology Research Center (IR)
- University of Salzburg (AT)
- Institute of Science and Technology Austria (AT)
- Corresponding author
- Salzer, Elisabeth
- Zoghi, Samaneh
- Kiss, Máté G.
- Kage, Frieda
- Rashkova, Christina
- Stahnke, Stephanie
- Haimel, Matthias
- Hammerl, Peter
- ORCID
- Salzer, Elisabeth
- Zoghi, Samaneh
- Kiss, Máté G.
- Kage, Frieda
- Stahnke, Stephanie
- Haimel, Matthias
- Platzer, René
- Caldera, Michael
- Ardy, Rico Chandra
- Hoeger, Birgit
- Block, Jana
- Sin, Celine
- Shahkarami, Sepideh
- Kain, Renate
- Ziaee, Vahid
- Bock, Christoph
- Menche, Jörg
- Dupré, Loïc
- Huppa, Johannes B.
- Sixt, Michael
- Lomakin, Alexis
- Rottner, Klemens
- Binder, Christoph J.
- Stradal, Theresia E. B.
- Rezaei, Nima
- Boztug, Kaan
- Venue
- Science Immunology
- Published
- 2020-07-03
- Volume
- 5
- Issue
- 49
- ISSN
- 2470-9468 (ISSN-L)
- PMC
- PMC7116756
- OpenAlex
- W3040732440
- Cited by
- 48
- References
- 3
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 10 · 2023: 5 · 2022: 12 · 2021: 15 · 2020: 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science Immunology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion)
- Institute of Science and Technology Austria (submittedVersion, other-oa)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Keywords
- B cell development, autoimmunity, B cell receptor signaling, autoreactive B cells, B cell fate, systemic autoimmunity, mouse model
- MeSH terms
- Animals, Autoimmune Diseases, B-Lymphocytes, Cell Line, Child, Cytoskeleton, Female, Humans, Infant, Membrane Proteins, Mice, Inbred C57BL, T-Lymphocytes, Autoimmunity, Bone Marrow Transplantation, Mice, Knockout
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