Background Atopic diseases are very common, and atopy has astrong genetic predisposition.
Methods Using single-strand conformation polymorphism analysisand DNA sequencing, we searched for mutations in the subunitof the interleukin-4 receptor that would predispose personsto atopy. We examined the prevalence of the alleles among patientswith allergic inflammatory disorders and among 50 prospectivelyrecruited adults. Subjects with atopy were identified on thebasis of an elevated serum lgE level (>95 IU per milliliter)or a positive radioimmunosorbent test in response to standardinhalant allergens. The signaling function of mutant interleukin-4receptor was examined by flow cytometry, binding assays, andimmunoblotting.
Results A novel interleukin-4 receptor allele was identifiedin which guanine was substituted for adenine at nucleotide 1902,causing a change from glutamine to arginine at position 576(R576) in the cytoplasmic domain of the interleukin-4 receptor protein. The R576 allele was common among patients with allergicinflammatory disorders (found in 3 of 3 patients with the hyper-IgEsyndrome and 4 of 7 patients with severe atopic dermatitis)and among the 50 prospectively recruited adults (found in 13of 20 subjects with atopy and 5 of 30 without atopy; P = 0.001;relative risk of atopy among those with a mutant allele, 9.3).The R576 allele was associated with higher levels of expressionof CD23 by interleukin-4 than the wild-type allele. This enhancedsignaling was associated with a change in the binding specificityof the adjacent tyrosine residue at position 575 to signal-transducingmolecules.
Conclusions The R576 allele of interleukin-4 receptor is stronglyassociated with atopy. This mutation may predispose personsto allergic diseases by altering the signaling function of thereceptor.
Source Information
From the Departments of Pediatrics (G.K.K.H., M.F.F., L.A.E., T.A.C.) and Pathology (M.L.T., T.A.C.), Howard Hughes Medical Institute (M.L.T.), and the Center for Immunology (M.L.T., T.A.C.), Washington University School of Medicine, St. Louis.
Address reprint requests to Dr. Chatila at the Division of ImmunologyRheumatology, Department of Pediatrics, Washington University School of Medicine, 1 Children's Pl., St. Louis, MO 63110.
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