Scientific publications

Whole Exome Sequencing Identifies Epithelial and Immune Dysfunction-Related Biomarkers in Food Protein-Induced Enterocolitis Syndrome. Scientific Publication

Sep 30, 2024 | Magazine: Clinical and Experimental Allergy

Alba Camino-Mera  1   2   3 , Jacobo Pardo-Seco  1   2   3 , Xabier Bello  1   2   3 , Laura Argiz  4 , Robert J Boyle  5 , Adnan Custovic  5 , Jethro Herberg  6 , Myrsini Kaforou  6 , Stefania Arasi  7 , Alessandro Fiocchi  7 , Valentina Pecora  7 , Simona Barni  8 , Francesca Mori  8 , Teresa Bracamonte  9 , Luis Echeverria  9 , Virginia O'Valle-Aísa  10 , Noelia Lara Hernández-Martínez  10 , Iria Carballeira  11 , Emilio García  11 , Carlos Garcia-Magan  12 , José Domingo Moure-González  12 , Purificación Gonzalez-Delgado  13 , Teresa Garriga-Baraut  14 , Sonsoles Infante  15 , Gabriela Zambrano-Ibarra  15 , Margarita Tomás-Pérez  15 , Adrianna Machinena  16 , Mariona Pascal  17   18 , Ana Prieto  19 , Sonia Vázquez-Cortes  20 , Montserrat Fernández-Rivas  21 , Leticia Vila  22 , Laia Alsina  23 , María José Torres  24   25   26   27 , Giusi Mangone  28 , Santiago Quirce  29 , Federico Martinón-Torres  1   3   30 , Marta Vázquez-Ortiz  5 , Alberto Gómez-Carballa  1   2   3 , Antonio Salas  1   2   3


Background: Food protein-induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology-key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well-characterised cohort of patients we explored the potential genome-wide susceptibility factors underlying FPIES.

Methods: Blood samples from 41 patients with oral food challenge-proven FPIES were collected for a comprehensive whole exome sequencing association study.

Results: Notable genetic variants, including rs872786 (RBM8A), rs2241880 (ATG16L1) and rs2289477 (ATG16L1), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including DGKZ and SIRPA. DGKZ induces TGF-β signalling, crucial for epithelial barrier integrity and IgA production; RBM8A is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; SIRPA is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; ATG16L1 is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between RBM8A and filaggrin gene (FLG) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE-mediated food allergy. A transcriptome-wide association study suggested genetic variability in patients impacted gene expression of RBM8A (stomach and pancreas) and ATG16L1 (transverse colon).

Conclusions: This study represents the first case-control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients.

CITATION  Clin Exp Allergy. 2024 Sep 30. doi: 10.1111/cea.14564