Document Type

Article

Publication Date

1-18-2024

Keywords

JGM, Child, Humans, Lung, Macrophages, Alveolar, Pulmonary Alveolar Proteinosis, Receptors, CCR2, Reinfection

JAX Source

Cell. 2024;187(2):390-408 e23.

ISSN

1097-4172

PMID

38157855

DOI

https://doi.org/10.1016/j.cell.2023.11.036

Abstract

We describe a human lung disease caused by autosomal recessive, complete deficiency of the monocyte chemokine receptor C-C motif chemokine receptor 2 (CCR2). Nine children from five independent kindreds have pulmonary alveolar proteinosis (PAP), progressive polycystic lung disease, and recurrent infections, including bacillus Calmette Gue ́ rin (BCG) disease. The CCR2 variants are homozygous in six patients and compound heterozygous in three, and all are loss-of-expression and loss-of-function. They abolish CCR2- agonist chemokine C-C motif ligand 2 (CCL-2)-stimulated Ca2+ signaling in and migration of monocytic cells. All patients have high blood CCL-2 levels, providing a diagnostic test for screening children with unexplained lung or mycobacterial disease. Blood myeloid and lymphoid subsets and interferon (IFN)-g- and granulocyte- macrophage colony-stimulating factor (GM-CSF)-mediated immunity are unaffected. CCR2-deficient mono- cytes and alveolar macrophage-like cells have normal gene expression profiles and functions. By contrast, alveolar macrophage counts are about half. Human complete CCR2 deficiency is a genetic etiology of PAP, polycystic lung disease, and recurrent infections caused by impaired CCL2-dependent monocyte migration to the lungs and infected tissues.

Comments

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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