New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort

BackgroundWiskott-Aldrich Syndrome (WAS) is a rare and severe X-linked immunodeficiency disorder characterized by microthrombocytopenia, eczema, and increased susceptibility to infections, autoimmunity, and malignancies. This study aims to explore molecular changes in the WAS gene in Brazilian patie...

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Main Authors: Lucas W. Santos, Samuel S. Medina, Jéssica O. Frade-Guanaes, Lúcia H. Siqueira, Luiz Gustavo R. de Lima, Bruna Chati, Marcos T. Nolasco da Silva, Adriana G. L. Riccetto, Paula Lyra, Ana Carla A. M. Falcão, Pedro P. A. Santos, Regina S. W. Di Gesu, Bianca Stefanello, Gabriela G. Yamaguti-Hayakawa, Carmem M. S. Bonfim, Maria M. S. Vilela, Margareth C. Ozelo
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Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1585594/full
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author Lucas W. Santos
Samuel S. Medina
Jéssica O. Frade-Guanaes
Lúcia H. Siqueira
Luiz Gustavo R. de Lima
Luiz Gustavo R. de Lima
Bruna Chati
Bruna Chati
Marcos T. Nolasco da Silva
Marcos T. Nolasco da Silva
Adriana G. L. Riccetto
Adriana G. L. Riccetto
Paula Lyra
Ana Carla A. M. Falcão
Pedro P. A. Santos
Regina S. W. Di Gesu
Bianca Stefanello
Bianca Stefanello
Gabriela G. Yamaguti-Hayakawa
Carmem M. S. Bonfim
Maria M. S. Vilela
Maria M. S. Vilela
Margareth C. Ozelo
Margareth C. Ozelo
author_facet Lucas W. Santos
Samuel S. Medina
Jéssica O. Frade-Guanaes
Lúcia H. Siqueira
Luiz Gustavo R. de Lima
Luiz Gustavo R. de Lima
Bruna Chati
Bruna Chati
Marcos T. Nolasco da Silva
Marcos T. Nolasco da Silva
Adriana G. L. Riccetto
Adriana G. L. Riccetto
Paula Lyra
Ana Carla A. M. Falcão
Pedro P. A. Santos
Regina S. W. Di Gesu
Bianca Stefanello
Bianca Stefanello
Gabriela G. Yamaguti-Hayakawa
Carmem M. S. Bonfim
Maria M. S. Vilela
Maria M. S. Vilela
Margareth C. Ozelo
Margareth C. Ozelo
author_sort Lucas W. Santos
collection DOAJ
description BackgroundWiskott-Aldrich Syndrome (WAS) is a rare and severe X-linked immunodeficiency disorder characterized by microthrombocytopenia, eczema, and increased susceptibility to infections, autoimmunity, and malignancies. This study aims to explore molecular changes in the WAS gene in Brazilian patients and assess their correlation with clinical manifestations and disease severity.MethodsThirty-one patients from 27 families with thrombocytopenia suspected to have WAS or X-linked thrombocytopenia (XLT) were analyzed. Clinical evaluation, cell morphology analysis, and flow cytometry (when feasible) were performed. DNA samples underwent direct sequencing to identify WAS gene mutations.ResultsGenomic sequencing identified 17 WAS gene variants, 10 of which were novel, expanding the genetic diversity of the disorder. The most frequent WAS gene variants were primarily frameshift indels that introduced premature stop codons, with five localized in exon 10. While thrombocytopenia and small platelets were prevalent, atypical presentations, including one patient with normal platelet size, were observed. The correlation between genotype and phenotype was complex, as some patients harboring similar mutations demonstrated varying disease severities. Of the 22 confirmed cases, 12 underwent hematopoietic stem cell transplantation (HSCT), while six succumbed to severe disease complications, including opportunistic infections and malignancies.ConclusionsThe study underscores the need for early molecular diagnosis and tailored treatments, particularly HSCT, which remains the standard curative therapy. Additionally, the findings emphasize the role of genetic variation in predicting disease severity, underlining the importance of personalized medical approaches for WAS patients.
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spelling doaj-art-f34c56a946ca4aa5b322e4b6a9c7fb052025-08-20T03:09:34ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.15855941585594New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohortLucas W. Santos0Samuel S. Medina1Jéssica O. Frade-Guanaes2Lúcia H. Siqueira3Luiz Gustavo R. de Lima4Luiz Gustavo R. de Lima5Bruna Chati6Bruna Chati7Marcos T. Nolasco da Silva8Marcos T. Nolasco da Silva9Adriana G. L. Riccetto10Adriana G. L. Riccetto11Paula Lyra12Ana Carla A. M. Falcão13Pedro P. A. Santos14Regina S. W. Di Gesu15Bianca Stefanello16Bianca Stefanello17Gabriela G. Yamaguti-Hayakawa18Carmem M. S. Bonfim19Maria M. S. Vilela20Maria M. S. Vilela21Margareth C. Ozelo22Margareth C. Ozelo23Hemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilDepartment of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilDepartment of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilCenter for Investigation in Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilDepartment of Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilCenter for Investigation in Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilDepartment of Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilDepartment of Pediatrics, Professor Fernando Figueira Institute of Integral Medicine (IMIP), Recife, PE, BrazilDepartment of Pediatrics, Professor Fernando Figueira Institute of Integral Medicine (IMIP), Recife, PE, BrazilDepartment of Pediatrics, Conceição Children’s Hospital (HCC), Porto Alegre, BrazilDepartment of Pediatrics, Conceição Children’s Hospital (HCC), Porto Alegre, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilDepartment of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilPediatric Blood and Marrow Transplantation Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, BrazilCenter for Investigation in Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilDepartment of Pediatrics, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilHemocentro UNICAMP, University of Campinas, Campinas, SP, BrazilDepartment of Internal Medicine, School of Medical Sciences, University of Campinas, UNICAMP, Campinas, SP, BrazilBackgroundWiskott-Aldrich Syndrome (WAS) is a rare and severe X-linked immunodeficiency disorder characterized by microthrombocytopenia, eczema, and increased susceptibility to infections, autoimmunity, and malignancies. This study aims to explore molecular changes in the WAS gene in Brazilian patients and assess their correlation with clinical manifestations and disease severity.MethodsThirty-one patients from 27 families with thrombocytopenia suspected to have WAS or X-linked thrombocytopenia (XLT) were analyzed. Clinical evaluation, cell morphology analysis, and flow cytometry (when feasible) were performed. DNA samples underwent direct sequencing to identify WAS gene mutations.ResultsGenomic sequencing identified 17 WAS gene variants, 10 of which were novel, expanding the genetic diversity of the disorder. The most frequent WAS gene variants were primarily frameshift indels that introduced premature stop codons, with five localized in exon 10. While thrombocytopenia and small platelets were prevalent, atypical presentations, including one patient with normal platelet size, were observed. The correlation between genotype and phenotype was complex, as some patients harboring similar mutations demonstrated varying disease severities. Of the 22 confirmed cases, 12 underwent hematopoietic stem cell transplantation (HSCT), while six succumbed to severe disease complications, including opportunistic infections and malignancies.ConclusionsThe study underscores the need for early molecular diagnosis and tailored treatments, particularly HSCT, which remains the standard curative therapy. Additionally, the findings emphasize the role of genetic variation in predicting disease severity, underlining the importance of personalized medical approaches for WAS patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1585594/fullWiskott-Aldrich syndromeWASWASp mutationthrombocytopeniainborn errors of immunity
spellingShingle Lucas W. Santos
Samuel S. Medina
Jéssica O. Frade-Guanaes
Lúcia H. Siqueira
Luiz Gustavo R. de Lima
Luiz Gustavo R. de Lima
Bruna Chati
Bruna Chati
Marcos T. Nolasco da Silva
Marcos T. Nolasco da Silva
Adriana G. L. Riccetto
Adriana G. L. Riccetto
Paula Lyra
Ana Carla A. M. Falcão
Pedro P. A. Santos
Regina S. W. Di Gesu
Bianca Stefanello
Bianca Stefanello
Gabriela G. Yamaguti-Hayakawa
Carmem M. S. Bonfim
Maria M. S. Vilela
Maria M. S. Vilela
Margareth C. Ozelo
Margareth C. Ozelo
New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
Frontiers in Immunology
Wiskott-Aldrich syndrome
WAS
WASp mutation
thrombocytopenia
inborn errors of immunity
title New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
title_full New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
title_fullStr New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
title_full_unstemmed New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
title_short New insights into Wiskott-Aldrich syndrome: ten novel WAS mutations and their clinical impact in a Brazilian cohort
title_sort new insights into wiskott aldrich syndrome ten novel was mutations and their clinical impact in a brazilian cohort
topic Wiskott-Aldrich syndrome
WAS
WASp mutation
thrombocytopenia
inborn errors of immunity
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1585594/full
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