Evidence map›Paper›PMID 38773005›Full record

ArticleJournal of clinical immunology2024

A Novel Frameshift Variant of the ELF4 Gene in a Patient with Autoinflammatory Disease: Clinical Features, Transcriptomic Profiling and Functional Studies.

Lina Sun, Ya'nan Han, Benchang Li, Ying Yang, Ying Fang, Xiaoxia Ren, Lu An, Xin Hou, Huafeng Fan, Yi Wu

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In one paragraph

Article in Journal of clinical immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. A truncatingFrontiers in immunology · 2026
    Article
  2. Review
  3. Two novel frameshift variations in theTranslational pediatrics · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lina Sun *MOE Key Laboratory of Environment and Genes Related to Diseases, School of Basic Medical Sciences, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, Shaanxi, 710049, China.
Ya'nan Han *Department of Gastroenterology, Xi'an Children's Hospital, Xi'an, China.
Benchang Li *Shaanxi Institute of Pediatric Diseases, Xi'an Children's Hospital, Xi'an, China.
Ying Yang *Shaanxi Institute of Pediatric Diseases, Xi'an Children's Hospital, Xi'an, China.
Ying FangDepartment of Gastroenterology, Xi'an Children's Hospital, Xi'an, China.
Xiaoxia RenDepartment of Gastroenterology, Xi'an Children's Hospital, Xi'an, China.
Lu AnDepartment of Pathology, Xi'an Children's Hospital, Xi'an, China.
Xin HouDepartment of Imaging, Xi'an Children's Hospital, Xi'an, China.
Huafeng FanDepartment of Education Science, Xi'an Children's Hospital, Xi'an, China.
Yi WuMOE Key Laboratory of Environment and Genes Related to Diseases, School of Basic Medical Sciences, Xi'an Jiaotong University, No.28 Xianning West Road, Xi'an, Shaanxi, 710049, China. wuyi_med@xjtu.edu.cn.

Funding

Key Program from Xi'an Children's Hospital 2022C01Medical Research Project of Xi'an Science and Technology Plan Program 23YXYJ0045Natural Science Basic Research Program of Shaanxi Province 2023-JC-QN-0829Special Program from Xi'an Children's Hospital 2019A05Special Program from Xi'an Children's Hospital 2020A08Youth Development Funds by Xi'an Municipal Health Commission 2020qn14
6 · The paper itself

Abstract

We described the diagnosis and treatment of a patient with autoinflammatory disease, named "Deficiency in ELF4, X-linked (DEX)". A novel ELF4 variant was discovered and its pathogenic mechanism was elucidated. The data about clinical, laboratory and endoscopic features, treatment, and follow-up of a patient with DEX were analyzed. Whole exome sequencing and Sanger sequencing were performed to identify potential pathogenic variants. The mRNA and protein levels of ELF4 were analyzed by qPCR and Western blotting, respectively. The association of ELF4 frameshift variant with nonsense-mediated mRNA decay (NMD) in the pathogenesis DEX was examined. Moreover, RNA-seq was performed to identify the key molecular events triggered by ELF4 variant. The relationship between ELF4 and IFN-β activity was validated using a dual-luciferase reporter assay and a ChIP-qPCR assay. An 11-year-old boy presented with a Behçet's-like phenotype. The laboratory abnormality was the most obvious in elevated inflammatory indicators. Endoscopy revealed multiple ileocecal ulcers. Intestinal histopathology showed inflammatory cell infiltrations. The patient was treated with long-term immunosuppressant and TNF-α blocker (adalimumab), which reaped an excellent response over 16 months of follow-up. Genetic analysis identified a maternal hemizygote frameshift variant (c.1022del, p.Q341Rfs*30) in ELF4 gene in the proband. The novel variant decreased the mRNA level of ELF4 via the NMD pathway. Mechanistically, insufficient expression of ELF4 disturbed the immune system, leading to immunological disorders and pathogen susceptibility, and disrupted ELF4-activating IFN-β responses. This analysis detailed the clinical characteristics of a Chinese patient with DEX who harbored a novel ELF4 frameshift variant. For the first time, we used patient-derived cells and carried out transcriptomic analysis to delve into the mechanism of ELF4 variant in DEX.

Indexed as

Frameshift MutationGene Expression ProfilingChildDNA-Binding ProteinsExome SequencingGenetic Predisposition to DiseaseHumansMaleNonsense Mediated mRNA DecayPedigreeProto-Oncogene Proteins c-etsTranscription FactorsTranscriptomeDNA-Binding ProteinsELF4 protein, humanProto-Oncogene Proteins c-etsTranscription FactorsAutoinflammatoryDEXELF4Nonsense-mediated mRNA DecayTranscriptome

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.