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ArticleClinical reviews in allergy & immunology2025

The c.64 + 2 T > A Founder Variant Hits Home: Report on 14 Patients Expands the Phenotypic Landscape of Inherited ARPC1B Deficiency - a Comparative Analysis.

Dharmagat Bhattarai, Aaqib Zaffar Banday, Pratap Kumar Patra, Ramji Baral, Chakshu Chaudhry, Katta M Girisha, Jolan E Walter, Ganga Narasimhan, Bénédicte Neven, Asbjørg Stray-Pedersen and 1 more

Abstract readComparative Study
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Article in Clinical reviews in allergy & immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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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

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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

2 citing papers in PubMed.

  1. Article
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4 · The record

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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

11 authors.

Dharmagat BhattaraiAdvanced Centre for Immunology & Rheumatology, Kathmandu, Nepal. dharmagat@yahoo.co.uk.ORCID http://orcid.org/0000-0003-4838-5037
Aaqib Zaffar BandayDepartment of Pediatrics, Government Medical College Srinagar, Srinagar, Kashmir, India. maaqibzb@gmail.com.ORCID http://orcid.org/0000-0001-5486-4267
Pratap Kumar PatraDepartment of Pediatrics, All India Institute of Medical Sciences Patna, Patna, Bihar, India.ORCID http://orcid.org/0000-0002-0338-7517
Ramji BaralPokhara Academy of Health Sciences, Pokhara, Kaski, Nepal.
Chakshu ChaudhryMedGenome Labs Limited, Bengaluru, India.ORCID http://orcid.org/0000-0002-0080-2172
Katta M GirishaDepartment of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.ORCID http://orcid.org/0000-0002-0139-8239
Jolan E WalterDivision of Allergy & Immunology, University of South Florida and Johns' Hopkins All Children's Hospital, St. Petersburg, FL, 33701, USA.ORCID http://orcid.org/0000-0002-6192-0703
Ganga NarasimhanMediomix Diagnosis and Bioresearch Limited, Bengaluru, India.ORCID http://orcid.org/0009-0008-7869-6729
Bénédicte NevenPediatric Immunology-Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, 149 Rue de Sèvres, 75015, Paris, France.ORCID http://orcid.org/0000-0001-8941-0935
Asbjørg Stray-PedersenNorwegian National Unit for Newborn Screening, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.ORCID http://orcid.org/0000-0002-9168-0878
Kathleen E SullivanDivision of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.ORCID http://orcid.org/0000-0002-3577-9021

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInherited ARPC1B deficiency (ARPC1BD) is a rare autosomal recessive inborn error of immunity that manifests with allergic, infective, and autoimmune/inflammatory features. Only about three dozen patients with ARPC1BD have been reported in the literature thus far.

methodsWe describe 14 patients (ten families) with ARPC1BD from Nepal. Many of these patients have unique/rare clinical features that expand the phenotypic spectrum of ARPC1BD. The study included data on clinical-epidemiological features, immuno-hematological parameters, treatment, and outcome. Homozygosity mapping and haplotype analysis were used to evaluate the founder effect.

resultsWe noted allergic/autoimmune and infective manifestations in all of our patients. Notable clinical features noted in our study include rheumatoid factor positive (RF+) chronic arthritis (mimicking RF+ juvenile idiopathic arthritis), significantly elevated anti-tissue transglutaminase antibody titers, generalized skin hyperpigmentation, distal phalangeal enlargement, frontal bone hypertrophy, hypertrophic skin scars, and hyperkeratosis. All cases harbored the founder splice-site variant c.64+2T>A in the ARPC1B gene. Long-term outcomes in our patients appeared worse than reported previously. Comparative phenotypic analysis showed significantly greater proportions of otitis, gastroenteritis, inflammatory bowel disease-like manifestations, and elevated IgA in patients with c.64+2T>A variant as compared to other variants. Homozygosity mapping (in eight probands) revealed that the gene/variant is contained within the only overlapping region of homozygosity (>1 Mb) across all autosomal chromosomes. Besides, the included probands share a similar haplotype around the said variant.

conclusionsc.64+2T>A is a founder variant in Nepalese patients with ARPC1BD. This variant is associated with a severe clinical phenotype and diverse clinical complications.

Indexed as

Founder EffectAdolescentAdultChildChild, PreschoolFemaleHaplotypesHomozygoteHumansMaleMutationNepalPedigreePhenotypeYoung AdultActin-related protein-2/3 complexGenotype–phenotype correlationInborn error of immunityPrimary atopic disorderRheumatoid arthritis

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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.