Evidence map›Paper›PMID 41608053›Full record

ArticleJournal of human immunity2026

Immune dysregulation from a novel CTLA-4 haploinsufficiency variant.

Nina N Brodsky, Alan Kennedy, Daniel Glaser, Lauren Jeffries, Weizhen Ji, Eesha Natarajan, Junghee J Shin, David M Sansom, Carrie L Lucas, Saquib A Lakhani

Abstract read
In one paragraph

Article in Journal of human immunity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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.

Nina N BrodskyDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0003-2472-7397
Alan KennedyUCL Institute of Immunity and Transplantation, London, UK.ORCID https://orcid.org/0000-0003-0384-3866
Daniel GlaserDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0002-2934-5366
Lauren JeffriesDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0002-6419-0515
Weizhen JiDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0002-3452-6030
Eesha NatarajanDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0009-0007-9006-4428
Junghee J ShinDepartment of Internal Medicine, Rheumatology, Allergy and Immunology, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0002-4765-7988
David M SansomUCL Institute of Immunity and Transplantation, London, UK.ORCID https://orcid.org/0000-0001-6506-3115
Carrie L LucasDepartment of Immunobiology, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0002-5754-0820
Saquib A LakhaniDepartment of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.ORCID https://orcid.org/0000-0003-3235-3460

Funding

Targetable pathways driving sub-optimal early-life CD8 T cell responsesK08AI177743 · NIAID · YALE UNIVERSITY · PI Nina Brodsky · 2024 to 2026
$585k
NIAID NIH HHS K08 AI177743Wellcome Trust 227384
6 · The paper itself

Abstract

Cytotoxic T lymphocyte antigen 4 (CTLA-4) is a key immune checkpoint receptor that regulates T cell activation through ligand competition and transendocytosis. Heterozygous loss-of-function variants in CTLA4 result in CTLA-4 haploinsufficiency with autoimmune infiltration (CHAI), characterized by immune dysregulation and autoimmunity. We report a multigenerational family carrying a novel heterozygous CTLA4 variant, c.654T>A (p.Tyr218*), which truncates the cytoplasmic tail. Affected individuals presented with recurrent infections and autoimmune manifestations. Patient T cells showed reduced CTLA-4 expression at baseline and after stimulation, suggesting impaired stability. Jurkat cells expressing CTLA-4 Y218* exhibited enhanced degradation, partially rescued by lysosomal inhibition, and reduced transendocytosis of CD80. Together, these findings suggest that the CTLA-4 p.Tyr218* variant compromises protein stability and ligand uptake, contributing to CTLA-4 haploinsufficiency and immune dysregulation. This work broadens the spectrum of CTLA4 variants and underscores the importance of the C-terminal cytoplasmic domain in CTLA-4 function and immune regulation.

Identifiers

PMID41608053
PMCPMC12829747

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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.