DOCK8 deficiency is a combined immunodeficiency disease that is characterized by severe problems with recurrent, persistent, and progressive infections, especially of the skin. This is a major contributing factor to the high morbidity and mortality seen in this disease. However, another key feature of DOCK8 deficiency is the allergic disease: patients typically have severe eczematous dermatitis, asthma, and life-threatening food allergies, often accompanied by high levels of serum IgE and eosinophilia. Most studies to date have focused on the infectious but not the allergic complications of this disease. In FY2016, we studied a cohort of twelve DOCK8-deficient patients who had undergone hematopoietic stem cell transplantation at the NIH Clinical Center. Although such treatment cures the eczema and infectious complications of DOCK8 deficiency, we found that the food allergies were not cured in significant number of patients. This study provides important information regarding the timing of transplantation and need for continued medical management after transplantation in DOCK8-deficient patients. Furthermore, as the first systemic study of hematopoietic stem cell transplantation for food allergies, the results are also more generalizable to other food allergic individuals who do not have DOCK8 deficiency.

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3
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2016
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Tangye, Stuart G; Pillay, Bethany; Randall, Katrina L et al. (2017) Dedicator of cytokinesis 8-deficient CD4(+) T cells are biased to a TH2 effector fate at the expense of TH1 and TH17 cells. J Allergy Clin Immunol 139:933-949
Dimitriades, Victoria R; Devlin, Vincent; Pittaluga, Stefania et al. (2017) DOCK 8 Deficiency, EBV+ Lymphomatoid Granulomatosis, and Intrafamilial Variation in Presentation. Front Pediatr 5:38
Shah, Nirali N; Freeman, Alexandra F; Su, Helen et al. (2017) Haploidentical Related Donor Hematopoietic Stem Cell Transplantation for Dedicator-of-Cytokinesis 8 Deficiency Using Post-Transplantation Cyclophosphamide. Biol Blood Marrow Transplant 23:980-990
Freeman, Alexandra F; Shah, Nirali N; Parta, Mark et al. (2016) Haploidentical related donor hematopoietic stem cell transplantation with post-transplantation cyclophosphamide for DOCK8 deficiency. J Allergy Clin Immunol Pract 4:1239-1242.e1
Zhang, Qian; Jing, Huie; Su, Helen C (2016) Recent Advances in DOCK8 Immunodeficiency Syndrome. J Clin Immunol 36:441-9
Happel, Corinne S; Stone, Kelly D; Freeman, Alexandra F et al. (2016) Food allergies can persist after myeloablative hematopoietic stem cell transplantation in dedicator of cytokinesis 8-deficient patients. J Allergy Clin Immunol 137:1895-1898.e5
Cuellar-Rodriguez, Jennifer; Freeman, Alexandra F; Grossman, Jennifer et al. (2015) Matched related and unrelated donor hematopoietic stem cell transplantation for DOCK8 deficiency. Biol Blood Marrow Transplant 21:1037-45
Aydin, Susanne E; Kilic, Sara Sebnem; Aytekin, Caner et al. (2015) DOCK8 deficiency: clinical and immunological phenotype and treatment options - a review of 136 patients. J Clin Immunol 35:189-98
Betts, K; Abusleme, L; Freeman, A F et al. (2015) A 17-year old patient with DOCK8 deficiency, severe oral HSV-1 and aggressive periodontitis - a case of virally induced periodontitis? J Clin Virol 63:46-50
Zhang, Qian; Dove, Christopher G; Hor, Jyh Liang et al. (2014) DOCK8 regulates lymphocyte shape integrity for skin antiviral immunity. J Exp Med 211:2549-66

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