Abstract
PLCG2 associated antibody deficiency and immune dysregulation (PLAID) is a complex dominantly inherited disease characterized almost universally by cold urticaria, and variably by recurrent bacterial infection, autoimmunty and skin granuloma formation. Several striking phenotypes can emerge from this disease, and the pathophysiology leads to a complex mix of loss and gain of function in cellular signaling. This review discusses the key phenotypic characteristics and pathophysiologic observations seen in PLAID, and contrasts PLAID to several related disorders in order to best contextualize this fascinating disease.
Similar content being viewed by others
References
Abajian M, Mlynek A, Maurer M. Physical urticaria. Curr Allergy Asthma Rep. 2012;12(4):281–7.
Mathur AN, Mathes EF. Urticaria mimickers in children. Dermatol Ther. 2013;26(6):467–75.
Soter NA, Joshi NP, Twarog FJ, Zeiger RS, Rothman PM, Colten HR. Delayed cold-induced urticaria: a dominantly inherited disorder. J Allergy Clin Immunol. 1977;59(4):294–7.
Gandhi C, Healy C, Wanderer AA, Hoffman HM. Familial atypical cold urticaria: description of a new hereditary disease. J Allergy Clin Immunol. 2009;124(6):1245–50.
Ombrello MJ, Remmers EF, Sun G, Freeman AF, Datta S, Torabi-Parizi P, et al. Cold urticaria, immunodeficiency, and autoimmunity related to PLCG2 deletions. N Engl J Med. 2012;366(4):330–8.
Aderibigbe OM, Priel DAL, Lee C-CR, Ombrello MJ, Prajapati VH, Liang MG, et al. Distinct cutaneous manifestations, autonomous and cold-induced leukocyte activation associated with PLCG2 mutations JAMA Dermatol. 2015; in press.
Bunney TD, Esposito D, Mas-Droux C, Lamber E, Baxendale RW, Martins M, et al. Structural and functional integration of the PLCgamma interaction domains critical for regulatory mechanisms and signaling deregulation. Structure. 2012;20(12):2062–75.
Wang D, Feng J, Wen R, Marine JC, Sangster MY, Parganas E, et al. Phospholipase Cgamma2 is essential in the functions of B cell and several Fc receptors. Immunity. 2000;13(1):25–35.
Tassi I, Presti R, Kim S, Yokoyama WM, Gilfillan S, Colonna M. Phospholipase C-gamma 2 is a critical signaling mediator for murine NK cell activating receptors. J Immunol. 2005;175(2):749–54.
Bai L, Chen Y, He Y, Dai X, Lin X, Wen R, et al. Phospholipase Cgamma2 contributes to light-chain gene activation and receptor editing. Mol Cell Biol. 2007;27(17):5957–67.
Abe K, Fuchs H, Boersma A, Hans W, Yu P, Kalaydjiev S, et al. A novel ENU-induced mutation in Phospholipase C gamma 2 causes inflammatory arthritis, metabolic defects, and in vitro male infertility in the mouse. Arthritis Rheum. 2011.
Yu P, Constien R, Dear N, Katan M, Hanke P, Bunney TD, et al. Autoimmunity and inflammation due to a gain-of-function mutation in phospholipase C gamma 2 that specifically increases external Ca2+ entry. Immunity. 2005;22(4):451–65.
Wang J, Sohn H, Sun G, Milner JD, Pierce SK. The autoinhibitory C-terminal SH2 domain of phospholipase C-gamma2 stabilizes B cell receptor signalosome assembly. Sci Signal. 2014;7(343):ra89.
Zhou Q, Lee GS, Brady J, Datta S, Katan M, Sheikh A, et al. A hypermorphic missense mutation in PLCG2, encoding phospholipase Cgamma2, causes a dominantly inherited autoinflammatory disease with immunodeficiency. Am J Hum Genet. 2012;91(4):713–20.
Acknowledgments
This research was supported by the Intramural Research Program of the NIH, NIAID.
Conflict of interest
The author reports no financial conflict of interest
Author information
Authors and Affiliations
Corresponding author
Additional information
Up to 1.0 AMA PRA Category 1 Credit™ of Continuing Medical Education Credit can now be obtained by reading this review article and completing all activity components by visiting the Clinical Immunology Society web site at http://www.clinimmsoc.org/education/continuing-medical-education/e-learning-tools/journal-cme
Rights and permissions
About this article
Cite this article
Milner, J.D. PLAID: a Syndrome of Complex Patterns of Disease and Unique Phenotypes. J Clin Immunol 35, 527–530 (2015). https://doi.org/10.1007/s10875-015-0177-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10875-015-0177-x