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Elsevier, Clinical Immunology, 1(153), p. 104-108, 2014

DOI: 10.1016/j.clim.2014.04.005

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Successful Interferon-alpha 2b Therapy for Unremitting Warts in a Patient with DOCK8 Deficiency.

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Abstract

The autosomal recessive form of the Hyper IgE syndrome (AR-HIES) with dedicator of cytokinesis 8 (DOCK8) deficiency is associated with difficult to treat persistent viral skin infections, including papilloma virus infection. Type I interferons play an important role in the defense against viruses. We examined the effect of therapy with IFN-α 2b in an 11-year old boy with DOCK8 deficiency due to a homozygous splice donor site mutation in DOCK8 intron 40. His unremitting warts showed dramatic response to IFN-α 2b therapy. Immunological studies revealed decreased circulating plasmacytoid dendritic cells (pDCs) and profound deficiency of IFN-α production by his peripheral blood mononuclear cells in response to treatment with CpG oligonucleotides. These findings indicate that underlying pDC deficiency and impaired IFN-α production may predispose to chronic viral infections in DOCk8 deficiency. IFN-α 2b therapy maybe useful in controlling recalcitrant viral infections in these patients.