Journal
SCIENCE
Volume 321, Issue 5889, Pages 691-696Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/science.1158298
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Funding
- Howard Hughes Medical Institute Funding Source: Medline
- NIAID NIH HHS [U19 AI057234, U19 AI057234-02] Funding Source: Medline
- PHS HHS [U19 AIO57234-02] Funding Source: Medline
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MyD88 is a key downstream adapter for most Toll- like receptors ( TLRs) and interleukin- 1 receptors ( IL- 1Rs). MyD88 deficiency in mice leads to susceptibility to a broad range of pathogens in experimental settings of infection. We describe a distinct situation in a natural setting of human infection. Nine children with autosomal recessive MyD88 deficiency suffered from life- threatening, often recurrent pyogenic bacterial infections, including invasive pneumococcal disease. However, these patients were otherwise healthy, with normal resistance to other microbes. Their clinical status improved with age, but not due to any cellular leakiness in MyD88 deficiency. The MyD88- dependent TLRs and IL- 1Rs are therefore essential for protective immunity to a small number of pyogenic bacteria, but redundant for host defense to most natural infections.
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