Understanding the Mechanism of Diabetes Mellitus in a LRBA-Deficient Patient

Simple Summary Deficiency of lipopolysaccharide responsive beige like anchoring protein (LRBA) has been reported to cause immunological complications that can be fatal in children. Diabetes mellitus (DM) has been reported in some patients with LRBA deficiency. However, the underlying mechanism of the DM is not known. The current study provides potential novel insights into the underlying mechanism of DM in a LRBA-deficient patient. Additionally, in mouse pancreatic beta-cells, we show that LRBA plays a role in the dynamics of insulin secretion and biosynthesis. The scope of this study is to show that DM in a LRBA-deficient patient with a stop codon mutation (c.3999 G > A) was not mediated through autoimmunity. We have evaluated the ability of the proband's T cells to be activated by assessing their CTLA-4 expression. A nonsignificant difference was seen in the CTLA-4 expression on CD3+ T cells compared to the healthy control at basal level and after stimulation with PMA/ionomycin. Blood transcriptomic analysis have shown a remarkable increase in abundance of transcripts related to CD71+ erythroid cells. There were no differences in the expression of modules related to autoimmunity diseases between the proband and pooled healthy controls. In addition, our novel findings show that siRNA knockdown of LRBA in mouse pancreatic beta-cells leads reduced cellular proinsulin, insulin and consequently insulin secretion, without change in cell viability in cultured MIN6 cells.