Loss of the TRPM4 channel in humans causes immune dysregulation with defective monocyte migration

J Allergy Clin Immunol. 2024 May 14:S0091-6749(24)00466-4. doi: 10.1016/j.jaci.2024.02.026. Online ahead of print.


Background: TRPM4 is a broadly expressed, calcium-activated, monovalent cation channel that regulates immune cell function in mice and cell lines. Clinically, however, partial loss- or gain-of-function mutations in TRPM4 lead to arrhythmia and heart disease, with no documentation of immunologic disorders.

Objective: To characterize functional cellular mechanisms underlying the immune dysregulation phenotype in a proband with a mutated TRPM4 gene.

Methods: We employed a combination of biochemical, cell biological, imaging, omics analyses, flow cytometry, and gene editing approaches.

Results: We report the first human cases to our knowledge with complete loss of the TRPM4 channel, leading to immune dysregulation with frequent bacterial and fungal infections. Single-cell and bulk RNA sequencing point to altered expression of genes affecting cell migration, specifically in monocytes. Inhibition of TRPM4 in T cells and the THP-1 monocyte cell line reduces migration. More importantly, primary T cells and monocytes from TRPM4 patients migrate poorly. Finally, CRISPR knockout of TRPM4 in THP-1 cells greatly reduces their migration potential.

Conclusion: Our results demonstrate that TRPM4 plays a critical role in regulating immune cell migration, leading to increased susceptibility to infections.

Keywords: TRPM4; immune dysregulation; infections; loss of function; migration; monocyte.