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Blood, 15 July 2006, Vol. 108, No. 2, pp. 493-500.
Prepublished online as a Blood First Edition Paper on March 21, 2006; DOI 10.1182/blood-2005-11-4689.
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HEMATOPOIESIS
Mutations in neutrophil elastase causing congenital neutropenia lead to cytoplasmic protein accumulation and induction of the unfolded protein response
Inga Köllner,
Beate Sodeik,
Sabine Schreek,
Holger Heyn,
Nils von Neuhoff,
Manuela Germeshausen,
Cornelia Zeidler,
Martin Krüger,
Brigitte Schlegelberger,
Karl Welte, and
Carmela Beger
From the Institute of Cell and Molecular Pathology, the Institute of Virology, the Department of Pediatric Hematology and Oncology, and the Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Severe congenital neutropenia (SCN) and cyclic neutropenia (CyN) are sporadic or inherited hematologic disorders of myelopoiesis. Heterozygous mutations in the gene encoding neutrophil elastase (ELA2) have been reported in both diseases. We used an inducible system to express a panel of ELA2 mutations and found for almost all mutants disruption of intracellular neutrophil elastase (HNE) protein processing at different levels. This disruption resulted in cytoplasmic accumulation of a nonfunctional protein, thereby preventing its physiologic transport to azurophil granules. Furthermore, the secretory capacity of the mutant proteins was greatly diminished, indicating alteration of the regulated and the constitutive pathways. Through analysis of primary granulocytes from SCN patients carrying ELA2 mutations, we found an identical pattern of intracellular accumulation of mutant HNE protein in the cytoplasm. Moreover, cells expressing mutant HNE protein exhibited a significant increase in apoptosis associated with up-regulation of the master ER chaperone BiP, indicating that disturbance of intracellular trafficking results in activation of the mammalian unfolded protein response.

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