Anti-IFN-? autoantibody syndrome presenting with disseminated NTM infections: A case series and therapeutic implications and review of literature

Title : Anti-IFN-? autoantibody syndrome presenting with disseminated NTM infections: A case series and therapeutic implications and review of literature

Abstract:

Anticytokine autoantibodies, particularly anti-IFN-γ autoantibodies (AAbs), disrupt cytokine functions, leading to infections, autoimmune-like diseases, and conditions resembling IL-12/IFN-γ pathway defects. Advances in genetic testing have clarified overlaps between autoinflammatory, autoimmune disorders, and primary immunodeficiencies but reveal complex phenotypes and pathways. While these insights deepen our understanding of immune mechanisms, they also complicate diagnosis and treatment, with limited options for IFN-γ deficiencies caused by genetic mutations. The adult-onset immunodeficiency with disseminated lymphadenitis due to nontuberculous mycobacteria (NTM) and other opportunistic infections, linked to high levels of anti–IFN-γ autoantibodies. This syndrome, initially identified in HIV-negative Asian patients, frequently affects individuals of Asian descent and may be associated with specific HLA alleles. The presence of neutralizing anti–IFN-γ autoantibodies impairs the IFN-γ–dependent immune response, likely contributing to the persistent NTM infection. This understanding of immunopathology underscores the potential for late-onset anti-IFN-γ autoantibody syndrome to manifest with disseminated NTM infections and highlights the timely diagnosis and prescribing rituximab as a potential therapeutic option

Biography:

Dr. Yazdan Mirzanejad is a highly respected Infectious Diseases specialist with formal certification in Tropical Medicine, and a Clinical Professor in the Division of Infectious Diseases at the University of British Columbia (UBC). He currently leads Undergraduate Medical Education at UBC’s Surrey Campus and holds an adjunct faculty appointment with the Simon Fraser University (SFU) Medical School. Dr. Mirzanejad also serves as Co-Site Director of the CDC-GeoSentinel Global Surveillance Network (Vancouver site), a prestigious international initiative monitoring emerging and travel-related infectious diseases. Over the course of his distinguished career, he has authored and contributed to more than 50 peer-reviewed publications, advancing knowledge in the diagnosis, management, and prevention of infectious and tropical diseases.

Renowned for his academic leadership, clinical expertise, and global health perspective, Dr. Mirzanejad has been a driving force in shaping the education of future physicians and in promoting excellence in infectious diseases care. His work has had a significant impact on public health policy, clinical training, and research both nationally and internationally. As a frequent keynote speaker and contributor at international conferences, he continues to influence the evolving landscape of infectious diseases through research, collaboration, and education. Dr. Mirzanejad practice and teaches in Surrey, Fraser Health, located in the South of Vancouver, British Columbia.