Immune cell functionality is highly dependent on the actin cytoskeleton. The actin cytoskeleton is regulated by a complex molecular machinery that involves multiple genes. Mutations in these genes can cause inborn errors of immunity, also termed immunoactinopathies, of which Wiskott-Aldrich syndrome is the best-characterized entity. Currently, mutations in 23 genes can be considered causative of immunoactinopathies. Immunoactinopathies are rare disease entities with complex combinations of clinical manifestations, including immunodeficiency, immune dysregulation, malignancies, atopy, thrombocytopenia and bleeding, skin involvement, or congenital defects. Prompt diagnosis is crucial, because hematopoietic stem cell transplantation in an early phase can offer cure and prevent further complications. This review provides a detailed summary of the clinical experience with immunoactinopathies so far, elaborates on the most distinguishing features of immunoactinopathies by providing a clinical categorization, and links this information to the underlying biological pathways. This information may be of help to clinicians in the diagnosis of patients and to eventually improve patient care.
            Skip Nav Destination
            
        
            
    
 
    
    
    
        
                
        
    
        
    
    
        
    
        
                
    
                
            
            
        
                
                
    
 
    
    
         
    
    
    
  
        
            
        
    
    
 
    
        
                
    
        
    
        
            
                
            
        
        
        
    
        
    
        
                
            
 
    
        
    
 
    
                
                
                            
                        
                        
                                    
        
    
                
 
    
            
        
     
    
        
    
        
 
    
        
    
        
    
    
    
        
    
    
    
        
    
    
    
        
    
        
        
        
        
 
    
    
 
    
    
    
        
    
    
    
            
    
                    
 
    
    
 
    
    
    
        
    
    
    
        
 
    
    
 
    
    
    
        
    
    
    
        
     
    
    
 
    
    
    
        
    
    
    
            
    
                    
 
    
    
 
    
    
 
    
    
 
    
        
    
        
 
    
     
    
         
    
    
         
    
        
    
        REVIEW ARTICLE|
        June 5, 2025
    Immunoactinopathies revisited: understanding clinical manifestations and biological pathways Available to Purchase
                            
            Fleur Hiensch,
                    
    
        
    
        
    
                        
                
                
    Fleur Hiensch
    1Department of Pediatrics, Laboratory for Pediatric Immunology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
    
        Search for other works by this author on:
    
    
    
                            
            Loïc Dupré,
                    
    
        
    
        
    
                        
                
                
    Loïc Dupré
    2Toulouse Institute for Infectious and Inflammatory Diseases, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Toulouse University, Toulouse, France
3Department of Dermatology, Medical University of Vienna, Vienna, Austria
    
        Search for other works by this author on:
    
    
    
                                Elisabeth Salzer
                    
    
        
    
        
    
                        
                
    
    Elisabeth Salzer
    1Department of Pediatrics, Laboratory for Pediatric Immunology, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
4Division of Neonatology, Pediatric Intensive Care, and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
5Department of Pediatrics, St. Anna Children’s Hospital, Medical University of Vienna, Vienna, Austria
    
        Search for other works by this author on:
    
    
    
Blood (2025) 145 (23): 2709–2732.
        
                    
                        Article history
                    
                    
                            
                                
                            
                                
                            
                                
                    
                
        Submitted:
                                September 3, 2024
                            Accepted:
                                February 3, 2025
                            First Edition:
                                February 19, 2025
                            Citation
  Fleur Hiensch, Loïc Dupré, Elisabeth Salzer; Immunoactinopathies revisited: understanding clinical manifestations and biological pathways. Blood 2025; 145 (23): 2709–2732. doi: https://doi.org/10.1182/blood.2024026763
Download citation file:
My Account
Sign In
            June 5 2025
        
    Advertisement intended for health care professionals
Cited By
Advertisement intended for health care professionals
 https://orcid.org/0009-0002-5690-1425
  https://orcid.org/0009-0002-5690-1425
        
This feature is available to Subscribers Only
Sign In or Create an Account Close Modal