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Sanz-Cabanillas JL, Gómez-García F, Gómez-Arias PJ, Montilla-López A, Gay-Mimbrera J, Ruano J, Isla-Tejera B, Parra-Peralbo E. Efficacy and safety of anakinra and canakinumab in PSTPIP1-associated inflammatory diseases: a comprehensive scoping review. Front Immunol 2024; 14:1339337. [PMID: 38259483 PMCID: PMC10801072 DOI: 10.3389/fimmu.2023.1339337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction This scoping review explores the effectiveness of IL-1 pathway inhibitors in managing PSTPIP1-associated inflammatory diseases (PAID). These diseases are marked by abnormal IL-1 pathway activation due to genetic mutations. Methods Our methodology adhered to a pre-published protocol and involved a thorough search of MEDLINE and EMBASE databases up to February 2022, following the Joanna Briggs Institute Reviewer's Manual and the PRISMA Extension for Scoping Reviews. The review included studies reporting on IL-1 pathway inhibitor use in PAID patients. Results From an initial pool of 5,225 articles, 36 studies involving 43 patients were selected. The studies predominantly used observational designs and exhibited diversity in patient demographics, treatment approaches, and outcomes. Anakinra and canakinumab demonstrated promise in treating sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) and PSTPIP1-associated myeloid-related-proteinemia inflammatory (PAMI) syndromes, with scant data on other syndromes. Notably, there was a paucity of information on the adverse effects of these treatments, necessitating cautious interpretation of their safety profile. Conclusion Current evidence on IL-1 pathway inhibitors for PAID is primarily from observational studies and remains limited. Rigorous research with larger patient cohorts is imperative for more definitive conclusions. Collaborative efforts among specialized research centers and international health initiatives are key to advancing this field.
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Affiliation(s)
- Juan Luis Sanz-Cabanillas
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
- Department of Dermatology, Reina Sofia University Hospital, Córdoba, Spain
| | - Francisco Gómez-García
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
- Department of Dermatology, Reina Sofia University Hospital, Córdoba, Spain
| | - Pedro Jesús Gómez-Arias
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
- Department of Dermatology, Reina Sofia University Hospital, Córdoba, Spain
| | - Ana Montilla-López
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
| | - Jesús Gay-Mimbrera
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
| | - Juan Ruano
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
- Department of Dermatology, Reina Sofia University Hospital, Córdoba, Spain
- School of Medicine and Nursing, University of Cordoba, Córdoba, Spain
| | - Beatriz Isla-Tejera
- Inflammatory Immune-mediated Chronic Skin Diseases’ Laboratory, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Córdoba, Spain
- Department of Pharmacology, Reina Sofia University Hospital, Córdoba, Spain
| | - Esmeralda Parra-Peralbo
- Department of Pharmacy and Nutrition, Faculty of Biomedical Science and Health, Universidad Europea, Madrid, Spain
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Yen H, Lalor L. Non-syndromic and Syndromic Severe Acne in Adolescent Patients. Med Clin North Am 2024; 108:27-42. [PMID: 37951654 DOI: 10.1016/j.mcna.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Acne is a common skin disorder in adolescents. However, severe acne that is persistent and refractory to conventional treatment or has other associated symptoms should raise suspicion for non-syndromic or syndromic acne.
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Affiliation(s)
- Hsi Yen
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA
| | - Leah Lalor
- Department of Dermatology, Division of Pediatric Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, TBRC 2nd Floor Suite C2010, Milwaukee, WI 53226, USA.
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Gupta UC, Gupta SC, Gupta SS. Clinical Overview of Arthritis with a Focus on Management Options and Preventive Lifestyle Measures for Its Control. CURRENT NUTRITION & FOOD SCIENCE 2022. [DOI: 10.2174/1573401318666220204095629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT:
Arthritis is the spectrum of conditions that cause swelling and tenderness of one or more body joints with key symptoms of joint pain and stiffness. Its progression is closely tied to age. Although there are a number of arthritis types, such as, ankylosing, gout, joint infections, juvenile idiopathic, reactive and septic; the two most common types are osteoarthritis and rheumatoid arthritis. Osteoarthritis causes the articulating smooth cartilage that covers the ends of bones, where they form a joint, to breakdown. Rheumatoid arthritis is a disease in which the immune system attacks joints, beginning with the cartilaginous lining of the joints. The latter is considered a systemic disease, i.e. affecting many parts of the body, but the respiratory system is involved in 10 to 20 % of all mortality. Osteoarthritis is one of the leading causes of disability globally. Several preventive measures to control arthritis have been suggested, such as the use of analgesics, non-steroid anti-inflammatory drugs, moderate to vigorous physical activity and exercise, reducing sedentary hours, getting adequate sleep and maintaining a healthy body weight. Foods including, a Mediterranean diet rich in fruits and vegetables, fish oil, medicinal plants and microbiota are vital protective methods. The intake of vitamins such as A and C, minerals e.g., selenium and zinc; poly unsaturated and n-3 fatty acids is also a significant preventive measures.
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Affiliation(s)
- Umesh Chandra Gupta
- Emeritus Research Scientist, Agriculture and Agri-food Canada, Charlottetown Research and Development Centre, 440 University Avenue, Charlottetown, PE, C1A 4N6, Canada
| | - Subhas Chandra Gupta
- Chairman and Professor, The Department of Plastic Surgery, Loma Linda University School of Medicine, Loma Linda, California, 92354, USA
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Yu L, Yu S, Tan J, Zhang T, Hao Z, Wang L, Feng S. What can we learn from a tortuous diagnosis and treatment experience for a child with PAPA syndrome? A case report. Indian J Dermatol 2022; 67:79-84. [PMID: 35656258 PMCID: PMC9154148 DOI: 10.4103/ijd.ijd_277_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zhang D, Su G, Liu Y, Lai J. Clinical and genetic characteristics of PSTPIP1-associated myeloid-related proteinemia inflammatory syndrome. Pediatr Rheumatol Online J 2021; 19:151. [PMID: 34620178 PMCID: PMC8499496 DOI: 10.1186/s12969-021-00636-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/30/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To summarise the clinical and genetic characteristics of three children with PSTPIP1-associated myeloid-related proteinemia inflammatory (PAMI) syndrome. METHODS This study retrospectively analysed the clinical and genetic data of three children with PAMI syndrome in our hospital between April 2018 and January 2020. RESULTS One male and two female children were 6 years and 5 months, 8 years and 7 months, and 13 years and 3 months of age. All three patients had a recurrent blood trilineage hypoplasia and splenomegaly. Patient 1 had pyoderma gangrenosum, and Ludwig's angina. Patient 2 had pyogenic arthritis, and pyoderma gangrenosum. Patient 3 had hepatomegaly, pyogenic arthritis, and pulmonary hypertension. Laboratory tests revealed that all three children had elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patient 1: C-antineutrophilic cytoplasmic antibodies(c-ANCA), positive; antiglobulin test (Coombs), positive. Patient 2: blood zinc, 4.38 mg/L (elevated). Patient 3: Antinuclear antibodies (ANA), 1:100, β2 glycoprotein I, positive; Coombs test, positive; RF, 28.3 U/ml (elevated); C3, 0.77 g/L (decreased). Genetic testing showed that all 3 patients had PSTPIP1 c.748G > A (p.E250K) spontaneous heterozygous mutations, suggesting the diagnosis of PAMI syndrome. Patient 1 was treated with a combination of methylprednisolone and cyclosporine for 8 months. The patient did not develop new skin lesions. The blood count showed mild neutropenia. The spleen was considerably retracted and the CRP became normal. Patient 2 was treated with etanercept and methylprednisolone. The patient had no further arthralgias and pyoderma gangrenosum showed improvement. The spleen was smaller than before. White blood cells were shown to be approximately 2-3 × 109/L. The haematocrit, platelets, CRP, and AESR were normal. Patient 3 was treated with methylprednisolone, methotrexate, and infliximab 4 times. The patient's joint symptoms disappeared gradually and the liver retracted markedly. The pulmonary artery pressure returned to normal. Moreover, Coombs test result was negative. CRP and AESR were lower than before. CONCLUSION PAMI syndrome can manifest as pyogenic arthritis, pyoderma gangrenosum, acne, and trilineage hypoplasia, as well as autoimmune diseases. Glucocorticoid and immunosuppressive therapy are partially effective and cytokine antagonists can be used in refractory cases. Whole-exome genetic testing is helpful to confirm diagnosis.
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Affiliation(s)
- Dan Zhang
- grid.418633.b0000 0004 1771 7032Department of Rheumatology, Capital institute of pediatrics, 2 yabao road, chaoyang district, Beijing, China
| | - Gaixiu Su
- Department of Rheumatology, Capital institute of pediatrics, 2 yabao road, chaoyang district, Beijing, China.
| | - Yan Liu
- Department of Rheumatology, Dalian municipal Women and Children’s Medical Center, No.1 and No.3, Sports newtown planning road 1,Ganjingzi district, Dalian City, Liaoning China
| | - Jianming Lai
- grid.418633.b0000 0004 1771 7032Department of Rheumatology, Capital institute of pediatrics, 2 yabao road, chaoyang district, Beijing, China
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Lu LY, Tang XY, Luo GJ, Tang MJ, Liu Y, Yu XJ. Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome in a Chinese family: A case report and review of literature. World J Clin Cases 2021; 9:6393-6402. [PMID: 34435004 PMCID: PMC8362586 DOI: 10.12998/wjcc.v9.i22.6393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/07/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is a rare autosomal dominant genetic disease characterized by severe autoimmune inflammation, caused by mutations in the PSTPIP1 gene. Due to PAPA heterogeneous clinical manifestation, misdiagnosis or delayed diagnoses are difficult to avoid. With the use of whole-exome sequencing, we identified a missense mutation in the PSTPIP1 gene in a Chinese family. To the best of our knowledge, this is the first case of PAPA reported in China.
CASE SUMMARY A 9-year-old boy suffered from recurrent aseptic pyogenic arthritis triggered by minor trauma or few obvious predisposing causes for more than 3 years. Pyogenic arthritis occurred every 3-5 mo, affecting his knees, elbows, and ankle joints. Treatments, such as glucocorticoids, antibiotics, even surgeries could alleviate joints pain and swelling to some extent but could not inhibit the recurrence of arthritis. Similar symptoms were present in his younger brother but not in his parents. According to the whole-exome sequencing, a missense mutation in exon 11 of the PSTPIP1 gene (c.748G>C; p.E250Q) was detected in the boy, his younger brother and his father. Taking into account the similar phenotypic features with PAPA syndrome reported previously, we confirmed a diagnosis of PAPA syndrome for the family.
CONCLUSION In this case, a missense mutation (c.748G>C; p.E250Q) in PSTPIP1 gene was identified in a Chinese family with PAPA syndrome. Previous studies emphasize the fact that PAPA syndrome is hard to diagnose just through the clinical manifestations owing to its heterogeneous expression. Genetic testing is an effectual auxiliary diagnostic method, especially in the early stages of pyogenic arthritis. Only if we have a deep understanding and rich experience of this rare disease can we make a prompt diagnosis, develop the best clinical treatment plan, and give good fertility guidance.
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Affiliation(s)
- Ling-Yun Lu
- Department of Endocrinology, Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xue-Yang Tang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Guo-Jing Luo
- Department of Endocrinology, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Zhuhai 519000, Guangdong Province, China
| | - Meng-Jia Tang
- Department of Endocrinology, Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Liu
- Department of Rheumatology and Immunology, Rare Disease Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xi-Jie Yu
- Department of Endocrinology, Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Xu XM, Huang H, Ding F, Yang Z, Wang J, Jin YL. PAMI syndrome: A rare cause that can be easily misdiagnosed. Am J Med Genet A 2021; 185:3074-3082. [PMID: 34047005 DOI: 10.1002/ajmg.a.62367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 04/22/2021] [Accepted: 05/07/2021] [Indexed: 11/09/2022]
Abstract
PSTPIP1-associated myeloid-related proteinemia inflammatory (PAMI) syndrome caused by mutations in PSTPIP1 is a rare inflammatory disorder that can be easily misdiagnosed. It is characterized by anemia, arthritis, cutaneous inflammation, recurrent infections, growth failure, hepatosplenomegaly, lymphadenopathy, hyperzincemia/hypercalprotectinemia, neutropenia, thrombocytopenia, and elevated inflammatory indicators. This study describes the cases of two pediatric female patients with long-standing recurrent arthralgia in different parts of the extremities and severe anemia, respectively, who were misdiagnosed and treated for aseptic necrosis of the femoral head and severe autoimmune hemolytic anemia, respectively. High-throughput sequencing analysis revealed a de novo heterozygous missense mutation (c.748G > A, p. Glu250Lys) in exon 11 of PSTPIP1 (NM_003978.5) in both patients, which supported a diagnosis of PAMI. The patients were treated with prednisone and etanercept, which improved their symptoms, but neutropenia remained unchanged. These cases highlight the importance of genetic assessment for the accurate diagnosis of PAMI and to ensure adequate and timely treatment of these patients.
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Affiliation(s)
- Xue-Mei Xu
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Huang
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Ding
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Yang
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Wang
- Department of Genetics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan-Liang Jin
- Department of Rheumatology and Immunology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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8
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Yamaguchi Y, Nakagawa M, Nakagawa S, Nagao K, Inoue S, Sugiyama T, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Rapidly Progressing Aseptic Abscesses in a Patient with Ulcerative Colitis. Intern Med 2021; 60:725-730. [PMID: 32999240 PMCID: PMC7990631 DOI: 10.2169/internalmedicine.5733-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aseptic abscesses (AAs) are extraintestinal manifestations of inflammatory bowel disease (IBD). IBD-associated AAs are rare in Japan. We treated a 45-year-old man with ulcerative colitis (UC)-associated AAs. During remission, multiple progressive abscesses were detected in the spleen; he underwent splenectomy because an infectious disease was suspected. Although his condition improved temporarily after splenectomy, a large liver abscess was noted, and a diagnosis of UC-associated AAs was made. Granulocytapheresis (GCAP) and infliximab (IFX) administration resolved the abscess. This is the first reported case of UC-associated AAs in a Japanese patient treated by splenectomy, GCAP, and IFX.
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Affiliation(s)
- Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Marie Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shoko Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazuhiro Nagao
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
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Kotzerke M, Mitri F, Marbach F, Enk A, Haenssle H. A case of PAPASH syndrome in a young man carrying a novel heterozygote missense variant in PSTPIP1. J Eur Acad Dermatol Venereol 2021; 35:e439-e440. [PMID: 33587775 DOI: 10.1111/jdv.17171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M Kotzerke
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - F Mitri
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - F Marbach
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - A Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - H Haenssle
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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10
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Boursier G, Piram M, Rittore C, Sarrabay G, Touitou I. Phenotypic Associations of PSTPIP1 Sequence Variants in PSTPIP1-Associated Autoinflammatory Diseases. J Invest Dermatol 2020; 141:1141-1147. [PMID: 33218716 DOI: 10.1016/j.jid.2020.08.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/12/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
Pathogenic variants in the PSTPIP1 gene cause pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome. They were also identified in a broad spectrum of phenotypes. As their interpretation is sometimes challenging, we discuss the genotype-phenotype association in PSTPIP1-associated autoinflammatory diseases (PAIDs) in light of a recent consensus classification of variant pathogenicity. Only 7 of 39 (18%) of the PSTPIP1 variants found in all reported cases and our national reference center (161 patients [114 probands]) were pathogenic. They were clearly associated with PAPA and PSTPIP1-associated myeloid-related proteinemia inflammatory syndrome (PAMI), reflecting a variable clinical expression of PAIDs.
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Affiliation(s)
- Guilaine Boursier
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Auto Inflammatory Diseases Unit, CEREMAIA, CHU Montpellier, University of Montpellier, Montpellier, France.
| | - Maryam Piram
- CEREMAIA, Pediatric Rheumatology Department, CHU de Bicêtre, University Paris Saclay, Le Kremlin-Bicêtre, France; Department of Pediatrics, Division of Dermatology, CHU Sainte Justine Research Center, CHU Sainte Justine, University of Montréal, Montréal, Québec, Canada
| | - Cécile Rittore
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Auto Inflammatory Diseases Unit, CEREMAIA, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Guillaume Sarrabay
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Auto Inflammatory Diseases Unit, CEREMAIA, CHU Montpellier, University of Montpellier, Montpellier, France; Cellules souches, plasticité cellulaire, médecine régénératrice et immunothérapies, INSERM, University of Montpellier, Montpellier, France
| | - Isabelle Touitou
- Department of Medical Genetics, Rare Diseases and Personalized Medicine, Rare and Auto Inflammatory Diseases Unit, CEREMAIA, CHU Montpellier, University of Montpellier, Montpellier, France; Cellules souches, plasticité cellulaire, médecine régénératrice et immunothérapies, INSERM, University of Montpellier, Montpellier, France
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Acne in the first three decades of life: An update of a disorder with profound implications for all decades of life. Dis Mon 2020; 67:101103. [PMID: 33041056 DOI: 10.1016/j.disamonth.2020.101103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acne vulgaris is a chronic, inflammatory, skin condition that involves the pilosebaceous follicles and is influenced by a variety of factors including genetics, androgen-stimulation of sebaceous glands with abnormal keratinization, colonization with Cutibacterium acnes (previously called Propionibacterium acnes), and pathological immune response to inflammation. Acne can occur at all ages and this discussion focuses on the first three decades of life. Conditions that are part of the differential diagnosis and/or are co-morbid with acne vulgaris are also considered. Acne in the first year of life includes neonatal acne (acne neonatorum) that presents in the first four weeks of life and infantile acne that usually presents between 3 and 6 months of the first year of life with a range of 3 to 16 months after birth. Acne rosacea is a chronic, inflammatory, skin condition that is distinct from acne vulgaris, typically presents in adults, and has four main types: erythemato-telangiectatic, papulopustular, phymatous and ocular. Treatment options for acne vulgaris include topical retinoids, topical benzoyl peroxide, antibiotics (topical, oral), oral contraceptive pills, isotretinoin, and others. Management must consider the increasing impact of antibiotic resistance in the 21st century. Psychological impact of acne can be quite severe and treatment of acne includes awareness of the potential emotional toll this disease may bring to the person with acne as well as assiduous attention to known side effects of various anti-acne medications (topical and systemic). Efforts should be directed at preventing acne-caused scars and depigmentation on the skin as well as emotional scars within the person suffering from acne.
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12
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Alsharief AN, Laxer RM, Wang Q, Stimec J, Man C, Babyn P, Doria AS. Monogenic autoinflammatory diseases in children: single center experience with clinical, genetic, and imaging review. Insights Imaging 2020; 11:87. [PMID: 32737687 PMCID: PMC7394994 DOI: 10.1186/s13244-020-00889-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/26/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose 1. To review the contemporary literature and present a list of the imaging findings for patients with autoinflammatory diseases from our hospital. All these patients are found to have a genetic mutation that is responsible for their disease. 2. To present follow-up imaging findings, when available, and correlate those with symptoms and type of treatment administered in approximately 40 patients with autoinflammatory diseases of a single tertiary pediatric health care center including familial Mediterranean fever, Cryopyrin-associated autoinflammatory syndrome, PAPA (pyogenic arthritis, pyoderma gangrenousum, and acne) syndrome, and more. These findings are related to disease progression, treatment response, or treatment-induced changes. Conclusion Autoinflammatory diseases are relatively rare entities that can affect any system of the body. Given the many nonspecific imaging features, awareness of these diseases and good communication with clinicians aid in reaching an accurate diagnosis.
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Affiliation(s)
- Alaa N Alsharief
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada. .,Medical Imaging Department, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City - Western Region, Old Makkah Road Kilo 24 1 Western, P.O. Box 9515, Jeddah, 21423, Saudi Arabia.
| | - Ronald M Laxer
- Department of Paediatric, Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Qiuyan Wang
- York Radiology Consultants, Toronto, ON, Canada
| | - Jennifer Stimec
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Carina Man
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Paul Babyn
- Department of Medical Imaging, Royal University Hospital, Saskatoon, SK, Canada
| | - Andrea S Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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13
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Abstract
Pyogenic arthritis, pyoderma gangrenosum (PG) and acne (PAPA) syndrome is an autosomal dominant autoinflammatory syndrome due to mutations in proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene and presenting with cutaneous and articular manifestations. Other autoinflammatory syndromes caused by mutations in PSTPIP1 gene or characterized by clinical findings overlapping with those found in PAPA syndrome have been recently included in the group of PAPA spectrum disorders. These disorders are PASH (PG, acne and hidradenitis suppurativa [HS]), PAPASH (PASH associated with pyogenic sterile arthritis), PsAPASH (PASH combined with psoriatic arthritis [PsA], PASS (PG, acne, ankylosing spondylitis, with or without HS), PAC (PG, acne and ulcerative colitis [UC]) and PAMI syndrome (PSTPIP1-associated myeloid-related-proteinemia inflammatory syndrome). Except for PAPA and PAMI, no specific pathogenetic mutations have been identified in these syndromes. Dermatologists should be aware that PG, acne and HS may represent cutaneous signs hiding the presence of these rare entities. Systemic corticosteroids, a number of immunosuppressants and biologics, such as interleukin (IL)-1 antagonists and tumour necrosis factor (TNF) α inhibitors, are nowadays therapy for these diseases. A pathogenesis-driven treatment is the near future in the management of these conditions.
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Affiliation(s)
- Giovanni Genovese
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simone Garcovich
- Institute of Dermatology, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Angelo V Marzano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy - .,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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14
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Navallas M, Inarejos Clemente EJ, Iglesias E, Rebollo-Polo M, Zaki FM, Navarro OM. Autoinflammatory diseases in childhood, part 1: monogenic syndromes. Pediatr Radiol 2020; 50:415-430. [PMID: 32065272 DOI: 10.1007/s00247-019-04536-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/14/2019] [Accepted: 09/10/2019] [Indexed: 02/07/2023]
Abstract
Autoinflammatory diseases constitute a family of disorders defined by aberrant stimulation of inflammatory pathways without involving antigen-directed autoimmunity. They may be divided into monogenic and polygenic types. Monogenic autoinflammatory syndromes are those with identified genetic mutations, such as familial Mediterranean fever, tumor necrosis factor receptor-associated periodic fever syndrome (TRAPS), mevalonate kinase deficiency or hyperimmunoglobulin D syndrome, cryopyrin-associated periodic fever syndromes (CAPS), pyogenic arthritis pyoderma gangrenosum and acne (PAPA) syndrome, interleukin-10 and interleukin-10 receptor deficiencies, adenosine deaminase 2 deficiency and pediatric sarcoidosis. Those without an identified genetic mutation are known as polygenic and include systemic-onset juvenile idiopathic arthritis, idiopathic recurrent acute pericarditis, Behçet syndrome, chronic recurrent multifocal osteomyelitis and inflammatory bowel disease among others. Autoinflammatory disorders are defined by repeating episodes or persistent fever, rash, serositis, lymphadenopathy, arthritis and increased acute phase reactants, and thus may mimic infections clinically. Most monogenic autoinflammatory syndromes present in childhood. However, because of their infrequency, diverse and nonspecific presentation, and the relatively new genetic recognition, diagnosis is usually delayed. In this article, which is Part 1 of a two-part series, the authors update monogenic autoinflammatory diseases in children with special emphasis on imaging features that may help establish the correct diagnosis.
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Affiliation(s)
- María Navallas
- Department of Radiology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2. 08950 Esplugues de Llobregat, Barcelona, Spain. .,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. .,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada.
| | - Emilio J Inarejos Clemente
- Department of Radiology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2. 08950 Esplugues de Llobregat, Barcelona, Spain
| | | | - Mónica Rebollo-Polo
- Department of Radiology, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2. 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Faizah Mohd Zaki
- Department of Radiology, UKM Medical Center, Kuala Lumpur, Malaysia
| | - Oscar M Navarro
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
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15
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Marino A, Tirelli F, Giani T, Cimaz R. Periodic fever syndromes and the autoinflammatory diseases (AIDs). J Transl Autoimmun 2019; 3:100031. [PMID: 32743516 PMCID: PMC7388371 DOI: 10.1016/j.jtauto.2019.100031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/14/2022] Open
Abstract
Innate immune system represents the ancestral defense against infectious agents preserved along the evolution and species; it is phylogenetically older than the adaptive immune system, which exists only in the vertebrates. Cells with phagocytic activity such as neutrophils, macrophages, and natural killer (NK) cells play a key role in innate immunity. In 1999 Kastner et al. first introduced the term “autoinflammation” describing two diseases characterized by recurrent episodes of systemic inflammation without any identifiable infectious trigger: Familial Mediterranean Fever (FMF) and TNF Receptor Associated Periodic Syndrome (TRAPS). Autoinflammatory diseases (AIDs) are caused by self-directed inflammation due to an alteration of innate immunity leading to systemic inflammatory attacks typically in an on/off mode. In addition to inflammasomopathies, nuclear factor (NF)-κB-mediated disorders (also known as Rhelopathies) and type 1 interferonopathies are subjects of more recent studies. This review aims to provide an overview of the field with the most recent updates (see “Most recent developments in..” paragraphs) and a description of the newly identified AIDs. Autoinflammatory diseases are caused by self-directed inflammation. Alteration of innate immunity leads to systemic inflammation attacks. The autoinflammatory field is exponentially expanding. The advances in AIDs have led to new insights into immune system understanding. Autoimmunity and autoinflammation features may be simultaneously present.
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Affiliation(s)
- Achille Marino
- Department of Pediatrics, Desio Hospital, ASST Monza, Desio, MB, Italy.,Biomedical Sciences, University of Florence, Florence, Italy
| | - Francesca Tirelli
- Rheumatology Unit, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Teresa Giani
- Rheumatology Unit, Meyer Children's Hospital, University of Florence, Florence, Italy.,Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Rolando Cimaz
- Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy
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