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Qu YD, Jiang N, Li JX, Zhang W, Xia CL, Ou SJ, Yang Y, Ma YF, Qi Y, Xu CP. Chronic osteomyelitis risk is associated with NLRP3 gene rs10754558 polymorphism in a Chinese Han Population. BMC Med Genomics 2024; 17:38. [PMID: 38287380 PMCID: PMC10823619 DOI: 10.1186/s12920-024-01799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) in the nucleotide-binding domain leucine-rich repeat protein-3 (NLRP3) gene are reported to be linked to many inflammatory disorders. However, uncertainty persists over the associations between these SNPs and susceptibilities to chronic osteomyelitis (COM). This study aimed to investigate potential relationships between NLRP3 gene SNPs and the risks of developing COM in a Chinese Han cohort. METHODS The four tag SNPs of the NLRP3 gene were genotyped in a total of 428 COM patients and 368 healthy controlsusing the SNapShot technique. The genotype distribution, mutant allele frequency, and the four genetic models (dominant, recessive, homozygous, and heterozygous) of the four SNPs were compared between the two groups. RESULTS A significant association was found between rs10754558 polymorphism and the probability of COM occurence by the heterozygous model (P = 0.037, odds ratio [OR] = 1.541, 95% confidence interval [CI] = 1.025-2.319), indicating that rs10754558 may be associated with a higher risk of developing COM.In addition, possible relationship was found between rs7525979 polymorphism and the risk of COM development by the outcomes of homozygous (P = 0.073, OR = 0.453, 95% CI = 0.187-1.097) and recessive (P = 0.093, OR = 0.478, 95% CI = 0.198-1.151) models, though no statistical differences were obtained. CONCLUSIONS Outcomes of the present study showed, for the first time, that rs10754558 polymorphism of the NLRP3 gene may increase the risk of COM development in this Chinese Han population, with genotype CG as a risk factor. Nonetheless, this conclusion requires verification from further studies with a larger sample size.
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Grants
- 81972083, 82172197 National Natural Science Foundation of China
- 81972083, 82172197 National Natural Science Foundation of China
- 2020A0505100039 Guangdong Provincial Science and Technology Project
- 2022A1515012385 Guangdong Basic and Applied Basic Research Foundation
- 202201020303, 202102080052, 202102010057, 201804010226 Science and Technology Planning Project of Guangzhou
- 202201020303, 202102080052, 202102010057, 201804010226 Science and Technology Planning Project of Guangzhou
- 3D-A2020004, 3D-A2020002, YQ2019-009, C2020019 Science Foundation of Guangdong Second Provincial General Hospital
- 3D-A2020004, 3D-A2020002, YQ2019-009, C2020019 Science Foundation of Guangdong Second Provincial General Hospital
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Affiliation(s)
- Yu-Dun Qu
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Nan Jiang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - Jia-Xuan Li
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Wei Zhang
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Chang-Liang Xia
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Shuan-Ji Ou
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Yang Yang
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Yun-Fei Ma
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - Yong Qi
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China.
| | - Chang-Peng Xu
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China.
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Yao Y, Cai X, Zhang M, Zhang X, Ren F, Zheng Y, Fei W, Zhao M, Zheng C. PSTPIP2 regulates synovial macrophages polarization and dynamics via ERβ in the joint microenvironment. Arthritis Res Ther 2022; 24:247. [PMID: 36324152 PMCID: PMC9628044 DOI: 10.1186/s13075-022-02939-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background The cytoskeletal protein, PSTPIP2, is associated with inflammation and is predominantly expressed in macrophages. Previous data have shown that PSTPIP2 inhibits articular bone damage in arthritic rats. The aim of this study is to explore the molecular mechanism of PSTPIP2’s resistance to bone erosion. Methods In the current study, peripheral blood and surgically excised synovial tissue from RA patients, DBA/1 mice, Pstpip2CreR26-ZsGreen reporter mice, and Esr2fl/fl/Adgre-Cre tool mice were used for in vivo studies. Adeno-associated viral vector was used to overexpress PSPTIP2 protein in vivo. Results We found that The level of PSTPIP2 in synovial macrophages is negatively correlated with RA disease activity, which is mediated by synovial macrophages polarization. PSTPIP2hi synovial macrophages form a tight immunological barrier in the lining layer. Notably, the ability of PSTPIP2 to regulate synovial macrophages polarization is dependent on ERβ. Additionally, PSTPIP2 regulates the dynamics of synovial macrophages via ERβ. Conclusions Together, this study reveals that PSTPIP2 regulates synovial macrophages polarization and dynamics via ERβ to form an immunological barrier (F4/80+PSTPIP2hi cell-enriched zone) for the joints. Thus, local modulation of PSTPIP2 expression in the joint microenvironment may be a potential strategy for controlling bone erosion in rheumatoid arthritis. Graphical Abstract PSTPIP2 regulates synovial macrophages polarization and dynamics via ERβ to form F4/80+PSTPIP2hi cellular barrier in joint microenvironment.![]() Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02939-y.
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Affiliation(s)
- Yao Yao
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Xiaoyu Cai
- Department of Clinical Pharmacology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Meng Zhang
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Xiao Zhang
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Fujia Ren
- Department of Pharmacy, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, China
| | - Yan Zheng
- Department of Geriatrics, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Weidong Fei
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Mengdan Zhao
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
| | - Caihong Zheng
- Department of Pharmacy, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, China.
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3
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Wang Y, Wang S, Zheng L, Wang X, Wang H, Zhong Z, Liu S, Zheng X, Gao M. Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome with Cutis Verticis Gyrata: Case Report and Review of Literature. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1415-1420. [PMID: 35910507 PMCID: PMC9329683 DOI: 10.2147/ccid.s372522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/14/2022] [Indexed: 12/01/2022]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is a rare disease clinically characterized by a wide range of cutaneous and osteoarticular manifestations. Here, we report a case of SAPHO syndrome with cutis verticis gyrata (CVG) and investigated the genetic causes in the four members of this pedigree. After failure of conventional treatments, a recombinant human TNF-α receptor II:IgG Fc fusion protein (rhTNFR:Fc, YISAIPU®) achieved good control of the disease at the 2-year follow-up. We did not identify any pathogenic mutation in this pedigree. We also summarized the clinical and therapeutic characteristics of 83 patients with SAPHO syndrome through the China National Knowledge Infrastructure (CKNI) database from 2016 to 2021. Patients with acne were young and predominantly male. About 45.8% patients were treated with biological therapies or traditional Chinese medicine (TCM), 84.2% of which showed positive effects against cutaneous and osteoarticular manifestations. We report a case of SAPHO syndrome with CVG that was successfully treated with rhTNFR:Fc. Our results reveal the genetic heterogeneity involved. Biologics and TCM are likely alternative options for the treatment of SAPHO syndrome.
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Affiliation(s)
- Yifan Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Shan Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Liyun Zheng
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Xiuli Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Hui Wang
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Zhenyu Zhong
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Siqi Liu
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Xiaodong Zheng
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
| | - Min Gao
- Department of Dermatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, Anhui, People's Republic of China.,Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, People's Republic of China
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4
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Schnabel A, Nashawi M, Anderson C, Felsenstein S, Lamoudi M, Poole-Cowley J, Lindell E, Oates B, Fowlie P, Walsh J, Ellis T, Hahn G, Goldspink A, Martin N, Mahmood K, Hospach T, Lj M, Hedrich CM. TNF-inhibitors or bisphosphonates in chronic nonbacterial osteomyelitis? - Results of an international retrospective multicenter study. Clin Immunol 2022; 238:109018. [PMID: 35460903 DOI: 10.1016/j.clim.2022.109018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
Chronic nonbacterial osteomyelitis (CNO) can cause significant morbidity, including bone pain and damage. In the absence of clinical trials, treatments include non-steroidal anti-inflammatory drugs, corticosteroids, TNF-inhibitors (TNFi) and/or bisphosphonates. In a retrospective chart review in the United Kingdom and Germany, we investigated response to TNFi and/or pamidronate. Ninety-one patients were included, receiving pamidronate (n = 47), TNFi (n = 22) or both sequentially (n = 22). Patients with fatigue [p = 0.003] and/or arthritis [p = 0.002] were more frequently treated with TNFi than pamidronate. Both therapies were associated with clinical remission at 6 months, and reduction of bone lesions on MRI at 12 months. While not reaching statistical significance, pamidronate resulted in faster resolution of MRI lesions. Fewer flares were observed with TNFi. Failure to respond to pamidronate was associated with female sex [p = 0.027], more lesions on MRI [p = 0.01] and higher CRP levels [p = 0.03]. Randomized clinical trials are needed to confirm observations and generate evidence.
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Affiliation(s)
- A Schnabel
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
| | - M Nashawi
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany; Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - C Anderson
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - S Felsenstein
- Department of Infectious Disease and Immunology, Alder Hey Children's NHS Foundation Trust, United Kingdom
| | - M Lamoudi
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - J Poole-Cowley
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - E Lindell
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - B Oates
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - P Fowlie
- Ninewells Hospital, Dundee, United Kingdom
| | - J Walsh
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - T Ellis
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Hahn
- Department of Radiology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - A Goldspink
- Raigmore Hospital, Inverness, United Kingdom
| | - N Martin
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - K Mahmood
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - T Hospach
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany
| | - McCann Lj
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - C M Hedrich
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom; Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom.
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5
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Zhao M, Wu D, Yu K, Shen M. Clinical and Genetic Features of Chinese Adult Patients With Chronic Non-Bacterial Osteomyelitis: A Single Center Report. Front Immunol 2022; 13:860646. [PMID: 35422809 PMCID: PMC9002012 DOI: 10.3389/fimmu.2022.860646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/07/2022] [Indexed: 12/21/2022] Open
Abstract
Objectives Chronic non-bacterial osteomyelitis (CNO) is a rare polygenic autoinflammatory bone disease. We aimed to characterize the clinical manifestations and gene variants of Chinese adult patients with CNO. Methods By reviewing data of all CNO patients being diagnosed and followed up at the Center for Adult Autoinflammation Diseases, Department of Rheumatology, Peking Union Medical College Hospital, clinical and genetic features of these patients were evaluated and concluded. Results The median age of disease onset was 19 (6-64) years old, and adult-onset was observed in 6 (60%) patients. The mean time of diagnosis delay was 92 ± 78 months. The common symptoms were bone pain (10, 100%), fever (9, 90%), and arthritis (6, 60%). In total, there were 54 skeletal lesions, and each patient had no less than 2 lesions. The most frequently affected sites included lower limbs (20.5%), mandible, vertebrae and pelvis (17.5%, separately). Variants of 4 genes were detected in our study including COL1A1, PSTPIP1, LRP5 and CLCN7. In seven patients who were treated with combination therapy containing tumor necrosis factor (TNF) α inhibitors, five (55.6%) had a complete response and 2 (44.4%) had a partial response. Conclusion This is the first and largest case series of CNO in the Chinese adult patients. Four novel genetic mutations potentially associated with CNO were identified. Notably, CNO should be considered in the differential diagnosis of adult patients with long disease course and recurrent multifocal osteomyelitis of unknown cause, and these patients might benefit from combination therapy containing TNFα inhibitors.
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Affiliation(s)
- Mengzhu Zhao
- Department of Rheumatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Di Wu
- Department of Rheumatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Keyi Yu
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Min Shen
- Department of Rheumatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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6
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Stavre Z, Bridgewood C, Zhou Q, Maeda Y, Huang TT, Karman J, Khan A, Giryes S, Sharif K, McGonagle D, Gravallese EM. A role for neutrophils in early enthesitis in spondyloarthritis. Arthritis Res Ther 2022; 24:24. [PMID: 35039073 PMCID: PMC8762869 DOI: 10.1186/s13075-021-02693-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/06/2021] [Indexed: 02/08/2023] Open
Abstract
Background Neutrophils are present in the early phases of spondyloarthritis-related uveitis, skin and intestinal disease, but their role in enthesitis, a cardinal musculoskeletal lesion in spondyloarthritis, remains unknown. We considered the role of neutrophils in the experimental SKG mouse model of SpA and in human axial entheses. Methods Early inflammatory infiltrates in the axial and peripheral entheseal sites in SKG mice were evaluated using immunohistochemistry and laser capture microdissection of entheseal tissue. Whole transcriptome analysis was carried out using Affymetrix gene array MTA 1.0, and data was analyzed via IPA. We further isolated neutrophils from human peri-entheseal bone and fibroblasts from entheseal soft tissue obtained from the axial skeleton of healthy patients and determined the response of these cells to fungal adjuvant. Results Following fungal adjuvant administration, early axial and peripheral inflammation in SKG mice was characterized by prominent neutrophilic entheseal inflammation. Expression of transcripts arising from neutrophils include abundant mRNA for the alarmins S100A8 and S100A9. In normal human axial entheses, neutrophils were present in the peri-entheseal bone. Upon fungal stimulation in vitro, human neutrophils produced IL-23 protein, while isolated human entheseal fibroblasts produced chemokines, including IL-8, important in the recruitment of neutrophils. Conclusion Neutrophils with inducible IL-23 production are present in uninflamed human entheseal sites, and neutrophils are prominent in early murine spondyloarthritis-related enthesitis. We propose a role for neutrophils in the early development of enthesitis. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02693-7.
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Affiliation(s)
- Zheni Stavre
- Department of Medicine/Division of Rheumatology, University of Massachusetts Chan Medical School, Worcester, MA, 01605, USA
| | - Charles Bridgewood
- The Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Qiao Zhou
- The Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Yukiko Maeda
- Department of Medicine/Division of Rheumatology, University of Massachusetts Chan Medical School, Worcester, MA, 01605, USA
| | - Ting-Ting Huang
- Department of Medicine/Division of Rheumatology, University of Massachusetts Chan Medical School, Worcester, MA, 01605, USA
| | - Jozsef Karman
- Abbvie Cambridge Research Center, Cambridge, MA, 02139, USA
| | - Almas Khan
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sami Giryes
- Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), University of Leeds, Leeds, UK
| | - Kassem Sharif
- The Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.,Sheba Medical Center, Tel Aviv, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dennis McGonagle
- The Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Ellen M Gravallese
- Department of Medicine/Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, 02115, USA.
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Evaluation of Healthy Lifestyle Behaviors in Psoriasis Patients. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:197-202. [PMID: 34349596 PMCID: PMC8298080 DOI: 10.14744/semb.2020.01799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 08/23/2020] [Indexed: 11/20/2022]
Abstract
Objectives The purpose of our study was to compare healthy lifestyle behaviors between psoriasis patients and healthy controls. Methods This case-control study included 80 psoriasis patients and 80 sex- and age- matched healthy controls aged over 18. Participants completed the socio-demographic data form and the Health-Promoting Lifestyle Profile II (HPLP-II). The HPLP-II consists of 52 items and measures six components of health-promoting behavior outcomes: Nutrition, physical activity, health responsibility, spiritual growth, interpersonal relations, and stress management. Higher scores show that the individual applies the specified health behaviors at a high level. Results HPLP-II total scores were 128.3±21.1 in patient group and 132.5±22.3 in control group. Based on the scores, psoriasis patients showed a moderate level of health-promoting lifestyle, while controls showed a good level of health-promoting lifestyle. Spiritual growth score of patients (mean±SD = 25.6±4.9) was statistically lower than the controls (mean±SD = 27.3±4.5) (p=0.040). In addition, spiritual growth score and disease duration were negatively correlated in the patient group (r=-0.287, p=0.01). Furthermore, nutrition score of those with additional comorbidity was significantly higher than those with psoriasis alone in patient group (p=0.002). Conclusion This is the first study to compare healthy lifestyle behaviors of psoriasis patients and healthy volunteers in Turkish population. The task of dermatologists is not only the medical treatment of psoriasis lesions but also questioning patients' lifestyle behaviors and supporting the development of healthy behaviors in patients.
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Xu JJ, Li HD, Du XS, Li JJ, Meng XM, Huang C, Li J. Role of the F-BAR Family Member PSTPIP2 in Autoinflammatory Diseases. Front Immunol 2021; 12:585412. [PMID: 34262554 PMCID: PMC8273435 DOI: 10.3389/fimmu.2021.585412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 06/11/2021] [Indexed: 12/11/2022] Open
Abstract
Proline-serine-threonine-phosphatase-interacting protein 2 (PSTPIP2) belongs to the Fes/CIP4 homology-Bin/Amphiphysin/Rvs (F-BAR) domain family. It exhibits lipid-binding, membrane deformation, and F-actin binding activity, suggesting broader roles at the membrane–cytoskeleton interface. PSTPIP2 is known to participate in macrophage activation, neutrophil migration, cytokine production, and osteoclast differentiation. In recent years, it has been observed to play important roles in innate immune diseases and autoinflammatory diseases (AIDs). Current research indicates that the protein tyrosine phosphatase PTP-PEST, Src homology domain-containing inositol 5’-phosphatase 1 (SHIP1), and C‐terminal Src kinase (CSK) can bind to PSTPIP2 and inhibit the development of AIDs. However, the mechanisms underlying the function of PSTPIP2 have not been fully elucidated. This article reviews the research progress and mechanisms of PSTPIP2 in AIDs. PSTPIP2 also provides a new therapeutic target for the treatment of AIDs.
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Affiliation(s)
- Jie-Jie Xu
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Hai-Di Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Xiao-Sa Du
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Juan-Juan Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Xiao-Ming Meng
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Cheng Huang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Jun Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
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9
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Ramautar AI, Appelman-Dijkstra NM, Lakerveld S, Schroijen MA, Snel M, Winter EM, Hamdy NA. Chronic Nonbacterial Osteomyelitis of the Sternocostoclavicular Region in Adults: A Single-Center Dutch Cohort Study. JBMR Plus 2021; 5:e10490. [PMID: 33977206 PMCID: PMC8101619 DOI: 10.1002/jbm4.10490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/13/2021] [Indexed: 01/15/2023] Open
Abstract
Sternocostoclavicular hyperostosis (SCCH) is a rare autoinflammatory bone disorder caused by chronic nonbacterial osteomyelitis (CNO), which is associated with sclerosis and hyperostosis primarily affecting the sternum, the medial end of the clavicles, and the first ribs. Other areas of the axial skeleton may also be affected. The more severe synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome is additionally associated with dermatoses and joint manifestations. This Dutch retrospective cross‐sectional single‐center cohort study characterizes the spectrum of clinical features in adult CNO/SCCH patients at the time of diagnosis. The only inclusion criteria was the availability of complete sets of clinical and imaging data systematically collected over three decades using in‐house protocols. Data from 213 predominantly female patients (88%) with a median age of 36 years at presentation were studied. The mean diagnostic delay was 5 ± 5 years. The main symptoms were chronic pain (92%), bony swelling (61%), and restricted shoulder girdle function (46%); 32% had palmoplantar pustulosis and 22% had autoimmune disease. The majority (73%) had isolated SCCH; 59 (27%) had additional localizations in vertebrae (19%), the mandible (9%), or both (2%); 4 had SAPHO. The prevalence of current or past smoking was high (58%), particularly for patients with palmoplantar pustulosis (76%). There was a significant relationship between delay in diagnosis and both the extent of affected skeletal sites (p = 0.036) and erythrocyte sedimentation rate levels (p = 0.023). Adult‐onset CNO is characterized by distinctive clinical and radiological features, but diverse aspects of its spectrum are currently not fully captured by a comprehensive classification. Delayed diagnosis is still common and potentially associated with irreversible structural changes and debilitating chronic symptoms, increasing the burden of illness and negatively impacting on quality of life. It is hoped that findings from this study will dispel confusion about nomenclature and classification of adult‐onset CNO and increase awareness of its distinctive clinical and radiological features, and thus facilitate early diagnosis and referral for treatment, which should positively impact prognosis by preventing disease progression, although this remains to be established. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Ashna Ie Ramautar
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Natasha M Appelman-Dijkstra
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Shannon Lakerveld
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Marielle A Schroijen
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Marieke Snel
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Elizabeth M Winter
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
| | - Neveen At Hamdy
- Centre for Bone Quality, Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands
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10
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Guo C, Tian X, Han F, Liu L, Gao J, Ma X. Copy Number Variation of Multiple Genes in SAPHO Syndrome. J Rheumatol 2020; 47:1323-1329. [PMID: 31615912 DOI: 10.3899/jrheum.181393] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome is a type of rare chronic aseptic inflammation of unknown etiology. To date, no research to our knowledge has reported copy number variation (CNV) of genes that could affect predisposition to SAPHO syndrome. We investigated the association between CNV profile and SAPHO syndrome. METHODS We used array comparative genomic hybridization (CGH) to screen for CNV in a nuclear family including 2 patients and a healthy control. We then validated the copy numbers of candidate genes found in the array CGH assay and other candidate genes by TaqMan real-time PCR in 360 case and control samples. RESULTS Ten regions from 8 chromosomes were found to have abnormal gene copies in the nuclear family, so the CNV of candidate genes (ADAM5, CSF2RA, IL3RA, and 9 other genes) were tested by TaqMan PCR. Significant copy number loss of CSF2RA (p = 0.000) and NOD2 (p = 0.005), and significant copy number gain of MEGF6 (p = 0.002) and ADAM5 (p = 0.000) were seen in patients with SAPHO compared with controls at the a = 0.05 level. There were no differences in the other 8 candidate genes between patient and control samples (p > 0.05). CONCLUSION Our study established the first association between CNV in CSF2RA, NOD2, MEGF6, and ADAM5 and SAPHO syndrome. These findings may offer insight into the pathogenesis of SAPHO and provide the basis for improved diagnosis and treatment.
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Affiliation(s)
- Changlong Guo
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning
| | - Xin Tian
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning
| | - Feifei Han
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning
| | - Lihong Liu
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning
| | - Jianen Gao
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. .,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning.
| | - Xu Ma
- From the National Research Institute for Family Planning, Beijing; The No. 1 Hospital of Shijiazhuang, Shijiazhuang; Shijiazhuang Maternity Hospital, Shijiazhuang; and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,C. Guo, MD, PhD, National Research Institute for Family Planning; X. Tian, BS, The No. 1 Hospital of Shijiazhuang, Shijiazhuang Maternity Hospital; F. Han, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; L. Liu, MD, PhD, Beijing Chao-Yang Hospital, Capital Medical University; J. Gao, MD, PhD, National Research Institute for Family Planning; X. Ma, MD, PhD, National Research Institute for Family Planning
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11
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Ricciuto A, Sherman PM, Laxer RM. Gut microbiota in chronic inflammatory disorders: A focus on pediatric inflammatory bowel diseases and juvenile idiopathic arthritis. Clin Immunol 2020; 215:108415. [DOI: 10.1016/j.clim.2020.108415] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 12/16/2022]
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12
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Nouadi B, Sbaoui Y, El Messal M, Bennis F, Chegdani F. Integrative Analysis of the Genes Induced by the Intestine Microbiota of Infant Born to Term and Breastfed. Bioinform Biol Insights 2020; 14:1177932220906168. [PMID: 32425510 PMCID: PMC7218278 DOI: 10.1177/1177932220906168] [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: 10/15/2019] [Accepted: 01/20/2020] [Indexed: 11/17/2022] Open
Abstract
Nowadays, the integration of biological data is a major challenge for bioinformatics. Many studies have examined gene expression in the epithelial tissue in the intestines of infants born to term and breastfed, generating a large amount of data. The integration of these data is important to understand the biological processes involved during bacterial colonization of the newborns intestine, particularly through breast milk. This work aims to exploit the bioinformatics approaches, to provide a new representation and interpretation of the interactions between differentially expressed genes in the host intestine induced by the microbiota.
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Affiliation(s)
- Badreddine Nouadi
- Laboratory of Health and Environment, Faculty of Sciences Aïn Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Yousra Sbaoui
- Laboratory of Health and Environment, Faculty of Sciences Aïn Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Mariame El Messal
- Laboratory of Health and Environment, Faculty of Sciences Aïn Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Faiza Bennis
- Laboratory of Health and Environment, Faculty of Sciences Aïn Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Fatima Chegdani
- Laboratory of Health and Environment, Faculty of Sciences Aïn Chock, Hassan II University of Casablanca, Casablanca, Morocco
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13
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Guo C, Li C, Han F, Gao J, Ma X. Association analysis of interleukin-23 receptor SNPs and SAPHO syndrome in Chinese people. Int J Rheum Dis 2019; 22:2178-2184. [PMID: 31701644 DOI: 10.1111/1756-185x.13741] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 06/23/2019] [Accepted: 09/28/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is an autoimmune disease of unknown etiology that seriously affects patients' daily lives. Family-based investigations support genetic contributions toward disease susceptibility. The present study evaluated whether the previously reported autoimmune disease-associated single nucleotide polymorphisms (SNPs) have any genetic overlap with SAPHO syndrome. METHOD Genomic DNA was obtained from 71 SAPHO patients and 104 healthy controls. The SNP genotypes of each patient were determined with polymerase chain reaction and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Genotype, allele, and haplotype frequencies were analyzed with SPSS software. RESULTS Three SNP sites (rs10889677 and rs2201841 of interleukin [IL]-23R, and rs2243248 of IL-4) showed significant correlation with the occurrence of SAPHO syndrome in additive and dominant genetic models, while rs7517847 of IL-23R showed substantial correlation with SAPHO in the dominant genetic model. The G allele of rs2243248 (IL-4) was a high risk factor for SAPHO (P = 2.41e-5, odds ratio [OR] =7.79, 95% CI: 2.59-23.3). The haplotype (A-G-C-G-T), comprising 5 SNPs of the IL-23R gene, had a significantly higher frequency in the SAPHO cohort than in the controls (P = .011, OR = 2.05, 95% CI: 1.12-3.60). CONCLUSION Variants rs10889677, rs2201841, and rs7517847 of IL-23R, and variant rs2243248 of IL-4, showed strong associations with SAPHO syndrome. Patients carrying the A-G-C-G-T haplotype of IL-23 are significantly more likely to develop SAPHO syndrome.
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Affiliation(s)
- Changlong Guo
- National Research Institute for Family Planning, Beijing, China
| | - Chen Li
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Feifei Han
- Beijing Chao-Yang Hospital, Beijing, China
| | - Jianen Gao
- National Research Institute for Family Planning, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China.,Beijing Chao-Yang Hospital, Beijing, China
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14
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Young S, Sharma N, Lee JH, Chitu V, Neumeister V, Sohr E, Stanley ER, Hedrich CM, Craig AWB. Mast cells enhance sterile inflammation in chronic nonbacterial osteomyelitis. Dis Model Mech 2019; 12:dmm.040097. [PMID: 31416928 PMCID: PMC6737947 DOI: 10.1242/dmm.040097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/21/2019] [Indexed: 12/19/2022] Open
Abstract
Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease, and patients with active or recurrent bone inflammation at multiple sites are diagnosed with chronic recurrent multifocal osteomyelitis (CRMO). The Chronic multifocal osteomyelitis (CMO) mouse model develops IL-1β-driven sterile bone lesions reminiscent of severe CRMO. The goal of this study was to evaluate the potential involvement of mast cells in CMO/CRMO. Here, we show that mast cells accumulate in inflamed tissues from CMO mice and that mast cell protease Mcpt1 can be detected in the peripheral blood. A transgenic model of connective tissue mast cell depletion (Mcpt5-Cre:Rosa26-Stopfl/fl-DTa) was crossed with CMO mice and the resulting mice (referred to as CMO/MC–) showed a significant delay in disease onset compared with age-matched CMO mice. At 5-6 months of age, CMO/MC– mice had fewer bone lesions and immune infiltration in the popliteal lymph nodes that drain the affected tissues. In bone marrow-derived mast cell cultures from CMO mice, cytokine production in response to the alarmin IL-33 was elevated compared with wild-type cultures. To test the relevance of mast cells to human CRMO, we tested serum samples from a cohort of healthy controls and from CRMO patients at diagnosis. Interestingly, mast cell chymase was elevated in CRMO patients as well as in patients with oligoarticular juvenile arthritis. Tryptase-positive mast cells were also detected in bone lesions from CRMO patients and patients with bacterial osteomyelitis. Together, our results identify mast cells as cellular contributors to bone inflammation in CMO/CRMO and provide rationale for further study of mast cells as therapeutic targets. Summary: This paper reports that mast cells promote bone loss in an autoinflammatory disease model and that mast cell mediators were detected in autoinflammatory disease patient samples.
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Affiliation(s)
- Stephanie Young
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Namit Sharma
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Jae Hoon Lee
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Violeta Chitu
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Volker Neumeister
- Departments of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden 01307, Germany
| | - Elisabeth Sohr
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Technical University Dresden, Dresden 01307, Germany
| | - E Richard Stanley
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Christian M Hedrich
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Technical University Dresden, Dresden 01307, Germany.,Department of Women's & Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool L14 5AB, UK.,Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool L14 5AB, UK
| | - Andrew W B Craig
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada
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15
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Madden SK, Flanagan KL, Jones G. How lifestyle factors and their associated pathogenetic mechanisms impact psoriasis. Clin Nutr 2019; 39:1026-1040. [PMID: 31155371 DOI: 10.1016/j.clnu.2019.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS AND AIMS Psoriasis is a skin disorder affecting approximately 2-3% of the global population. While research has revealed a strong genetic component, there are few studies exploring the extent to which lifestyle factors influence psoriasis pathogenesis. The aim of this review was to describe the role of lifestyle factors as both a potential cause and treatment for psoriasis. The review also examines the underlying mechanisms through which these lifestyle factors may operate. METHODS This narrative review aims to incorporate current knowledge relating to both lifestyle and pathogenetic factors that contribute to and alleviate psoriasis presentation. Studies reporting the effect of an inflammatory diet and potential dietary benefits are reported, as well as insights into the effects of stress, smoking and alcohol, insulin resistance and exercise. RESULTS Poor nutrition and low Omega 3 fatty acid intake, likely combined with fat malabsorption caused by gut dysbiosis and systemic inflammation, are associated with psoriasis. The data strongly suggest that improvements to disease severity can be made through dietary and lifestyle interventions and increased physical activity. Less conclusive, although worthy of mention, is the beneficial effect of bile acid supplementation. CONCLUSIONS Lifestyle interventions are a promising treatment for psoriasis and its associated co-morbidities. However, gaps and inadequacies exist within the literature, e.g. methodology, absence of a unified scoring system, lack of controlled clinical data and lack of studies without simultaneous usage of biologics or alternative therapies. Future directions should focus on high quality cohort studies and clinical trials.
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Affiliation(s)
- Seonad K Madden
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Australia.
| | - Katie L Flanagan
- School of Medicine, College of Health and Medicine, University of Tasmania, Australia; School of Health & Biomedical Science, Royal Melbourne Institute of Technology, Australia; Infectious Diseases Service, Launceston General Hospital, Australia; Dept. of Immunology and Pathology, Monash University, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Australia
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16
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Oligbu G, Jacobs B, Khan T. The Dilemma of Chronic Recurrent Multifocal Osteomyelitis. ACTA ACUST UNITED AC 2019; 16:490-492. [PMID: 30616941 DOI: 10.1016/j.reuma.2018.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/28/2018] [Accepted: 10/18/2018] [Indexed: 12/31/2022]
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic inflammatory disease that affects mainly children and young adults, resulting in significant morbidity especially if not diagnosed early. The clinical signs and symptoms are nonspecific, with a consequential delay in diagnosis. Radiological and histopathological criteria are important for its definition. Two cases of CRMO are reported, highlighting the diagnostic challenge and demonstrating the importance of timely investigations.
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Affiliation(s)
- Godwin Oligbu
- Children and Adolescence Unit, Royal National Orthopaedic Hospital, Stanmore, UK; Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St. George's, University of London, UK.
| | - Benjamin Jacobs
- Children and Adolescence Unit, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Tahir Khan
- Children and Adolescence Unit, Royal National Orthopaedic Hospital, Stanmore, UK
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17
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Hofmann SR, Kapplusch F, Mäbert K, Hedrich CM. The molecular pathophysiology of chronic non-bacterial osteomyelitis (CNO)-a systematic review. Mol Cell Pediatr 2017; 4:7. [PMID: 28685269 PMCID: PMC5500598 DOI: 10.1186/s40348-017-0073-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/27/2017] [Indexed: 02/07/2023] Open
Abstract
Chronic non-bacterial osteomyelitis (CNO) belongs to the growing spectrum of autoinflammatory diseases and primarily affects the skeletal system. Peak onset ranges between 7 and 12 years of age. The clinical spectrum of CNO covers sometimes asymptomatic inflammation of single bones at the one end and chronically active or recurrent multifocal osteitis at the other.Despite the intense scientific efforts, the exact molecular mechanisms of CNO remain unknown. Recent data suggest CNO as a genetically complex disorder with dysregulated TLR4/MAPK/inflammasome signaling cascades resulting in an imbalance between pro- and anti-inflammatory cytokine expression, leading to osteoclast activation and osteolytic lesions.In this manuscript, the current understanding of molecular patho-mechanisms in CNO will be discussed.
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Affiliation(s)
- Sigrun Ruth Hofmann
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Franz Kapplusch
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Katrin Mäbert
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Christian Michael Hedrich
- Pediatric Rheumatology and Immunology, Children's Hospital Dresden, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany.
- Department of Women's & Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
- Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK.
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18
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Hofmann SR, Kapplusch F, Girschick HJ, Morbach H, Pablik J, Ferguson PJ, Hedrich CM. Chronic Recurrent Multifocal Osteomyelitis (CRMO): Presentation, Pathogenesis, and Treatment. Curr Osteoporos Rep 2017; 15:542-554. [PMID: 29080202 PMCID: PMC5705736 DOI: 10.1007/s11914-017-0405-9] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Chronic non-bacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder. We summarize the clinical presentation, diagnostic approaches, most recent advances in understanding the pathophysiology, and available treatment options and outcomes in CNO/CRMO. RECENT FINDINGS Though the exact molecular pathophysiology of CNO/CRMO remains somewhat elusive, it appears likely that variable defects in the TLR4/MAPK/inflammasome signaling cascade result in an imbalance between pro- and anti-inflammatory cytokine expressions in monocytes from CNO/CRMO patients. In this context, we present previously unpublished data on cytokine and chemokine expression in monocytes and tissues. CNO/CRMO is an autoinflammatory bone disorder resulting from imbalanced cytokine expression from innate immune cells. Though the exact molecular pathophysiology remains unclear, variable molecular defects appear to result in inflammasome activation and pro-inflammatory cytokine expression in monocytes from CNO/CRMO patients. Recent advances suggest signaling pathways and single molecules as biomarkers for CNO/CRMO as well as future treatment targets.
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Affiliation(s)
- Sigrun R Hofmann
- Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Franz Kapplusch
- Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Henner Morbach
- Pediatric Rheumatology and Immunology, Children's Hospital, University of Würzburg, Würzburg, Germany
| | - Jessica Pablik
- Division of Pathology, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Polly J Ferguson
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - Christian M Hedrich
- Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
- Department of Women's and Children's Health, Institute of Translational Medicine (Child Health), University of Liverpool, East Prescott Road, Liverpool, L14 5AB, UK.
- Department of Pediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, UK.
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Bader-Meunier B, Van Nieuwenhove E, Breton S, Wouters C. Bone involvement in monogenic autoinflammatory syndromes. Rheumatology (Oxford) 2017; 57:606-618. [DOI: 10.1093/rheumatology/kex306] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Indexed: 01/12/2023] Open
Affiliation(s)
- Brigitte Bader-Meunier
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, France
- INSERM UMR 1163, Laboratory of Immunogenetics of Pediatric Autoimmunity, Imagine Institut, Paris, France
| | - Erika Van Nieuwenhove
- Department of Microbiology and Immunology, KUL – University of Leuven, Belgium
- VIB Centre for Brain and Disease Research, KUL – University of Leuven, Belgium
- Laboratory of Pediatric Immunology, University Hospitals Leuven, Leuven, Belgium
| | - Sylvain Breton
- Pediatric Radiology Department, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Carine Wouters
- Department of Microbiology and Immunology, KUL – University of Leuven, Belgium
- Laboratory of Pediatric Immunology, University Hospitals Leuven, Leuven, Belgium
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20
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Ata Y, Inaba Y, Choe H, Kobayashi N, Machida J, Nakamura N, Saito T. Bone metabolism and inflammatory characteristics in 14 cases of chronic nonbacterial osteomyelitis. Pediatr Rheumatol Online J 2017; 15:56. [PMID: 28693592 PMCID: PMC5504748 DOI: 10.1186/s12969-017-0183-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/03/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic nonbacterial osteomyelitis (CNO) is a multifocal autoinflammatory disease that often impairs daily life in children. This study aimed to investigate the bone metabolic and inflammatory characteristics of patients with CNO, and to assess the differences between responders and nonresponders to conservative treatment. METHODS We investigated the clinical symptoms; laboratory data including inflammatory and bone metabolic biomarkers; and imaging findings from plain radiography, magnetic resonance imaging (MRI), fluorodeoxyglucose-positron emission tomography (FDG-PET), and dual-energy x-ray absorption (DEXA) in 14 patients with CNO. All patients underwent first-line treatment comprising systemic nonsteroidal anti-inflammatory drugs with or without bisphosphonate. According to the response to the first-line treatment, the patients were divided into the clinical remission/partial response group and the no response group. The differences in bone metabolic and inflammatory characteristics between the two groups were assessed. RESULTS All patients had low bone mineral density assessed with DEXA. The bone metabolic biomarkers (bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase 5b) were increased in boys of all ages and in young girls. Multiple inflammatory regions were detected in all patients by using FDG-PET including asymptomatic regions. The no response group had higher immunoglobulin G (IgG) and a greater number of bone inflammatory lesions detected on MRI than the clinical remission/partial response group. CONCLUSION Our data indicate the involvement of abnormal bone turnover, necessity of whole-body scanning, and association of higher serum IgG levels and greater numbers of inflammatory lesions with prolonged disease activity in patients with CNO.
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Affiliation(s)
- Yurika Ata
- 0000 0001 1033 6139grid.268441.dDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan ,0000 0004 0377 7528grid.414947.bDepartment of Orthopaedic Surgery, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Japan
| | - Yutaka Inaba
- Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
| | - Hyonmin Choe
- 0000 0001 1033 6139grid.268441.dDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan
| | - Naomi Kobayashi
- 0000 0001 1033 6139grid.268441.dDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan
| | - Jiro Machida
- 0000 0004 0377 7528grid.414947.bDepartment of Orthopaedic Surgery, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Japan
| | - Naoyuki Nakamura
- 0000 0004 0377 7528grid.414947.bDepartment of Orthopaedic Surgery, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, Japan
| | - Tomoyuki Saito
- 0000 0001 1033 6139grid.268441.dDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan
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Pardeo M, Pires Marafon D, Messia V, Garganese MC, De Benedetti F, Insalaco A. Anakinra in a Cohort of Children with Chronic Nonbacterial Osteomyelitis. J Rheumatol 2017; 44:1231-1238. [PMID: 28620059 DOI: 10.3899/jrheum.160690] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To report efficacy and safety in patients with chronic nonbacterial osteomyelitis (CNO) unresponsive to nonsteroidal antiinflammatory drugs (NSAID) and bisphosphonates and/or glucocorticoids treated with anakinra. METHODS Nine patients (6 females) with refractory CNO were treated with anakinra for at least 6 months. We recorded, at baseline and after 6 months of treatment, clinical and laboratory features, and number and distribution of bone lesions detected by 99mTc-MDP bone scintigraphy. Disease activity was evaluated using a physician's global assessment (PGA). RESULTS At baseline, 9/9 patients had mild to severe PGA. After 6 months of treatment, in 5 patients the PGA score was graded from none to minimal. At baseline, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 8 out of 9 patients. After 6 months, 5/9 patients had normalized CRP and ESR and in all except 1, CRP and ESR decreased. Before starting anakinra, a total of 77 bone lesions were detected by bone scintigraphy. After 6 months of treatment of the 77 lesions, 42 had resolved and 35 were stable. In 7/9 patients, 20 new lesions appeared during treatment; 2 of these 7 patients were symptomatic. At the last followup visit (median 1.7 yrs, range 0.8-2.8), 6/9 patients maintained a PGA graded as none to minimal. CONCLUSION Anakinra is a possible therapeutic alternative in patients with refractory CNO. The practical significance of clinically silent bone lesions detected by bone scintigraphy remains to be established.
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Affiliation(s)
- Manuela Pardeo
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy. .,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS.
| | - Denise Pires Marafon
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy.,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - Virginia Messia
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy.,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - Maria Carmen Garganese
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy.,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - Fabrizio De Benedetti
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy.,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS
| | - Antonella Insalaco
- From the Division of Rheumatology, and the Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy. .,M. Pardeo, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; D. Pires Marafon, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; V. Messia, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; M.C. Garganese, MD, Nuclear Medicine Unit, Ospedale Pediatrico Bambino Gesù IRCCS; F. De Benedetti, MD, PhD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS; A. Insalaco, MD, Division of Rheumatology, Ospedale Pediatrico Bambino Gesù IRCCS.
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Taddio A, Zennaro F, Pastore S, Cimaz R. An Update on the Pathogenesis and Treatment of Chronic Recurrent Multifocal Osteomyelitis in Children. Paediatr Drugs 2017; 19:165-172. [PMID: 28401420 DOI: 10.1007/s40272-017-0226-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic non-bacterial osteomyelitis (CNO), is a rare inflammatory disorder that primarily affects children. It is characterized by pain, local bone expansion, and radiological findings suggestive of osteomyelitis, usually at multiple sites. CRMO predominantly affects the metaphyses of long bones, but involvement of the clavicle or mandible are suggestive of the diagnosis. CRMO is a diagnosis of exclusion, and its pathogenesis remains unknown. Differential diagnosis includes infection, malignancies, benign bone tumors, metabolic disorders, and other autoinflammatory disorders. Biopsy of the bone lesion is not often required but could be necessary in unclear cases, especially for differentiation from bone neoplasia. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment. Alternative therapies have been used, including corticosteroids, methotrexate, bisphosphonates, and tumor necrosis factor (TNF)-α inhibitors. No guidelines have been established regarding diagnosis and treatment options. This manuscript gives an overview of the most recent findings on the pathogenesis of CRMO and clinical approaches for patients with the condition.
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Affiliation(s)
- Andrea Taddio
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34100, Trieste, Italy. .,University of Trieste, Piazzale Europa, 1, 34100, Trieste, Italy.
| | - Floriana Zennaro
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34100, Trieste, Italy
| | - Serena Pastore
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34100, Trieste, Italy
| | - Rolando Cimaz
- Rheumatology Unit, Anna Meyer Children's Hospital, University of Florence, Viale Pieraccini 24, 50139, Florence, Italy
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Bacterial Osteomyelitis or Nonbacterial Osteitis in Children: A Study Involving the German Surveillance Unit for Rare Diseases in Childhood. Pediatr Infect Dis J 2017; 36:451-456. [PMID: 28403046 DOI: 10.1097/inf.0000000000001469] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although bacterial osteomyelitis (BO) is a commonly recognized diagnosis in pediatrics, it is often difficult to distinguish from nonbacterial osteitis (NBO). The goal of our study was to distinguish between the 2 disease entities and better define NBO. METHODS Using the German Surveillance Unit for Rare Diseases in Childhood (Erhebungseinheit für Seltene Paediatrische Erkrankungen in Deutschland), this prospective study during a 5-year period captured 657 patients at first diagnosis of either BO (n = 378) or NBO (n = 279) while analyzing epidemiologic, clinical and radiologic data. RESULTS BO was reported in 1.2 per 100,000 children with a higher prevalence in younger male patients (58%), and NBO was reported in 0.45 per 100,000 children. BO patients tended to present with fevers (68%), elevated inflammation markers (82%) and local swelling (62%) but a shorter course of symptoms than NBO patients. NBO patients presented in good general health (86%) and were more likely to have multifocal lesions (66%). Staphylococcus aureus was the most prominent pathogen (83%), with only one methicillin-resistant S. aureus reported. Complications ranged from arthritis adjacent to the lesion to hyperostosis and vertebral fractures. CONCLUSIONS BO and NBO can be distinguished based on symptoms, associated diseases and inflammation markers. NBO should always be considered in pediatric patients presenting with bone lesions and pain, especially in young female patients presenting with good general health, minimal inflammation markers and multifocal lesions in the vertebrae, clavicle and sternum.
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Roderick MR, Sen ES, Ramanan AV. Chronic recurrent multifocal osteomyelitis in children and adults: current understanding and areas for development. Rheumatology (Oxford) 2017; 57:41-48. [DOI: 10.1093/rheumatology/kex066] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Indexed: 11/14/2022] Open
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Safra N, Hitchens PL, Maverakis E, Mitra A, Korff C, Johnson E, Kol A, Bannasch MJ, Pedersen NC, Bannasch DL. Serum levels of innate immunity cytokines are elevated in dogs with metaphyseal osteopathy (hypertrophic osteodytrophy) during active disease and remission. Vet Immunol Immunopathol 2016; 179:32-5. [PMID: 27590423 PMCID: PMC5570445 DOI: 10.1016/j.vetimm.2016.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/19/2016] [Accepted: 08/03/2016] [Indexed: 12/18/2022]
Abstract
Metaphyseal osteopathy (MO) (hypertrophic osteodystrophy) is a developmental disorder of unexplained etiology affecting dogs during rapid growth. Affected dogs experience relapsing episodes of lytic/sclerotic metaphyseal lesions and systemic inflammation. MO is rare in the general dog population; however, some breeds (Weimaraner, Great Dane and Irish Setter) have a much higher incidence, supporting a hereditary etiology. Autoinflammatory childhood disorders of parallel presentation such as chronic recurrent multifocal osteomyelitis (CRMO), and deficiency of interleukin-1 receptor antagonist (DIRA), involve impaired innate immunity pathways and aberrant cytokine production. Given the similarities between these diseases, we hypothesize that MO is an autoinflammatory disease mediated by cytokines involved in innate immunity. To characterize immune dysregulation in MO dogs we measured serum levels of inflammatory markers in 26 MO and 102 control dogs. MO dogs had significantly higher levels (pg/ml) of serum Interleukin-1beta (IL-1β), IL-18, IL-6, Granulocyte-macrophage colony stimulating factor (GM-CSF), C-X-C motif chemokine 10 (CXCL10), tumor necrosis factor (TNF), and IL-10. Notably, recovered MO dogs were not different from dogs during active MO disease, providing a suggestive mechanism for disease predisposition. This is the first documentation of elevated immune markers in MO dogs, uncovering an immune profile similar to comparable autoinflammatory disorders in children.
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Affiliation(s)
- Noa Safra
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA.
| | - Peta L Hitchens
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA; Swedish University of Agricultural Sciences, Almas Allé 8, 750 07 Uppsala, Sweden
| | - Emanual Maverakis
- Department of Dermatology, University of California, Davis, 3301 C Street, Sacramento, CA 95816, USA
| | - Anupam Mitra
- Department of Dermatology, University of California, Davis, 3301 C Street, Sacramento, CA 95816, USA
| | - Courtney Korff
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Eric Johnson
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Amir Kol
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Michael J Bannasch
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Niels C Pedersen
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
| | - Danika L Bannasch
- School of Veterinary Medicine, University of California, Davis, 1 Garrod Drive, Davis, CA 95616, USA
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Hofmann SR, Schnabel A, Rösen-Wolff A, Morbach H, Girschick HJ, Hedrich CM. Chronic Nonbacterial Osteomyelitis: Pathophysiological Concepts and Current Treatment Strategies. J Rheumatol 2016; 43:1956-1964. [PMID: 27585682 DOI: 10.3899/jrheum.160256] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 12/22/2022]
Abstract
Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder, covering a clinical spectrum with asymptomatic inflammation of single bones at the one end, and chronic recurrent multifocal osteomyelitis (CRMO) at the other end. The exact molecular pathophysiology of CNO remains largely unknown. Provided familial clusters and the association with inflammatory disorders of the skin and intestine suggest a genetic predisposition. Recently, profound dysregulation of cytokine responses was demonstrated in CRMO. Failure to produce antiinflammatory cytokines interleukin (IL)-10 and IL-19 contributes to activation of inflammasomes and subsequent IL-1β release. In IL-10-deficient and in CNO-prone chronic multifocal osteomyelitis mice, IL-1β was linked to bone inflammation. Further, alterations to the gut microbiome were suggested in contributing to IL-1β release from innate immune cells in mice, offering an interesting target in the search for molecular mechanisms in CNO. Here, we summarize clinical presentation and treatment options in CNO/CRMO, current pathophysiological concepts, available mouse models, and promising future scientific directions.
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Affiliation(s)
- Sigrun R Hofmann
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany.,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Anja Schnabel
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany.,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Angela Rösen-Wolff
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany.,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Henner Morbach
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany.,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Hermann J Girschick
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany.,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden
| | - Christian M Hedrich
- From the Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden; Department of Pediatrics, University of Würzburg, Würzburg; Children's Hospital, Vivantes Klinikum-Friedrichshain, Berlin, Germany. .,S.R. Hofmann, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Schnabel, MD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; A. Rösen-Wolff, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden; H. Morbach, MD, PhD, Department of Pediatrics, University of Würzburg; H.J. Girschick, MD, PhD, Children's Hospital, Vivantes Klinikum-Friedrichshain; C.M. Hedrich, MD, PhD, Pediatric Rheumatology and Immunology, Department of Pediatrics, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden.
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Martín-Nalda A, Roca I, Fontecha CG, Fernández-Polo A, Barber I, Martinez-Gallo M, Soler-Palacin P. Chronic Recurrent Multifocal Osteomyelitis and Thalidomide in Chronic Granulomatous Disease. Pediatrics 2016; 138:peds.2015-4017. [PMID: 27436506 DOI: 10.1542/peds.2015-4017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/24/2022] Open
Abstract
Chronic granulomatous disease (CGD) is a primary immunodeficiency that leads to severe recurrent infection and inflammatory complications that are usually difficult to diagnose and treat. Several hyperinflammation mechanisms, such as decreased neutrophil apoptosis, toll-like receptor activation imbalance, Th17 cell induction, Nrf2 activity deficiency, and inflammasome activation, have been described in CGD patients However, there have been no reports of chronic recurrent multifocal osteomyelitis as an inflammatory complication in CGD, and the differential diagnosis of this condition with infectious osteomyelitis is challenging. Thalidomide has been used to treat several inflammatory manifestations in CGD patients with good clinical results. Here, we report the case of a previously asymptomatic 11-year-old boy who consulted for difficulty walking and pain at the back of the right thigh, with increased inflammatory markers. Multifocal bone involvement was seen on bone scintigraphy, and acute-phase reactants were elevated. On the basis of a suspected diagnosis of infectious osteomyelitis, broad-spectrum antibiotic therapy was started, with no clinical response. Bone biopsy and microbiological tests yielded negative results; at that point, chronic recurrent multifocal osteomyelitis was suspected. The patient was unresponsive to nonsteroidal antiinflammatory drugs and corticosteroids. Thalidomide was started, and within 6 months, clinical and radiologic resolution of the condition was achieved with no adverse effects. More than 1 year after stopping thalidomide, the patient remained free of symptoms and inflammatory parameters are within normal levels. Thalidomide has a favorable safety profile compared with other alternatives and could be considered a feasible therapeutic option for this type of condition in selected patients.
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Affiliation(s)
| | | | | | | | | | - Mónica Martinez-Gallo
- Division of Immunology, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Shimizu M, Saikawa Y, Yachie A. Role of 18-fluoro-2-deoxyglucose positron emission tomography in detecting acute inflammatory lesions of non-bacterial osteitis in patients with a fever of unknown origin: A comparative study of 18-fluoro-2-deoxyglucose positron emission tomography, bone scan, and magnetic resonance imaging. Mod Rheumatol 2016; 28:1058-1062. [DOI: 10.1080/14397595.2016.1193112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan and
| | - Yutaka Saikawa
- Department of Pediatrics, School of Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Akihiro Yachie
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan and
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Phillips FC, Gurung P, Kanneganti TD. Microbiota and caspase-1/caspase-8 regulate IL-1β-mediated bone disease. Gut Microbes 2016; 7:334-341. [PMID: 27148834 PMCID: PMC4988461 DOI: 10.1080/19490976.2016.1182289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A leucine-to-proline missense mutation at residue 98 in the proline-serine-threonine phosphatase interacting protein 2 (Pstpip2) gene leads to autoinflammatory disease that is characterized by splenomegaly, necrosis, and spontaneous development of osteomyelitis in mice (Pstpip2cmo). Disease progression in these mice resembles that of chronic recurrent multifocal osteomyelitis in humans. Our group and others have shown that disease progression in Pstpip2cmo mice is mediated by the cytokine IL-1β, independently of inflammasomes or IL-1α. Our recent publication highlighted herein establishes that diet-induced changes in intestinal microbiota provide protection against the development of osteomyelitis in Pstpip2cmo mice. Moreover, the proteases caspase-1 and caspase-8 have redundant roles in cleaving IL-1β and promoting disease. This addendum reviews the current literature on the Pstpip2cmo murine disease model and the clinical significance of the role of PSTPIP2 in regulating autoinflammatory osteomyelitis, which is mediated by innate components of immune cells.
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Affiliation(s)
- Farrah C. Phillips
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Prajwal Gurung
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
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NLRP3 inflammasome plays a redundant role with caspase 8 to promote IL-1β-mediated osteomyelitis. Proc Natl Acad Sci U S A 2016; 113:4452-7. [PMID: 27071119 DOI: 10.1073/pnas.1601636113] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Missense mutation in the proline-serine-threonine phosphatase-interacting protein 2 (Pstpip2) gene results in the development of spontaneous chronic bone disease characterized by bone deformity and inflammation that is reminiscent of patients with chronic multifocal osteomyelitis (cmo). Interestingly, this disease is specifically mediated by IL-1β but not IL-1α. The precise molecular pathways that promote pathogenic IL-1β production inPstpip2(cmo)mice remain unidentified. Furthermore, how IL-1β provokes inflammatory bone disease inPstpip2(cmo)mice is not known. Here, we demonstrate that double deficiency of Nod like receptor family, pyrin domain containing 3 (NLRP3) and caspase 8 inPstpip2(cmo)mice provides similar protection as observed in caspase-1 and caspase-8-deficientPstpip2(cmo)mice, demonstrating redundant roles for the NLRP3 inflammasome and caspase 8 in provoking osteomyelitic disease inPstpip2(cmo)mice. Consistently, immunofluorescence studies exhibited distinct caspase-1 and caspase-8 puncta in diseasedPtpn6(spin)neutrophils. Data from our chimera studies demonstrated that IL-1β produced by hematopoietic cells is sensed by the radioresistant compartment to promote bone disease. Furthermore, our results showed that the IL-1β signaling is unidirectional and feedback signaling of IL-1β onto the hematopoietic compartment is not important for disease induction. In conclusion, our studies have uncovered the combined actions of the NLRP3 inflammasome and caspase 8 leading to IL-1β maturation and the directionality of IL-1β in driving disease inPstpip2(cmo)mice.
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Hofmann SR, Kubasch AS, Ioannidis C, Rösen-Wolff A, Girschick HJ, Morbach H, Hedrich CM. Altered expression of IL-10 family cytokines in monocytes from CRMO patients result in enhanced IL-1β expression and release. Clin Immunol 2015; 161:300-7. [PMID: 26404542 DOI: 10.1016/j.clim.2015.09.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/16/2015] [Accepted: 09/19/2015] [Indexed: 02/08/2023]
Abstract
Chronic recurrent multifocal osteomyelitis (CRMO) is characterized by reduced activation of protein kinases ERK1 and 2 in monocytes resulting in impaired IL-10 expression. IL10 and its homologs IL19 and IL20 are organized in the IL10 cluster on chromosome 1q32. IL-10 and IL-19 are immune-regulatory cytokines, while IL-20 acts in a pro-inflammatory manner. The NLRP3 inflammasome, a multi-protein complex forming in response to innate stimuli, mediates IL-1β cleavage and release. Here, we investigated IL-10-related cytokine expression in CRMO monocytes, underlying molecular events, and effects on inflammatory responses. We observed reduced anti-inflammatory IL-10 and IL-19 expression, and enhanced IL-20 expression in CRMO monocytes. Reduced IL-10 and IL-19 expression was associated with impaired Sp-1 recruitment to regulatory regions, contributing to NLRP3 inflammasome activation, which may induce inflammatory bone-loss. Our findings underscore the importance of balanced receptor-, cell-, and tissue-specific cytokine expression for immune homeostasis, providing additional arguments for cytokine blocking strategies in CRMO.
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Affiliation(s)
- S R Hofmann
- Pediatric Rheumatology and Immunology, Children's Hospital, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - A S Kubasch
- Pediatric Rheumatology and Immunology, Children's Hospital, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Ioannidis
- Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - A Rösen-Wolff
- Pediatric Rheumatology and Immunology, Children's Hospital, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - H J Girschick
- Vivantes Klinikum Friedrichshain, Children's Hospital, Berlin, Germany
| | - H Morbach
- Pediatric Rheumatology and Immunology, Children's Hospital, University of Würzburg, Würzburg, Germany
| | - C M Hedrich
- Pediatric Rheumatology and Immunology, Children's Hospital, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany; Division of Rheumatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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