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Putnam CD, Broderick L, Hoffman HM. The discovery of NLRP3 and its function in cryopyrin-associated periodic syndromes and innate immunity. Immunol Rev 2024; 322:259-282. [PMID: 38146057 PMCID: PMC10950545 DOI: 10.1111/imr.13292] [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: 09/15/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 12/27/2023]
Abstract
From studies of individual families to global collaborative efforts, the NLRP3 inflammasome is now recognized to be a key regulator of innate immunity. Activated by a panoply of pathogen-associated and endogenous triggers, NLRP3 serves as an intracellular sensor that drives carefully coordinated assembly of the inflammasome, and downstream inflammation mediated by IL-1 and IL-18. Initially discovered as the cause of the autoinflammatory spectrum of cryopyrin-associated periodic syndrome (CAPS), NLRP3 is now also known to play a role in more common diseases including cardiovascular disease, gout, and liver disease. We have seen cohesion in results from clinical studies in CAPS patients, ex vivo studies of human cells and murine cells, and in vivo murine models leading to our understanding of the downstream pathways, cytokine secretion, and cell death pathways that has solidified the role of autoinflammation in the pathogenesis of human disease. Recent advances in our understanding of the structure of the inflammasome have provided ways for us to visualize normal and mutant protein function and pharmacologic inhibition. The subsequent development of targeted therapies successfully used in the treatment of patients with CAPS completes the bench to bedside translational loop which has defined the study of this unique protein.
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Affiliation(s)
- Christopher D. Putnam
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Lori Broderick
- Division of Allergy, Immunology & Rheumatology, Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Rady Children’s Hospital, San Diego, California, USA
| | - Hal M. Hoffman
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
- Division of Allergy, Immunology & Rheumatology, Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
- Rady Children’s Hospital, San Diego, California, USA
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Diaz VL, Gribbons KB, Yazdi-Nejad K, Kuemmerle-Deschner J, Wanderer AA, Broderick L, Hoffman HM. Cold Urticaria Syndromes: Diagnosis and Management. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2275-2285. [PMID: 37290539 DOI: 10.1016/j.jaip.2023.05.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
Cold urticaria is a chronic condition causing episodic symptoms of cold-induced wheals or angioedema in response to direct or indirect exposure to cold temperatures. Whereas symptoms of cold urticaria are typically benign and self-limiting, severe systemic anaphylactic reactions are possible. Acquired, atypical, and hereditary forms have been described, each with variable triggers, symptoms, and responses to therapy. Clinical testing, including response to cold stimulation, helps define disease subtypes. More recently, monogenic disorders characterized by atypical forms of cold urticaria have been described. Here, we review the different forms of cold-induced urticaria and related syndromes and propose a diagnostic algorithm to aid clinicians in making a timely diagnosis for the appropriate management of these patients.
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Affiliation(s)
- Vanessa L Diaz
- Department of Pediatrics, Rady Children's Hospital, San Diego, San Diego, Calif
| | | | | | - Jasmin Kuemmerle-Deschner
- Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany; Member of European Reference Network (ERN-RITA), Tuebingen, Germany
| | - Alan A Wanderer
- Allergy and Clinical Immunology, School of Medicine, University of Colorado, Denver, Colo
| | - Lori Broderick
- Department of Pediatrics, Rady Children's Hospital, San Diego, San Diego, Calif; Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California, San Diego, La Jolla, Calif
| | - Hal M Hoffman
- Department of Pediatrics, Rady Children's Hospital, San Diego, San Diego, Calif; Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California, San Diego, La Jolla, Calif.
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