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Kostik MM, Makhova MA, Maletin AS, Magomedova SM, Sorokina LS, Tsukasaki M, Okamoto K, Takayanagi H, Vasiliev DS, Kozlova DI, Mushkin AY. Cytokine profile in patients with chronic non-bacterial osteomyelitis, juvenile idiopathic arthritis, and insulin-dependent diabetes mellitus. Cytokine 2021; 143:155521. [PMID: 33863633 DOI: 10.1016/j.cyto.2021.155521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Our study aimed to evaluate the cytokine levels in pediatric chronic non-bacterial osteomyelitis (CNO) patients and compare these with other immune-mediated diseases and healthy controls. METHODS In this prospective study, we included 42 children with CNO, 28 patients with non-systemic juvenile idiopathic arthritis (JIA), 17 children with insulin-dependent diabetes mellitus (IDDM), and 30 healthy age-matched controls. In each of the CNO patients and comparison groups, the levels of 14-3-3-η protein, S100A8/A9 protein, interleukin-4 (IL-4), interleukin-17 (IL-17), interleukin-18 (IL-18), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) were measured by ELISA assay. RESULTS All studied cytokines in the CNO patients were significantly higher than controls, and IDDM, 14-3-3-η protein, IL-18, IL-4, IL-17, IL-1β, and TNF-α were less than in JIA patients. In the discriminant analysis, ESR, 14-3-3 protein, S100A8/A9, IL-18, IL-4, and TNF-α can discriminate CNO from JIA, and 14-3-3 protein, S100A8/A9, IL-18, IL-17, IL-4, and TNF-α can distinguish CNO from other diseases and HC. CONCLUSION The increased level of pro-inflammatory cytokines confirms the role of monocyte-driven inflammation in CNO patients. Cytokines may prove valuable as biomarkers and potential therapeutic targets for CNO.
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Affiliation(s)
- Mikhail M Kostik
- Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation.
| | - Maria A Makhova
- Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Alexei S Maletin
- Science Research Institute of Phthisiopulmonology, Saint-Petersburg, Russian Federation
| | - Shamai M Magomedova
- Republican Children's Clinical Hospital, Makhachkala, Russian Federation; Dagestan State Medical University, Makhachkala, Russian Federation
| | - Lybov S Sorokina
- Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russian Federation
| | - Masayuki Tsukasaki
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan
| | - Kazuo Okamoto
- Department of Osteoimmunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan
| | - Hiroshi Takayanagi
- Department of Immunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan
| | - Dmitriy S Vasiliev
- Sechenov Institute of Evolutionary Physiology and Biochemistry, Saint Petersburg, Russian Federation
| | - Darya I Kozlova
- Department of Osteoimmunology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, 113-0033 Tokyo, Japan
| | - Alexander Yu Mushkin
- Science Research Institute of Phthisiopulmonology, Saint-Petersburg, Russian Federation
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Pimpale Chavan P, Aksentijevich I, Daftary A, Panwala H, Khemani C, Khan A, Khubchandani R. Majeed Syndrome: Five Cases With Novel Mutations From Unrelated Families in India With a Review of Literature. J Rheumatol 2021; 48:1850-1855. [PMID: 33993107 DOI: 10.3899/jrheum.201663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Majeed syndrome (MJS) is an autosomal recessive, systemic autoinflammatory disease (SAID) caused by biallelic loss-of-function variants in the LPIN2 gene. It is characterized by early-onset chronic recurrent multifocal osteomyelitis (CRMO), dyserythropoietic anemia, and neutrophilic dermatosis. We analyzed a cohort of uncharacterized Indian patients for pathogenic variants in LPIN2 and other genes associated with SAIDs. METHODS We performed whole-exome sequencing (WES) for 1 patient and next-generation sequencing (NGS) targeted gene panel for SAIDs in 3 patients. One patient was a referral from neurology after clinical exome sequencing identified a novel variant in LPIN2. We reviewed the literature for all published studies of mutation-positive MJS patients and have summarized their clinical features and disease-causing variants. RESULTS We describe the largest series of patients with MJS outside of the Middle East. All 5 patients are homozygous for novel, possibly pathogenic variants in the LPIN2 gene. Two of these variants are missense substitutions, and 3 are predicted to alter transcript splicing and create a truncated protein. In addition to the classical features of CRMO and anemia, patients exhibited previously unreported features, including abdominal pain, recurrent diarrhea/ear discharge, and erythema nodosum. CONCLUSION Patients with MJS may present initially to different specialists, and thus it is important to create awareness in the medical community. In India, consanguinity is a common sociocultural factor in many ethnic communities and an abbreviated NGS gene panel for autoinflammatory diseases should include MJS. The unavailability of interleukin 1 inhibitors in some countries poses a treatment challenge.
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Affiliation(s)
- Pallavi Pimpale Chavan
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Ivona Aksentijevich
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Aditya Daftary
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Hiren Panwala
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Chetna Khemani
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Archana Khan
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
| | - Raju Khubchandani
- P. Pimpale Chavan, DNB Pediatrics, Fellowship in Pediatric Rheumatology, A. Khan, DCH DNB Pediatrics, R. Khubchandani, MD, Section of Pediatric Rheumatology, NH SRCC Children's Hospital, Mumbai, India; I. Aksentijevich, MD, Genetics, Inflammatory Disease Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA; A. Daftary, DABNM, DABR, Consultant Radiologist, H. Panwala, DNB Radiology, Fellowship in Pediatric Radiology, Consultant Pediatric Radiologist, NH SRCC Children's Hospital, Mumbai, India; C. Khemani, DCH DNB Pediatrics, Department of Pediatrics, North Goa District Hospital, Mapusa, Goa, India. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. R. Khubchandani, 31, Kailash Darshan, 8th floor, Opposite Ness Baug, Nana Chowk, 7, Kennedy Bridge, Gamdevi, Mumbai 400007, Maharashtra, India. . Accepted for publication April 29, 2021
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Liu J, Hu XY, Zhao ZP, Guo RL, Guo J, Li W, Hao CJ, Xu BP. Compound heterozygous LPIN2 pathogenic variants in a patient with Majeed syndrome with recurrent fever and severe neutropenia: case report. BMC MEDICAL GENETICS 2019; 20:182. [PMID: 31727123 PMCID: PMC6857307 DOI: 10.1186/s12881-019-0919-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/06/2019] [Indexed: 01/28/2023]
Abstract
Background Majeed syndrome is a rare, autosomal recessive autoinflammatory disorder first described in 1989. The syndrome starts during infancy with recurrent relapses of osteomyelitis typically associated with fever, congenital dyserythropoietic anemia (CDA), and often neutrophilic dermatosis. Mutations in the LPIN2 gene located on the short arm of chromosome 18 have been identified as being responsible for Majeed syndrome. Case presentation We report an 8-month-old boy, who presented with recurrent fever, mild to moderate anemia, and severe neutropenia. Erythrocyte sedimentation rate and C-reactive protein were elevated. Molecular testing identified a paternal splicing donor site variant c.2327 + 1G > C and a maternal frameshift variant c.1691_1694delGAGA (Arg564Lysfs*3) in LPIN2. Conclusions Only a few cases with LPIN2 mutation have been reported, mainly in the Middle East with homozygous variants. Our patient exhibited a mild clinical phenotype and severe neutropenia, different from previous reports.
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Affiliation(s)
- Jun Liu
- China National Clinical Research Center of Respiratory Diseases, Respiratory Department of Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xu-Yun Hu
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.,Henan Key Laboratory of Pediatric Inherited & Metabolic Diseases, Henan Children's Hospital, Zhengzhou Hospital of Beijing Children's Hospital, Zhengzhou, 450018, China
| | - Zhi-Peng Zhao
- China National Clinical Research Center of Respiratory Diseases, Respiratory Department of Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Ruo-Lan Guo
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.,Henan Key Laboratory of Pediatric Inherited & Metabolic Diseases, Henan Children's Hospital, Zhengzhou Hospital of Beijing Children's Hospital, Zhengzhou, 450018, China
| | - Jun Guo
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.,Henan Key Laboratory of Pediatric Inherited & Metabolic Diseases, Henan Children's Hospital, Zhengzhou Hospital of Beijing Children's Hospital, Zhengzhou, 450018, China
| | - Wei Li
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.,Henan Key Laboratory of Pediatric Inherited & Metabolic Diseases, Henan Children's Hospital, Zhengzhou Hospital of Beijing Children's Hospital, Zhengzhou, 450018, China
| | - Chan-Juan Hao
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute; MOE Key Laboratory of Major Diseases in Children; Genetics and Birth Defects Control Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China. .,Henan Key Laboratory of Pediatric Inherited & Metabolic Diseases, Henan Children's Hospital, Zhengzhou Hospital of Beijing Children's Hospital, Zhengzhou, 450018, China.
| | - Bao-Ping Xu
- China National Clinical Research Center of Respiratory Diseases, Respiratory Department of Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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