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Mortensen SB, Hansen AE, Byg KE, Diederichsen L, Schade Larsen C, Goldschmidt MI, Jakobsen MA, Assing K, Lambertsen KL, Andersen DC, Johansen IS. Monocyte secretory profiling in a clinical and MEFV genotype-characterized cohort of Danish familial Mediterranean fever patients: diagnostic potential of CCL1 and CXCL1. Scand J Rheumatol 2023; 52:181-189. [PMID: 35258407 DOI: 10.1080/03009742.2022.2028382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The autoinflammatory disease familial Mediterranean fever (FMF), characterized by recurrent attacks of sterile fever, serosal, and/or synovial inflammation, is caused by variants in the Mediterranean fever gene, MEFV, coding for the pyrin inflammasome sensor. The diagnosis of FMF is mainly based on clinical symptoms and confirmed by detection of disease-associated MEFV variants. However, the diagnosis is challenging among patients carrying variants of uncertain clinical significance (VUS). In this study, we aimed to identify potential FMF discriminatory diagnostic markers in a cohort of clinically characterized FMF patients. METHOD We established a cohort of clinically and MEFV genotype-characterized FMF patients by enrolling patients from major Danish hospitals (n = 91). The secretory profile of pyrin inflammasome-activated monocytes from healthy donors (HDs) and MEFV-characterized FMF patients (n = 28) was assessed by analysing cell supernatants for a custom-designed panel of 23 cytokines, chemokines, and soluble tumour necrosis factor receptors associated with monocyte and macrophage function. RESULTS MEFV genotypes in Danish FMF patients were associated with age at symptom onset (p < 0.05), FMF among relatives (p < 0.01), proportion of patients in colchicine treatment (p < 0.01), and treatment response (p < 0.05). Secretion of chemokines CCL1 and CXCL1 from pyrin-activated FMF monocytes was significantly decreased compared to HDs (p < 0.05), and could discriminate FMF patients with 'non-confirmatory' MEFV genotypes from HDs with 80.0% and 70.0% sensitivity for CCL1 and CXCL1, respectively (p < 0.05). CONCLUSION Our data suggest that a functional diagnostic assay based on CCL1 or CXCL1 levels in pyrin-activated patient monocytes may contribute to FMF diagnosis in patients with VUS.
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Affiliation(s)
- S B Mortensen
- Research Unit for Infectious Diseases, Odense University Hospital/University of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Immunology, Odense University Hospital, Odense, Denmark.,OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - A E Hansen
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - K-E Byg
- Department of Rheumatology, Odense University Hospital, Odense, Denmark.,Department of Neurology, Odense University Hospital, Odense, Denmark.,BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - L Diederichsen
- Department of Rheumatology, Odense University Hospital, Odense, Denmark.,Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Schade Larsen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - M I Goldschmidt
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - M A Jakobsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - K Assing
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - K L Lambertsen
- Department of Neurology, Odense University Hospital, Odense, Denmark.,BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Neurobiology Research; Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - D C Andersen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Laboratory of Molecular and Cellular Cardiology/Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - I S Johansen
- Research Unit for Infectious Diseases, Odense University Hospital/University of Southern Denmark, Odense, Denmark
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Endo Y, Koga T, Ubara Y, Sumiyoshi R, Furukawa K, Kawakami A. Mediterranean fever gene variants modify clinical phenotypes of idiopathic multi-centric Castleman disease. Clin Exp Immunol 2021; 206:91-98. [PMID: 34096620 PMCID: PMC8663796 DOI: 10.1111/cei.13632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/05/2021] [Accepted: 05/26/2021] [Indexed: 01/03/2023] Open
Abstract
Four cases of idiopathic multi-centric Castleman disease (iMCD) reportedly have variants in hereditary autoinflammatory disease-related genes; however, the frequency and role of these variants in iMCD is still unknown. We therefore investigated such gene variants among patients with iMCD and aimed to reveal the relationship between iMCD and autoinflammatory disease-related genes. We reviewed 14 Japanese iMCD patients who were recruited between January 2015 and September 2019. All patients met both the Japanese tentative diagnostic criteria for Castleman disease and the international consensus diagnostic criteria for iMCD. We performed genetic analyses for 31 autoinflammatory disease-related genes by targeted next-generation sequencing. The MEFV gene variants were observed in 10 of 14 patients with iMCD. Although iMCD had a high percentage of exons 2 or 3 variants of MEFV, comparison of data from healthy Japanese subjects indicated that there was no significant difference in the percentage between healthy Japanese subjects and patients with iMCD. Variants of uncertain significance (VUS) in the TNFRSF1A and CECR1 genes were observed in two of the patients, respectively. We divided patients into two groups-those with MEFV variants (excluding E148Q variants) and those without MEFV variants-and compared the clinical characteristics between these two groups. Patients with MEFV variants, excluding E148Q variants, exhibited a significantly higher likelihood of fever and significantly lower levels of hemoglobin than those lacking MEFV variants. Our results indicated that patients with iMCD tended to have a high frequency of MEFV gene variants and the presence of such variants can affect iMCD clinical phenotypes.
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Affiliation(s)
- Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Yoshihumi Ubara
- Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Kaori Furukawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
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TRIM E3 Ubiquitin Ligases in Rare Genetic Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1233:311-325. [PMID: 32274764 DOI: 10.1007/978-3-030-38266-7_14] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The TRIM family comprises proteins characterized by the presence of the tripartite motif composed of a RING domain, one or two B-box domains and a coiled-coil region. The TRIM shared domain structure underscores a common biochemical function as E3 ligase within the ubiquitination cascade. The TRIM proteins represent one of the largest E3 ligase families counting in human more than 70 members. These proteins are implicated in a plethora of cellular processes such as apoptosis, cell cycle regulation, muscular physiology, and innate immune response. Consistently, their alteration results in several pathological conditions emphasizing their medical relevance. Here, the genetic and pathogenetic mechanisms of rare disorders directly caused by mutations in TRIM genes will be reviewed. These diseases fall into different pathological areas, from malformation birth defects due to developmental abnormalities, to neurological disorders and progressive teenage neuromuscular disorders. In many instances, TRIM E3 ligases act on several substrates thus exerting pleiotropic activities: the need of unraveling disease-specific TRIM pathways for a precise targeting therapy avoiding dramatic side effects will be discussed.
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Tucker LB, Lamot L, Niemietz I, Chung BK, Cabral DA, Houghton K, Petty RE, Morishita KA, Rice GI, Turvey SE, Gibson WT, Brown KL. Complexity in unclassified auto-inflammatory disease: a case report illustrating the potential for disease arising from the allelic burden of multiple variants. Pediatr Rheumatol Online J 2019; 17:70. [PMID: 31660995 PMCID: PMC6819641 DOI: 10.1186/s12969-019-0374-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite recent advances in the diagnosis and understanding of many autoinflammatory diseases, there are still a great number of patients with phenotypes that do not fit any clinically- and/or genetically-defined disorders. CASE PRESENTATION We describe a fourteen-year-old boy who presented at two and a half years of age with recurrent febrile episodes. Over the course of the disease, the episodes increased in frequency and severity, with new signs and symptoms continuing to appear. Most importantly, these included skin changes, splenomegaly and transaminitis. Only partial control of the disease was achieved with anti-IL-1 therapy. Extensive investigation showed generalized inflammation without immune deficiency, with increased levels of serum amyloid A and several pro-inflammatory cytokines including interferon-γ, as well as an increased type I interferon score. Exome sequence analysis identified P369S and R408Q variants in the MEFV innate immunity regulator, pyrin (MEFV) gene and T260 M and T320 M variants in the NLR family pyrin domain containing 12 (NLRP12) gene. CONCLUSION Patients with unclassified and/or unexplained autoinflammatory syndromes present diagnostic and therapeutic challenges and collectively form a substantial part of every cohort of patients with autoinflammatory diseases. Therefore, it is important to acquire their full genomic profile through whole exome and/or genome sequencing and present their cases to a broader audience, to facilitate characterization of similar patients. A critical mass of well-characterized cases will lead to improved diagnosis and informed treatment.
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Affiliation(s)
- Lori B. Tucker
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Lovro Lamot
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Iwona Niemietz
- 0000 0001 2288 9830grid.17091.3eDepartment of Microbiology and Immunology, The University of British Columbia Faculty of Science, Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Rm A4-145, 950 West 28th Ave, Vancouver, BC V5Z 4H4 Canada
| | - Brian K. Chung
- 0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Rm A4-145, 950 West 28th Ave, Vancouver, BC V5Z 4H4 Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Medical Genetics, The University of British Columbia Faculty of Medicine, 4500 Oak Street, Vancouver, BC V6H 3N1 Canada ,0000 0004 0389 8485grid.55325.34Present Address: Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Postboks 4950, Nydalen, N-0424 Oslo, Norway
| | - David A. Cabral
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Kristin Houghton
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Ross E. Petty
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Kimberly A. Morishita
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4The Division of Rheumatology at British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | - Gillian I. Rice
- 0000000121662407grid.5379.8Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Rd, Manchester, M13 9PL UK
| | - Stuart E. Turvey
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Rm A4-145, 950 West 28th Ave, Vancouver, BC V5Z 4H4 Canada
| | - William T. Gibson
- 0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Rm A4-145, 950 West 28th Ave, Vancouver, BC V5Z 4H4 Canada ,0000 0001 2288 9830grid.17091.3eDepartment of Medical Genetics, The University of British Columbia Faculty of Medicine, 4500 Oak Street, Vancouver, BC V6H 3N1 Canada
| | - Kelly L. Brown
- 0000 0001 2288 9830grid.17091.3eDepartment of Pediatrics, The University of British Columbia Faculty of Medicine, BC Children’s Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Rm A4-145, 950 West 28th Ave, Vancouver, BC V5Z 4H4 Canada
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