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Clinical heterogeneity of NLRP12-associated autoinflammatory diseases

FULL LENGTH ARTICLE

Clinical heterogeneity of NLRP12-associated autoinflammatory diseases

Yue Li
Mengyue Deng
Yulu Li
Xiaolan Mao
Shi Yan
Xuemei Tang
Huawei Mao
Genes & Diseases第10卷, 第3期pp.1090-1100纸质出版 2023-05-01在线发表 2022-05-27
121500

Nod-like receptor family pyrin domain-containing protein 12 (NLRP12) is one of the critical pattern recognition receptors which participates in the regulation of multiple inflammatory responses. Mutations in NLRP12 cause exceptionally rare NLRP12-associated autoinflammatory disease (NLRP12-AID). So far, very few patients with NLRP12-AID have been identified worldwide; therefore, data on the clinical phenotype and genetic pro file are limited. In this study, we reported 10 patients who presented mainly with periodic fever syndrome or arthritis. Next-generation sequencing (NGS) identified 6 heterozygous mutations of NLRP12, including 2 novel null mutations. Of the patients, some with same mutations showed different clinical features. Compared to healthy controls, the increased levels of cytokines were revealed in the patients'plasmas, as well as in the supernatants of patients'cells stimulated with lipopolysaccharide (LPS) or tumor necrosis factor-a (TNF-a). The missense mutations did not change the protein expression; but decreased level of NLRP12 protein was shown in the null mutations. And in vitro expression assay demonstrated a truncating protein induced by the frameshift mutation. Further functional studies revealed the deleterious effect of mutations on nuclear factor-kappa B (NF-kB) signaling. Both the null and missense mutations impaired their inhibition of NF-kB activation induced by p65. Collectively, this study reported a relatively large NLRP12-AID case series. Our findings expand the clinical spectrum, and reinforce the diversity of genetic mutations and clinical phenotypes. The NLRP12-associated disorder should be considered when autoinflammatory diseases are encountered in the clinical practice, especially for patients presenting with periodic fever but no other genetic cause identified.

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Autoinflammatory diseasesFamilial cold autoinflammatory syndrome type 2 (FCAS2)NLRP12-Associated autoinflammatory disease (NLRP12-AID)Nod-like receptor family pyrin domain-containing protein 12 (NLRP12)Nuclear factor-Kappa B (NF-kB)