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Yamada S, Honzawa Y, Yamamoto S, Matsuura M, Kitamoto H, Okabe M, Kakiuchi N, Toyonaga T, Kobayashi T, Hibi T, Seno H, Nakase H. Single Nucleotide Polymorphisms of the MEFV Gene E148Q Are Highly Associated With Disease Phenotype in Crohn's Disease. Inflamm Bowel Dis 2024; 30:970-980. [PMID: 37951297 DOI: 10.1093/ibd/izad259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) of the MEFV gene may modify inflammatory bowel disease (IBD) activity. The prevalence of MEFV gene SNPs in IBD patients and their involvement in IBD pathophysiology remains unclear. METHODS We analyzed 12 MEFV gene SNPs in peripheral leukocytes of Japanese IBD patients (Crohn's disease [CD]: 69 patients, ulcerative colitis: 32 patients) by polymerase chain reaction using next-generation DNA sequencing and evaluated their prevalence and association with the disease characteristics. Inflammasome activity and mature interleukin (IL)-1β and IL-18 production were evaluated in peripheral blood mononuclear cells obtained from CD patients stimulated with lipopolysaccharides and adenosine triphosphate, and compared between those with and without the E148Q SNP. COL1A1 and HSP47 gene expression was analyzed in CCD-18Co cells costimulated with IL-1β and other inflammatory cytokines. RESULTS The prevalence of MEFV gene SNPs in IBD patients was similar to that in the human gene database. E148Q was the most common SNP. Compared with CD patients without E148Q, those with E148Q had a significantly greater frequency of the stricture phenotype, and their peripheral blood mononuclear cells exhibited significantly higher IL-1β and IL-18 levels and higher caspase-1 activity. IL-1β and IL-17A synergistically increased COL1A1 and HSP47 gene expression. CONCLUSIONS MEFV gene SNPs, including E148Q, modify the behavior of CD. IL-1β and IL-18 are produced through enhanced caspase-1 activity in monocytes of CD patients with E148Q. IL-1β promotes gene expression of fibrosis-related genes by cooperating with IL-17A in myofibroblasts. Therefore, E148Q might be a disease-modifying gene associated with the fibrostenosis phenotype in CD patients.
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Affiliation(s)
- Satoshi Yamada
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Honzawa
- Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
| | - Shuji Yamamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Minoru Matsuura
- Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Makoto Okabe
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuyuki Kakiuchi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiko Toyonaga
- Center for Advanced IBD Research and Treatment, Kitasato University Hospital, Kitasato University, Tokyo, Japan
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Hospital, Kitasato University, Tokyo, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Hospital, Kitasato University, Tokyo, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Nakase
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Reygaerts T, Laohamonthonkul P, Hrovat-Schaale K, Moghaddas F, Baker PJ, Gray PE, Masters SL. Pyrin variant E148Q potentiates inflammasome activation and the effect of pathogenic mutations in cis. Rheumatology (Oxford) 2024; 63:882-890. [PMID: 37481715 PMCID: PMC10907813 DOI: 10.1093/rheumatology/kead376] [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: 05/03/2023] [Revised: 06/23/2023] [Accepted: 06/30/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVE The p.E148Q variant in pyrin is present in different populations at a frequency of up to 29%, and has been associated with diseases, including vasculitis and FMF. The pathogenicity of p.E148Q in FMF is unclear, even when observed in cis or in trans to a single, typically recessive, pathogenic mutation. We performed functional validation to determine whether p.E148Q increases the ability of pyrin to form an active inflammasome complex in cell lines. METHODS We interrogated the Australian Autoinflammatory Disease RegistrY (AADRY) to find candidate inheritance patterns for the p.E148Q variant in pyrin. Different pyrin variant combinations were tested in HEK293T cells stably expressing the adaptor protein apoptosis-associated speck-like (ASC), which were analysed by flow cytometry to visualize inflammasome formation, with and without stimulation by Clostridioides difficile toxin B (TcdB). Inflammasome-dependent cytokine secretion was also quantified by ELISA of supernatants from THP-1 cells transduced with lentiviral expression vectors. RESULTS In AADRY, we observed the p.E148Q allele in individuals with autoinflammatory diseases alone or in conjunction with other pyrin variants. Two FMF families harboured the allele p.E148Q-M694I in cis with dominant heritability. In vitro, p.E148Q pyrin could spontaneously potentiate inflammasome formation, with increased IL-1β and IL-18 secretion. p.E148Q in cis to classical FMF mutations provided significant potentiation of inflammasome formation. CONCLUSION The p.E148Q variant in pyrin potentiates inflammasome activation in vitro. In cis, this effect is additive to known pathogenic FMF mutations. In some families, this increased effect could explain why FMF segregates as an apparently dominant disease.
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Affiliation(s)
- Thomas Reygaerts
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Pawat Laohamonthonkul
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Katja Hrovat-Schaale
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Fiona Moghaddas
- Immunology and Allergy Centre, North Bristol NHS Trust, Bristol, UK
| | - Paul J Baker
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
| | - Paul E Gray
- Department of Medicine, University of Western Sydney, Campbelltown, NSW, Australia
- Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, NSW, Australia
| | - Seth L Masters
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
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Ozdel S, Coşkuner T, Demirkan F, Torun R, Aydın EA, Bağlan E, Yener GO, Öztürk K, Demir F, Karadağ ŞG, Çakan M, Sönmez HE, Makay BB, Ünsal ŞE, Bülbül M, Ayaz NA, Sözeri B. Inflammatory comorbidities ın the largest pediatric Familial Mediterranean fever cohort: a multicenter retrospective study of Pediatric Rheumatology Academy (PeRA)-Research Group (RG). Clin Rheumatol 2024; 43:407-413. [PMID: 37926798 DOI: 10.1007/s10067-023-06802-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
AIM The aim of this study was to investigate the frequency and type of FMF-associated inflammatory diseases in a large FMF pediatric patients and to compare them to those FMF patients without concomitant inflammatory diseases. MATERIALS AND METHODS Familial Mediterranean fever patients enrolled in the Pediatric Rheumatology Academy (PeRA)-Research Group (RG) were included. The patients were divided into two groups according to concomitant inflammatory disease as FMF patients who had a concomitant inflammatory disease (group 1) and FMF patients who did not have a concomitant inflammatory disease (group 1). The clinical findings and treatments were compared between the two groups. RESULTS The study group comprised 3475 patients with FMF. There were 294 patients (8.5%) in group 1 and 3181 patients (91.5%) in group 2. Juvenile idiopathic arthritis (n = 136) was the most common accompanying inflammatory disease. Arthritis, M694V homozygosity, and the need for biological therapy were more frequently observed in Group 1 (p < 0.05). Fever and abdominal pain were more frequently detected in Group 2 (p < 0.05). FMF patients with concomitant inflammatory diseas more frequently demonstrated colchicine resistance. There were no significant differences in the median attack frequency, chest pain, amyloidosis, erysipelas-like erythema, or family history of FMF between the two patient groups. CONCLUSION To the best of our knowledge, this is the largest pediatric cohort reviewed to date. FMF patients may have different clinical profiles and colchicine responses if they have with concomitant inflammatory diseases. Key points • FMF is associated with some inflammatory comorbidities diseases. • To the best of our knowledge, this is the largest cohort evlauated pediatric FMF associated inflammatory comorbidities diseases reviewed to date.
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Affiliation(s)
- Semanur Ozdel
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
- Department of Pediatric Rheumatology, Etlik City Hospital, Ankara, Turkey.
| | - Taner Coşkuner
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Fatmagül Demirkan
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Rüya Torun
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Elif Arslanoglu Aydın
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Gülçin Otar Yener
- Department of Pediatric Rheumatology, Medicalpark Hospital, Gaziantep, Turkey
| | - Kübra Öztürk
- Department of Pediatric Rheumatology, Istanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Acıbadem Healthcare Group, Istanbul, Turkey
| | - Şerife Gül Karadağ
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
| | - Hafize Emine Sönmez
- Department of Pediatric Rheumatology, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Balahan Bora Makay
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Şevket Erbil Ünsal
- Department of Pediatric Rheumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Betül Sözeri
- Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Research and Training Hospital, Istanbul, Turkey
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Autoinflammatory syndromes with coexisting variants in Mediterranean FeVer and other genes: Utility of multiple gene screening and the possible impact of gene dosage. Semin Arthritis Rheum 2022; 56:152055. [DOI: 10.1016/j.semarthrit.2022.152055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/22/2022]
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Özdel S, Bağlan E, Çakıcı EK, Yazılıtas F, Gür G, Çelikkaya E, Güngör T, Bülbül M. Similarities between pediatric FMF patients with sacroiliitis and pediatric juvenile spondyloarthropathy patients with sacroiliitis: a preliminary study. Acta Clin Belg 2021; 76:294-299. [PMID: 32009575 DOI: 10.1080/17843286.2020.1724450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent, self-limited attacks of fever with serositis. Acute recurrent arthritis is the most common form of musculoskeletal involvement in FMF; however, ≤5% of FMF patients can develop chronic arthritis, including sacroiliitis. It is difficult to determine if sacroiliitis is a musculoskeletal finding of FMF or if they are concomitant diseases-FMF and juvenile spondyloarthropathy (JSpA). The present study aimed to compare clinical and laboratory findings in FMF patients with concomitant sacroiliitis and JSpA patients with concomitant sacroiliitis.Materials and Methods: The medical files of patients diagnosed with FMF and JSpA with concomitant sacroiliitis were retrospectively evaluated. All patients had MRI findings consistent with sacroiliitis. Patient demographic data, clinical features, and laboratory findings were compared between the patients with FMF and concomitant sacroiliitis, and those with JSpA and concomitant sacroiliitis.Results: The study included 18 patients with FMF and sacroiliitis, and 38 patients with JSpA and sacroiliitis. The median (range) age at diagnosis of FMF accompanied by sacroiliitis and JSpA accompanied by sacroiliitis was 12.0 years (3.5-18 years) and 13 years (4-18 years), respectively. There weren't any significant differences in HLA-B27 positivity, family history of ankylosing spondylitis, presenting complaints, arthritis, enthesitis, or treatment between the 2 patient groups.Conclusion: The present findings show that pediatric patients with FMF and sacroiliitis, and those with JSpA and sacroiliitis have the same clinical and laboratory findings.
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Affiliation(s)
- Semanur Özdel
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Evrim Kargın Çakıcı
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Fatma Yazılıtas
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Gökçe Gür
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Evra Çelikkaya
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Tülin Güngör
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
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Cuervo A, Sanmartí R, Ramírez J, Castellanos-Moreira R, Inciarte-Mundo J, Aróstegui JI, McGonagle D, Cañete JD. Palindromic rheumatism: Evidence of four subtypes of palindromic-like arthritis based in either MEFV or rheumatoid factor/ACPA status. Joint Bone Spine 2021; 88:105235. [PMID: 34098104 DOI: 10.1016/j.jbspin.2021.105235] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/20/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION MEFV mutations have been documented in patients with palindromic rheumatism (PR) who do not meet FMF criteria, and RF and ACPA positive RA may start with PR. OBJECTIVE To analyze the clinical phenotype and disease evolution of patients with intermittent, palindromic-like (PL) arthritis seen in our Arthritis Unit according to the RF, ACPA and MEFV mutation status. METHODS MEFV genotyping was done in 76 patients with PL arthritis as defined by predominantly short attacks (≤7days) and a relapsing course. Characteristics of arthritic episodes, RF and ACPA positivity, and the colchicine response were retrospectively collected. Patients were stratified and evaluated according to MEFV mutations and/or positive autoantibodies (ACPA and/or RF). RESULTS Among the patients, 26.3% (20/76) had a MEFV mutation and 23 (30%) were ACPA and/or RF positive. MEFV mutations and/or autoantibody status allowed four PL arthritis patients to be distinguished: group I (MEFV+), with younger age of onset, short duration attacks (<3days), mainly located in the knee, more frequent non-articular manifestations (fever, pericarditis or abdominal pain) and good response to colchicine; group II (autoantibody+) is older than group I, with the same frequency of short attacks, but the most affected joints were the wrists and small joints of hands: 48% met RA classification criteria during follow-up and were taking DMARDs; group III (MEFV- and autoantibody-) was the most frequent (48%) and clinically heterogeneous group; 51% had attacks lasting>3days, and 15 patients developed criteria of immune-mediated inflammatory, autoinflammatory or infectious diseases. Group IV (MEFV+ associated with preexisting immune-inflammatory disease), was associated with very short attacks, like groups I and II, superimposed or coincident with definite immune-inflammatory disease, including seropositive RA, with good response to colchicine. CONCLUSIONS Patients with PL arthritis can be classified in four groups according to the presence or not of MEFV mutations and ACPA/RF antibodies with a different clinical evolution and therapeutic response.
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Affiliation(s)
- Andrea Cuervo
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - Raimon Sanmartí
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - Julio Ramírez
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - Raúl Castellanos-Moreira
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - José Inciarte-Mundo
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - Juan I Aróstegui
- Hospital Clínic, Department of Immunology, University of Barcelona and IDIBAPS, Barcelona, Spain
| | - Dennis McGonagle
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, NIHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Juan D Cañete
- Hospital Clínic, Arthritis Unit, Department of Rheumatology, University of Barcelona and IDIBAPS, Barcelona, Spain.
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Nigrovic PA, Lee PY, Hoffman HM. Monogenic autoinflammatory disorders: Conceptual overview, phenotype, and clinical approach. J Allergy Clin Immunol 2021; 146:925-937. [PMID: 33160483 DOI: 10.1016/j.jaci.2020.08.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/04/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
Autoinflammatory diseases are conditions in which pathogenic inflammation arises primarily through antigen-independent hyperactivation of immune pathways. First recognized just over 2 decades ago, the autoinflammatory disease spectrum has expanded rapidly to include more than 40 distinct monogenic conditions. Related mechanisms contribute to common conditions such as gout and cardiovascular disease. Here, we review the basic concepts underlying the "autoinflammatory revolution" in the understanding of immune-mediated disease and introduce major categories of monogenic autoinflammatory disorders recognized to date, including inflammasomopathies and other IL-1-related conditions, interferonopathies, and disorders of nuclear factor kappa B and/or aberrant TNF activity. We highlight phenotypic presentation as a reflection of pathogenesis and outline a practical approach to the evaluation of patients with suspected autoinflammation.
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Affiliation(s)
- Peter A Nigrovic
- Division of Immunology, Boston Children's Hospital, Department of Pediatrics, Boston, Mass; Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Mass.
| | - Pui Y Lee
- Division of Immunology, Boston Children's Hospital, Department of Pediatrics, Boston, Mass; Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Mass
| | - Hal M Hoffman
- Division of Pediatric Allergy, Immunology, and Rheumatology, Rady Children's Hospital and University of California at San Diego, San Diego, Calif
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Mohammad H. Value of mean platelets volume in children with familial mediterranean fever: A case–control prospective study from Sulaymaniyah, Kurdistan Region, Iraq. IRAQI JOURNAL OF HEMATOLOGY 2021. [DOI: 10.4103/ijh.ijh_55_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Omma A, Armaǧan B, Güven SC, Sandıkçı SC, Çolak S, Yücel Ç, Küçükşahin O, Erden A. Endocan: A Novel Marker for Colchicine Resistance in Familial Mediterranean Fever Patients? Front Pediatr 2021; 9:788864. [PMID: 34912764 PMCID: PMC8667615 DOI: 10.3389/fped.2021.788864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction: Familial Mediterranean fever (FMF) patients had 5-10% colchicine resistance. Although FMF attacks are characterized by acute phase elevation, there are no biomarkers that can show colchicine resistance yet. The serum endocan levels may elevate in inflammatory and auto-inflammatory diseases. Objectives: This study aimed to evaluate serum endocan levels in FMF patients according to whether attack and colchicine resistance or not and also compare them with classical acute phase reactants. Methods: In this single-center and cross-sectional study, a total of 111 FMF patients and 60 healthy individuals were enrolled. All patients' basic demographic and clinical data were recorded and blood samples were collected. Results: A total of 46 (41.4%) FMF patients had colchicine resistance. In comparison to the FMF patients according to colchicine response, colchicine resistance patients had a significantly higher median (IQR) endocan levels than colchicine responsive patients [36.98 ng/ml (97.41) vs. 13.57 ng/ml (27.87), p = 0.007], but there were no differences between in terms of median ESR and CRP levels. Inversely, serum endocan levels were similar during an attack and attack-free period in FMF patients, although ESR and CRP levels were significantly different. Interestingly, the highest serum endocan levels were in the control group. Conclusion: In conclusion, serum endocan levels were higher in colchicine resistance than colchicine responsive patients, but attack state had no effect on serum endocan levels in our study. Unlike ESR and CRP, serum endocan may be a novel biomarker for detection of colchicine resistance and distinguish the FMF attacks.
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Affiliation(s)
- Ahmet Omma
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Berkan Armaǧan
- Clinic of Rheumatology, Ankara City Hospital, Ankara, Turkey
| | | | - Sevinç Can Sandıkçı
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Seda Çolak
- Department of Rheumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Çiǧdem Yücel
- Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Orhan Küçükşahin
- Division of Rheumatology, Department of Internal Medicine, Ankara City Hospital, Yildirim Beyazit University, Ankara, Turkey
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10
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Eyal O, Shinar Y, Pras M, Pras E. Familial Mediterranean fever: Penetrance of the p.[Met694Val];[Glu148Gln] and p.[Met694Val];[=] genotypes. Hum Mutat 2020; 41:1866-1870. [DOI: 10.1002/humu.24090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 07/16/2020] [Accepted: 07/26/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Ori Eyal
- The Danek Gertner Institute of Human Genetics Sheba Medical Center, Tel‐Hashomer Ramat Gan Israel
- St George's, University of London MBBS Program at Sheba Medical Center Tel‐Hashomer Israel
| | - Yael Shinar
- FMF Clinic and the Heller Institute of Medical Science Sheba Medical Center, Tel‐Hashomer Ramat Gan Israel
| | - Mordechai Pras
- FMF Clinic and the Heller Institute of Medical Science Sheba Medical Center, Tel‐Hashomer Ramat Gan Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Elon Pras
- The Danek Gertner Institute of Human Genetics Sheba Medical Center, Tel‐Hashomer Ramat Gan Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
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Salehzadeh F, Mirzarahimi M. Recurrent synovitis of hip and MEFV gene related arthritis in children. Pediatr Rheumatol Online J 2020; 18:63. [PMID: 32778116 PMCID: PMC7418299 DOI: 10.1186/s12969-020-00456-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/03/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Recurrent and relapsing arthritis has been proposed to describe a group of arthritis with recurring and periodic nature, in which the joints are intermittently involved. This study reports three non-FMF patients with heterozygous MEFV gene mutations and an extraordinary arthritis as a recurrent synovitis of hip (RSH). METHODS During 16-years from 2003 to 2019 at pediatric rheumatologic clinic among 195 recorded files with chronic oligoarthritis, 3 patients with diagnosis of recurrent synovitis of hip (RSH) were reviewed thoroughly. Peripheral blood was collected from patients and the samples were screened for the 12 common MEFV gene pathogenic variants. RESULTS This study included three patients, two female and one male with relapsing idiopathic arthritis that has been located on hip joints as a sole manifestation and pathologic findings of MEFV mutations as follow: A744S, V726A, and R761H. CONCLUSION On the basis of possible role of MEFV gene in different rheumatic disease, MEFV gene related arthritis may be considered as a background of RSH particularly in Mediterranean area.
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Affiliation(s)
- Farhad Salehzadeh
- grid.411426.40000 0004 0611 7226Pediatric Rheumatology, Pediatric Department, Bouali Children’s Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Mehrdad Mirzarahimi
- Pediatric Rheumatology, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran.
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Nakamura T, Shiraishi N, Morikami Y, Fujii H, Yoshinaga T. Amyloid A amyloidosis in a patient with Caplan's syndrome, with special reference to genetic predisposition. Mod Rheumatol Case Rep 2020; 4:212-217. [PMID: 33087017 DOI: 10.1080/24725625.2020.1749361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
Secondary amyloid A (AA) amyloidosis, which is a disorder of protein conformation and metabolism, is an important serious complication of inflammatory diseases, especially rheumatoid arthritis (RA). AA amyloidosis develops when AA fibrils, which are derived from the acute-phase reactant, serum amyloid AA (SAA) protein, in the circulation, are deposited in organs and cause systemic organ dysfunction. Caplan's syndrome, or rheumatoid pneumoconiosis, is a rare type of lung disease in which individuals suffering from RA develop lung nodules that are associated with occupational exposure to silica and coal dust. Confirmation of diagnosing as Caplan's syndrome requires the patient's occupational history, imaging studies, and serology. A 72-year-old male, working as a tunnel construction worker for 38 years, with RA who had both chronic cardiac and renal dysfunction was referred to our hospital. He received a diagnosis of pneumoconiosis about 20 years ago, after which he was also diagnosed with RA. So far we performed medical English literature searches on the combination of Caplan's syndrome with AA amyloidosis; there were no articles in relation to such association. Although RA is one of the most common underlying diseases that occur with AA amyloidosis, our report here is the first description of a case of Caplan's syndrome associated with AA amyloidosis. In this report, we provide details about this rare disease occurring with AA amyloidosis and discuss on the possible pathogenesis of AA amyloidosis from a genetic point of aetiological view.
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Affiliation(s)
- Tadashi Nakamura
- Section of Clinical Rheumatology, Sakurajyuji Hospital, Kumamoto, Japan
| | - Naoki Shiraishi
- Section of Nephrology, Sakurajyuji Hospital, Kumamoto, Japan
| | | | - Hiromi Fujii
- Section of Cardiology, Sakurajyuji Hospital, Kumamoto, Japan
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Tanatar A, Çakan M, Karadağ ŞG, Kısaarslan AP, Sözeri B, Ayaz NA. The influence of carrying MEFV gene variants on juvenile systemic lupus erythematosus. Rheumatol Int 2019; 41:157-161. [PMID: 31432226 DOI: 10.1007/s00296-019-04420-7] [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: 06/24/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
Juvenile-onset systemic lupus erythematosus (jSLE) patients typically have a more severe disease course than adults with SLE. We aimed to assess the prevalence and disease course of jSLE patients carrying MEFV variants. MEFV variant analyses were performed in 44 jSLE patients and effect of these variants on disease severity and course was analyzed by SLEDAI score and SLICC/ACR index. Ten of the patients (22.7%) had a MEFV variant. The median (min-max) SLEDAI score and SLICC/ACR index were 2(0-13) and 0(0-3), respectively. Median age at disease onset, disease duration, SLICC/ACR indexes, SLEDAI scores, clinical and laboratory findings of the patients were comparable in carriers of variants and non-carriers. Nineteen patients (43.2%) had biopsy-proven lupus nephritis and four of these patients had MEFV variants. There was no significant difference between patients with and without MEFV carriers in terms of lupus nephritis. Even though not significant statistically, renal involvement was milder in MEFV carriers than non-carriers. The presence of MEFV variants does not increase the overall susceptibility to jSLE in our cohort, while larger number of patients is required to display the protective role of MEFV variants in jSLE.
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Affiliation(s)
- Ayşe Tanatar
- Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, No: 46/1, Kucukcekmece, 34303, Istanbul, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, No: 46/1, Kucukcekmece, 34303, Istanbul, Turkey
| | - Şerife Gül Karadağ
- Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, No: 46/1, Kucukcekmece, 34303, Istanbul, Turkey
| | - Ayşenur Paç Kısaarslan
- Department of Pediatric Rheumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Betül Sözeri
- Department of Pediatric Rheumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, University of Health Sciences, No: 46/1, Kucukcekmece, 34303, Istanbul, Turkey.
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Salehzadeh F, Mirzarahimi M, Hosseini Asl S, Nematdoust Haghi R. Kawasaki disease and familial mediterranean fever gene mutations, is there any link? Open Access Rheumatol 2019; 11:127-131. [PMID: 31191052 PMCID: PMC6535441 DOI: 10.2147/oarrr.s202217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/01/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aim: Kawasaki disease (KD) is an acute febrile, self-limiting, and systemic vasculitis of unknown etiology. MEFV gene has a major role in autoinflammatory disorders and innate immune reactions. Several reports revealed that MEFV gene mutations are associated with systemic vasculitis. The aim of this study was to determine the association between KD and MEFV gene mutations. Methods: The peripheral blood of 30 patients who were diagnosed with KD based on ACC criteria and 224 healthy people as a control group (113 male and 111 female), were collected and the samples screened for the 12 common pathogenic variants according to manufacturer's instructions. Results: The mean age of patients (13 females and 17 males) was 7.7 years. Ten percent of patients showed a mutation, that was meaningfully (p<0.05%) lower than that of healthy controls (25%). E148Q was shown in two patients and compound heterozygous (E148Q-M680I) was detected in one of them with lack of FMF presentations. No significant and meaningful associations were detected between the MEFV gene variant alleles and KD. Conclusion: Unlike in other types of pediatric vasculitis, this study did not reveal any significant association between the MEFV gene mutations and KD, moreover, because of the lower frequency of mutations in these patients, it seems that this gene has a modifier and/or protective role in KD.
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Affiliation(s)
- Farhad Salehzadeh
- Pediatric Rheumatology, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Mehrdad Mirzarahimi
- Pediatric, Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
| | - Saied Hosseini Asl
- Molecular-Genetic, Genetic Laboratory, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Roghayeh Nematdoust Haghi
- Pediatric Department, Bouali Children's Hospital, Ardabil University of Medical Sciences (ARUMS), Ardabil, Iran
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Westwell-Roper C, Niemietz I, Tucker LB, Brown KL. Periodic fever syndromes: beyond the single gene paradigm. Pediatr Rheumatol Online J 2019; 17:22. [PMID: 31088470 PMCID: PMC6515597 DOI: 10.1186/s12969-019-0324-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/30/2019] [Indexed: 12/16/2022] Open
Abstract
Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease in Canada and is characterized by a clinical syndrome of episodic inflammatory symptoms. Traditionally, the disease is defined by autosomal recessive inheritance of MEFV gene variants, yet FMF also not uncommonly manifests in individuals with only one identified disease-associated allele. Increasing availability and affordability of gene sequencing has led to the identification of multiple MEFV variants; however, they are often of unknown clinical significance. Variants in other genes affecting overlapping or distinct inflammatory signaling pathways - together with gene-environment interactions including epigenetic modulation - likely underlie the significant genetic and phenotypic heterogeneity seen among patients with this disease. We review recent evidence of the expanding spectrum of FMF genotype and phenotype and suggest that current drug funding schemes restricting biologic agents to patients with homozygous mutations have not kept pace with our biological understanding of the disease.
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Affiliation(s)
- Clara Westwell-Roper
- 0000 0001 2288 9830grid.17091.3eDivision of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Iwona Niemietz
- 0000 0001 2288 9830grid.17091.3eDepartment of Microbiology & Immunology, University of British Columbia, Vancouver, Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Vancouver, Canada
| | - Lori B. Tucker
- 0000 0001 2288 9830grid.17091.3eDivision of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital, K4-124 4480 Oak St, Vancouver, BC V6H 3N1 Canada
| | - Kelly L. Brown
- 0000 0001 2288 9830grid.17091.3eDivision of Rheumatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada ,0000 0001 0684 7788grid.414137.4BC Children’s Hospital Research Institute, Vancouver, Canada
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YAŞAR BİLGE NŞ, SARI İ, SOLMAZ D, ŞENEL S, EMMUNGİL H, KILIÇ L, YILMAZ ÖNER S, YILDIZ F, YILMAZ S, ERSÖZLU BOZKIRLI D, AYDIN TUFAN M, YILMAZ S, YAZISIZ V, PEHLİVAN Y, BES C, YILDIRIM ÇETİN G, ERTEN Ş, GÖNÜLLÜ E, ŞAHİN F, AKAR S, AKSU K, KALYONCU U, DİRESKENELİ H, ERKEN E, KISACIK B, SAYARLIOGLU M, ÇINAR M, KAŞİFOĞLU T. The distribution of MEFV mutations in Turkish FMF patients:
multicenter study representing results of Anatolia. Turk J Med Sci 2019; 49:472-477. [PMID: 30887796 PMCID: PMC7018361 DOI: 10.3906/sag-1809-100] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background/aim The distribution of Mediterranean fever (MEFV) gene mutations in Turkish familial Mediterranean fever (FMF)
patients varies according to geographic area of Turkey. There is a need for highly representative data for Turkish FMF patients. The aim
of our study was to investigate the distribution of the common MEFV mutations in Turkish FMF patients in a nationwide, multicenter
study. Materials and methods Data of the 2246 FMF patients, from 15 adult rheumatology clinics located in different parts of the country,
were evaluated retrospectively. The following mutations have been tested in all patients: M694V, M680I, M694I, V726A, and E148Q. Results There were 1719 FMF patients with available genetic testing. According to the genotyping, homozygous M694V, present in
413 patients (24%), was the most common mutation . One hundred and fifty-four (9%) of patients had no detectable mutations. Allele
frequencies of common mutations were: M694V (n = 1529, 44.5%), M680I (n = 423, 12.3%), V726A (n = 315, 9.2%), E148Q (n = 214,
1%), and M694I (n = 12, <1%). Conclusion In this large-scale multicenter study, we provided information about the frequencies of common MEFV gene mutations
obtained from adult Turkish FMF patients. Nearly half of the patients were carrying at least one M694V mutations in their alleles.
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Affiliation(s)
- N. Şule YAŞAR BİLGE
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, EskişehirTurkey
- * To whom correspondence should be addressed. E-mail:
| | - İsmail SARI
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University, İzmirTurkey
| | - Dilek SOLMAZ
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University, İzmirTurkey
| | - Soner ŞENEL
- Division of Rheumatology, Department of Internal Medicine, Erciyes University, KayseriTurkey
| | - Hakan EMMUNGİL
- Division of Rheumatology, Department of Internal Medicine, Ege University, İzmirTurkey
| | - Levent KILIÇ
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, AnkaraTurkey
| | - Sibel YILMAZ ÖNER
- Division of Rheumatology, Department of Internal Medicine, Marmara University, İstanbulTurkey
| | - Fatih YILDIZ
- Division of Rheumatology, Department of Internal Medicine, Çukurova University, AdanaTurkey
| | - Sedat YILMAZ
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences,Gülhane Faculty of Medicine, AnkaraTurkey
| | - Duygu ERSÖZLU BOZKIRLI
- Division of Rheumatology, Department of Internal Medicine, Adana Numune Education and Research Hospital, AdanaTurkey
| | - Müge AYDIN TUFAN
- Division of Rheumatology, Department of Internal Medicine, Adana Numune Education and Research Hospital, AdanaTurkey
| | - Sema YILMAZ
- Division of Rheumatology, Department of Internal Medicine, Selçuk University, KonyaTurkey
| | - Veli YAZISIZ
- Division of Rheumatology, Department of Internal Medicine, Şişli Etfal Education and Research Hospital, İstanbulTurkey
| | - Yavuz PEHLİVAN
- Division of Rheumatology, Department of Internal Medicine, Gaziantep University, GaziantepTurkey
| | - Cemal BES
- Division of Rheumatology, Department of Internal Medicine, Abant İzzet Baysal University, BoluTurkey
| | - Gözde YILDIRIM ÇETİN
- Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University, KahramanmaraşTurkey
| | - Şükran ERTEN
- Division of Rheumatology, Department of Internal Medicine, Yıldırım Beyazıt University, AnkaraTurkey
| | - Emel GÖNÜLLÜ
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, EskişehirTurkey
| | - Fezan ŞAHİN
- Department of Biostatistics, Eskişehir Osmangazi University, EskişehirTurkey
| | - Servet AKAR
- Division of Rheumatology, Department of Internal Medicine, Dokuz Eylül University, İzmirTurkey
| | - Kenan AKSU
- Division of Rheumatology, Department of Internal Medicine, Ege University, İzmirTurkey
| | - Umut KALYONCU
- Division of Rheumatology, Department of Internal Medicine, Hacettepe University, AnkaraTurkey
| | - Haner DİRESKENELİ
- Division of Rheumatology, Department of Internal Medicine, Marmara University, İstanbulTurkey
| | - Eren ERKEN
- Division of Rheumatology, Department of Internal Medicine, Çukurova University, AdanaTurkey
| | - Bünyamin KISACIK
- Division of Rheumatology, Department of Internal Medicine, Medical Park, GaziantepTurkey
| | - Mehmet SAYARLIOGLU
- Division of Rheumatology, Department of Internal Medicine, Kahramanmaraş Sütçü İmam University, KahramanmaraşTurkey
| | - Muhammed ÇINAR
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences,Gülhane Faculty of Medicine, AnkaraTurkey
| | - Timuçin KAŞİFOĞLU
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, EskişehirTurkey
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Endo Y, Koga T, Ishida M, Fujita Y, Tsuji S, Takatani A, Shimizu T, Sumiyoshi R, Igawa T, Umeda M, Fukui S, Nishino A, Kawashiri SY, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Agematsu K, Yachie A, Masumoto J, Migita K, Kawakami A. Musculoskeletal manifestations occur predominantly in patients with later-onset familial Mediterranean fever: Data from a multicenter, prospective national cohort study in Japan. Arthritis Res Ther 2018; 20:257. [PMID: 30458853 PMCID: PMC6247522 DOI: 10.1186/s13075-018-1738-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/02/2018] [Indexed: 12/02/2022] Open
Abstract
Background We showed previously that Japanese individuals with familial Mediterranean fever (FMF) have a more atypical phenotype compared to endemic areas. The clinical differences between young-onset FMF (YOFMF), adult-onset FMF (AOFMF), and late-onset FMF (LOFMF) in Japan are unclear. Methods We enrolled 395 consecutive patients. We defined YOFMF, AOFMF, and LOFMF as the onset of FMF at < 20, 20–39, and ≥ 40 years of age, respectively. We compared clinical manifestations and MEFV mutations patterns among these groups. Results Median ages at onset were YOFMF 12.5 years (n = 182), AOFMF 28 years (n = 115), and LOFMF 51 years (n = 90). A family history, MEFV mutations in exon 10, and more than two MEFV mutations were significantly more frequent in the earlier-onset groups (p < 0.01, p < 0.0001, and p < 0.001, respectively). In the accompanying manifestations, thoracic and abdominal pain were significantly more frequent in the earlier-onset groups (p < 0.01 and p < 0.0001, respectively), whereas arthritis and myalgia were significantly more frequent in the later-onset groups (p < 0.0001 and p < 0.01, respectively). The multiple logistic regression analysis revealed that the presence of MEFV exon 10 mutations and earlier onset were significantly associated with serositis, whereas the absence of MEFV exon 10 mutations, later onset, and the presence of erysipelas-like erythema were significantly associated with musculoskeletal manifestations. There was no significant between-group difference in the responsiveness to colchicine. Conclusions Our results indicate that the later-onset FMF patients had a lower percentage of MEFV mutations in exon 10 and predominantly presented arthritis and myalgia. It is important to distinguish their FMF from other inflammatory diseases. Electronic supplementary material The online version of this article (10.1186/s13075-018-1738-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yushiro Endo
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Midori Ishida
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yuya Fujita
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Sosuke Tsuji
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Ayuko Takatani
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Remi Sumiyoshi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Igawa
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shoichi Fukui
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Ayako Nishino
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Shin-Ya Kawashiri
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Naoki Iwamoto
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kunihiro Ichinose
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mami Tamai
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hideki Nakamura
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kazunaga Agematsu
- Department of Infection and Host Defense, Graduate School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, 390-8621, Japan
| | - Akihiro Yachie
- Department of Pediatrics, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan
| | - Junya Masumoto
- Proteo-Science Center, Ehime University, 3 Bunkyo-cho, Matsuyama, 790-8577, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Sahli H, Skouri W, Bachali A, Miledi B, Amri R, Bouzaidi K, Tekaya R. Familial Mediterranean fever and spondyloarthritis: Case report, diagnostic and therapeutic difficulties. EGYPTIAN RHEUMATOLOGIST 2018. [DOI: 10.1016/j.ejr.2017.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Ou-Yang LJ, Tang KT. A case of adult onset Still's disease with mutations of the MEFV gene who is partially responsive to colchicine. Medicine (Baltimore) 2018; 97:e0333. [PMID: 29642170 PMCID: PMC5908639 DOI: 10.1097/md.0000000000010333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
RATIONALE Familial Mediterranean fever (FMF) and adult onset Still's disease (AOSD) have overlapping features, and are categorized as being on the spectrum of autoinflammatory diseases (AIDs). FMF is more prevalent in the Mediterranean region but rarely, described in the Chinese population. PATIENT CONCERNS We present an interesting case of a Han Chinese AOSD patient with episodic fever, wheals, and polyarthritis for 2 years. DIAGNOSIS Sequencing analysis found exon 2 mutations of the MEFV gene (c.329T>C [L110P], and c.442G>C [E148Q]). INTERVENTION Her arthritis was well-controlled with colchicine treatment, but fever, and rashes were not. OUTCOMES She eventually received tocilizumab, in addition to colchicine, and her symptoms completely disappeared. LESSONS MEFV mutations may exist in AOSD patients, and treatment with colchicine might be helpful in such patients.
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Affiliation(s)
| | - Kuo-Tung Tang
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, R.O.C
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20
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Asano T, Furukawa H, Sato S, Yashiro M, Kobayashi H, Watanabe H, Suzuki E, Ito T, Ubara Y, Kobayashi D, Iwanaga N, Izumi Y, Fujikawa K, Yamasaki S, Nakamura T, Koga T, Shimizu T, Umeda M, Nonaka F, Yasunami M, Ueki Y, Eguchi K, Tsuchiya N, Tohma S, Yoshiura KI, Ohira H, Kawakami A, Migita K. Effects of HLA-DRB1 alleles on susceptibility and clinical manifestations in Japanese patients with adult onset Still's disease. Arthritis Res Ther 2017; 19:199. [PMID: 28899403 PMCID: PMC5596459 DOI: 10.1186/s13075-017-1406-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/22/2017] [Indexed: 01/01/2023] Open
Abstract
Background HLA-DRB1 alleles are major determinants of genetic predisposition to rheumatic diseases. We assessed whether DRB1 alleles are associated with susceptibility to particular clinical features of adult onset Still’s disease (AOSD) in a Japanese population by determining the DRB1 allele distributions. Methods DRB1 genotyping of 96 patients with AOSD and 1,026 healthy controls was performed. Genomic DNA samples from the AOSD patients were also genotyped for MEFV exons 1, 2, 3, and 10 by direct sequencing. Results In Japanese patients with AOSD, we observed a predisposing association of DRB1*15:01 (p = 8.60 × 10−6, corrected p (Pc) = 0.0002, odds ratio (OR) = 3.04, 95% confidence interval (95% CI) = 1.91–4.84) and DR5 serological group (p = 0.0006, OR = 2.39, 95% CI = 1.49–3.83) and a protective association of DRB1*09:01 (p = 0.0004, Pc = 0.0110, OR = 0.34, 95% CI = 0.18–0.66) with AOSD, and amino acid residues 86 and 98 of the DRβ chain were protectively associated with AOSD. MEFV variants were identified in 49 patients with AOSD (56.3%). The predisposing effect of DR5 was confirmed only in patients with AOSD who had MEFV variants and not in those without MEFV variants. Additionally, DR5 in patients with AOSD are associated with macrophage activation syndrome (MAS) and steroid pulse therapy. Conclusion The DRB1*15:01 and DR5 are both associated with AOSD susceptibility in Japanese subjects. A protective association between the DRB1*09:01 allele and AOSD was also observed in these patients. Our data also highlight the effects of DRB1 alleles in susceptibility to AOSD. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1406-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hiroshi Furukawa
- Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Makiko Yashiro
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hiroko Kobayashi
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Hiroshi Watanabe
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Eiji Suzuki
- Department of Rheumatology, Ohta Nishinouchi General Hospital Foundation, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan
| | - Tomoyuki Ito
- Department of Rheumatology Nagaoka Red Cross Hospital, 297-1, Senshu-2, Nagaoka, Niigata, 940-2085, Japan
| | - Yoshifumi Ubara
- Department of Rheumatology, Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo, 105-8470, Japan
| | - Daisuke Kobayashi
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata, Niigata, 957-0054, Japan
| | - Nozomi Iwanaga
- Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Yasumori Izumi
- Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Keita Fujikawa
- Department of Rheumatology, Japan Community Health care Organization, Isahaya General Hospital, Eishohigashi-machi 24-1, Isahaya, 854-8501, Japan
| | - Satoshi Yamasaki
- Department of Rheumatology, Kurume University Medical Center, Kokubu 155-1 1-2-3, Kurume, 734-8551, Japan
| | - Tadashi Nakamura
- Department of Rheumatology, Sakurajyuji Hospital, Miyukibe 1-1-1, Kumamoto, 861-4173, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Fumiaki Nonaka
- Departments of Rheumatology, Sasebo City General Hospital, Hirase 9-3, Sasebo, 857-8511, Japan
| | - Michio Yasunami
- Department of Medical Genomics, Life Science Institute, Saga-ken Medical Centre Koseikan, 400 Kasemachi-Nakabaru, Saga, 840-8571, Japan
| | - Yukitaka Ueki
- Department of Rheumatology, Sasebo Chuo Hospital, Yamato 15, Sasebo, 857-1195, Japan
| | - Katsumi Eguchi
- Department of Rheumatology, Sasebo Chuo Hospital, Yamato 15, Sasebo, 857-1195, Japan
| | - Naoyuki Tsuchiya
- Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Shigeto Tohma
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, 252-0392, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
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Zhong L, Song H, Wang W, Li J, Ma M. MEFV M694V mutation has a role in susceptibility to ankylosing spondylitis: A meta-analysis. PLoS One 2017; 12:e0182967. [PMID: 28800602 PMCID: PMC5553723 DOI: 10.1371/journal.pone.0182967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The aim of the current study was to determine the contributions of several common mutations in the Mediterranean fever (MEFV) gene, namely, E148Q, M680I, M694V and V726A, to ankylosing spondylitis (AS) susceptibility. METHODS Two investigators independently searched the literature regarding the association of MEFV with AS in the PubMed, EMBASE, Web of Science, and Scopus databases. They independently selected eligible articles and then extracted data from the included studies. The associations between MEFV mutations and AS risk were assessed with odds ratios (ORs) and 95% confidence intervals (95% CI). Further analyses were conducted with STATA 12.0 software (Stata Corp.; College Station, Texas, USA). RESULTS Four mutations (E148Q, M680I, M694V and V726A) were genotyped in 869 AS cases and 879 controls from the 8 eligible studies. Of the four mutations, M694V (pooled OR: 3.330, 95% CI: 2.129-5.208) was found to be associated with AS through overall analysis. However, the other mutations demonstrated no relation with AS (pooled ORs: 1.295, 1.258, 1.778; 95% CI: 0.886-1.891, 0.688-2.298 and 0.938-3.371). No significant publication bias was discovered in the meta-analysis. CONCLUSIONS The present study indicates that the MEFV M694V mutation may contribute to the pathogenesis of AS. The associations between the other mutations and AS need to be validated with more relevant and well-designed studies.
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Affiliation(s)
- Linqing Zhong
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji Li
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingsheng Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Migita K, Izumi Y, Jiuchi Y, Iwanaga N, Kawahara C, Agematsu K, Yachie A, Masumoto J, Fujikawa K, Yamasaki S, Nakamura T, Ubara Y, Koga T, Nakashima Y, Shimizu T, Umeda M, Nonaka F, Yasunami M, Eguchi K, Yoshiura KI, Kawakami A. Familial Mediterranean fever is no longer a rare disease in Japan. Arthritis Res Ther 2016; 18:175. [PMID: 27473114 PMCID: PMC4967332 DOI: 10.1186/s13075-016-1071-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/04/2016] [Indexed: 12/15/2022] Open
Abstract
Background The aim of this study was to evaluate the clinical manifestations and prevalence of familial Mediterranean fever (FMF) in Japanese patients with unexplained fever and rheumatic manifestations. Methods We enrolled 601 patients with unexplained fever or suspected FMF throughout Japan between 2009 and 2015. Patients were divided into three groups according to Tel Hashomer criteria: sure FMF, probable FMF, and non-FMF patients, including definitive rheumatic diseases. Mutation detection in exons 1, 2, 3, and 10 of the FMF gene MEFV was performed by direct sequencing. Results A total of 192 patients (31.9 %) were diagnosed with FMF according to FMF diagnostic criteria. These could be divided into sure FMF (56.3 %, n = 108) and probable FMF (43.7 %, n = 84) patients. Fever, abdominal symptoms, and thoracic symptoms were significantly more common in FMF than non-FMF patients. Among FMF patients, 26 (13.5 %) had concomitant rheumatic diseases. Most FMF patients (94.3 %, 181/192) carried at least one MEFV mutation. Allele frequencies of M694I (13.5 % vs 0 %) and E148Q (39.1 % vs 24.8 %) mutations were significantly higher in FMF compared with healthy subjects. Allele frequencies of common MEFV mutations in FMF patients were M694I (13.5 %), P369S (8.6 %), R408Q (8.1 %), G304R (2.9 %), R202Q (4.4 %), E148Q (39.1 %), L110P (11.7 %), and E84K (3.1 %). Patients with a sure FMF phenotype had a higher frequency of MEFV exon 10 mutation (M694I) and a lower frequency of MEFV exon 3 mutations (P369S, R408Q) compared with those with a probable FMF phenotype. Conclusion The high prevalence of FMF in Japanese patients with unexplained fever was confirmed in the present study. FMF should be suspected in cases of unexplained fever or non-specific rheumatic manifestations, and mutational analysis of MEFV could be useful to predict the clinical phenotypes of FMF in Japan.
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Affiliation(s)
- Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, Fukushima, 960-1295, Japan. .,Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan.
| | - Yasumori Izumi
- Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Yuka Jiuchi
- Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Nozomi Iwanaga
- Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura, Nagasaki, 856-8562, Japan
| | - Chieko Kawahara
- Department of Rheumatology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, Fukushima, 960-1295, Japan
| | - Kazunaga Agematsu
- Department of Infectious Immunology, Shinshu University Graduate School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Akihiro Yachie
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Takara13-1, Kanazawa, 920-8640, Japan
| | - Junya Masumoto
- Department of Pathology, Ehime University Proteo-Science Center and Graduate School of Medicine, Shitsukawa 454, Toon, Ehime, 791-0295, Japan
| | - Keita Fujikawa
- Department of Rheumatology, Japan Community Health care Organization, Isahaya General Hospital, Eishohigashi-machi 24-1, Isahaya, 854-8501, Japan
| | - Satoshi Yamasaki
- Department of Rheumatology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tadashi Nakamura
- Department of Rheumatology, Kumamoto Shinto General Hospital, Shinyashiki 1-17-27, Kumamoto, 862-8655, Japan
| | - Yoshifumi Ubara
- Department of Rheumatology, Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo, 105-8470, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Yoshikazu Nakashima
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Masataka Umeda
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
| | - Fumiaki Nonaka
- Departments of Rheumatology, Sasebo City General Hospital, Hirase 9-3, Sasebo, 857-8511, Japan
| | - Michio Yasunami
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8501, Japan
| | - Katsumi Eguchi
- Sasebo Chuo Hospital, Yamato 15, Sasebo, 857-1195, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Unit of Translational Medicine, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto1-7-1, Nagasaki, 852-8501, Japan
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Affiliation(s)
- Tomohiro Koga
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan and
| | - Kiyoshi Migita
- Department of Rheumatology and Clinical Research Center, Nagasaki Medical Center, Omura, Japan, Nagasaki
| | - Atsushi Kawakami
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan and
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Manukyan G, Aminov R. Update on Pyrin Functions and Mechanisms of Familial Mediterranean Fever. Front Microbiol 2016; 7:456. [PMID: 27066000 PMCID: PMC4815028 DOI: 10.3389/fmicb.2016.00456] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/21/2016] [Indexed: 01/09/2023] Open
Abstract
Mutations in the MEFV gene, which encodes the protein named pyrin (also called marenostrin or TRIM20), are associated with the autoinflammatory disease familial Mediterranean fever (FMF). Recent genetic and immunologic studies uncovered novel functions of pyrin and raised several new questions in relation to FMF pathogenesis. The disease is clinically heterogeneous reflecting the complexity and multiplicity of pyrin functions. The main functions uncovered so far include its involvement in innate immune response such as the inflammasome assemblage and, as a part of the inflammasome, sensing intracellular danger signals, activation of mediators of inflammation, and resolution of inflammation by the autophagy of regulators of innate immunity. Based on these functions, the FMF-associated versions of pyrin confer a heightened sensitivity to a variety of intracellular danger signals and postpone the resolution of innate immune responses. It remains to be demonstrated, however, what kind of selective advantage the heterozygous carriage conferred in the past to be positively selected and maintained in populations from the Mediterranean basin.
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Affiliation(s)
- Gayane Manukyan
- Group of Molecular and Cellular Immunology, Institute of Molecular Biology, National Academy of Sciences Yerevan, Armenia
| | - Rustam Aminov
- School of Medicine and Dentistry, University of Aberdeen Aberdeen, UK
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Nureki SI, Ishii K, Fujisaki H, Torigoe M, Maeshima K, Shibata H, Miyazaki E, Kadota JI. Familial Mediterranean Fever with Rheumatoid Arthritis Complicated by Pulmonary Paragonimiasis. Intern Med 2016; 55:2889-2892. [PMID: 27725555 PMCID: PMC5088556 DOI: 10.2169/internalmedicine.55.6999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A 42-year-old woman presented with an intermittent fever and chest and back pain, and an abnormal chest shadow was detected. She was diagnosed with paragonimiasis caused by Paragonimus westermani. Praziquantel therapy improved the abnormal chest shadow, but did not relieve her symptoms. She was also diagnosed with familial Mediterranean fever (FMF), and colchicine therapy resolved her symptoms. She subsequently developed arthralgia and morning stiffness in her hands. We also diagnosed the patient with rheumatoid arthritis (RA), and corticosteroid and salazosulfapyridine therapy improved her symptoms. The existence of paragonimiasis complicated the diagnosis of FMF. The coexistence of FMF and RA is very rare, but does exist.
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Affiliation(s)
- Shin-Ichi Nureki
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Japan
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Heshin-Bekenstein M, Hashkes PJ. Intestinal malrotation as a misdiagnosis of pediatric colchicine resistant familial Mediterranean fever. Pediatr Rheumatol Online J 2015; 13:45. [PMID: 26554556 PMCID: PMC4641426 DOI: 10.1186/s12969-015-0044-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/04/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Familial Mediterranean fever (FMF) is a disorder characterized by recurrent attacks of fever and serosal inflammation, particularly abdominal pain. Other disease processes, including medical and surgical emergencies, may mimic FMF, especially in atypical cases. CASE PRESENTATION We present a case of an adolescent male, referred to us with a diagnosis of colchicine resistant FMF, ultimately diagnosed with intestinal malrotation and recurrent volvulus. CONCLUSIONS In atypical presentations of FMF with potential "red flags", a thorough patient history is extremely important and should result in prompt referral for the appropriate diagnostic tests.
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Affiliation(s)
- Merav Heshin-Bekenstein
- Pediatric Department, Shaare Zedek Medical Center, P.O. Box 3235, 9103102, Jerusalem, Israel
| | - Philip J Hashkes
- Pediatric Rheumatology Unit, Shaare Zedek Medical Center, P.O. Box 3235, 9103102, Jerusalem, Israel.
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28
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Batu ED, Ozen S. Coexistence of systemic lupus erythematosus and familial Mediterranean fever. Lupus 2015; 24:1006. [DOI: 10.1177/0961203315580874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E D Batu
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - S Ozen
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Lotfy HM, Kandil ME, Issac MSM, Salah S, Ismail NA, Abdel Mawla MA. MEFV mutations in Egyptian children with systemic-onset juvenile idiopathic arthritis. Mol Diagn Ther 2015; 18:549-57. [PMID: 24862656 DOI: 10.1007/s40291-014-0105-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Systemic-onset juvenile idiopathic arthritis (SoJIA) is a chronic auto-inflammatory disease of childhood, with a complex genetic trait, which is characterized by arthritis associated with systemic manifestations. Familial Mediterranean fever (FMF) is another auto-inflammatory disorder that is monogenic. There are speculations as to whether Mediterranean fever (MEFV) mutations are among the genetic determinants of SoJIA. Our aim was to explore the frequency and clinical significance of MEFV mutations in Egyptian SoJIA patients. A group of healthy children were assigned to the control group in an attempt to estimate the carrier rate of MEFV mutations in Egypt. METHODS Eighty-four children were recruited in this study; 54 children, age (mean ± standard deviation; 8.31 ± 2.85 years), diagnosed as having SoJIA with no typical symptoms of FMF; 30 healthy age- and gender-matched children served as the control group. All recruited children were screened for 12 common MEFV mutations using a reverse hybridization assay of biotinylated PCR products. RESULTS SoJIA patients had a significantly higher frequency of MEFV mutations (66.7 %) than in the healthy control population (16.7 %). V726A was the leading mutation in SoJIA patients, with an allelic frequency of 15.74 %, followed by E148Q, with an allelic frequency of 7.4 %. Children who were carriers of MEFV mutations had an 18 times higher risk of developing SoJIA than wild-type carriers [odds ratio 18.0 (95 % CI 5-69), P < 0.01]. E148Q was the leading mutation, present in 13.3 % of healthy controls. CONCLUSION These findings suggest that MEFV mutations may be responsible for auto-inflammatory diseases other than FMF, and patients with SoJIA, especially those with a positive family history of FMF or SoJIA, should be screened for MEFV mutations in countries where FMF is frequent.
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Affiliation(s)
- Hala M Lotfy
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
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Migita K, Hisanaga S, Izumi Y, Kawahara C, Shigemitsu Y, Iwanaga N, Araki T, Kamata M, Izumi M, Kumagai K, Kawakami A. Protracted arthritis in a Japanese patient with familial Mediterranean fever. Mod Rheumatol 2015; 27:905-909. [PMID: 25800639 DOI: 10.3109/14397595.2015.1031722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kiyoshi Migita
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Sachi Hisanaga
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Yasumori Izumi
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Chieko Kawahara
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Yoshika Shigemitsu
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Nozomi Iwanaga
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Toshitaka Araki
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Masatsugu Kamata
- Departments of General Internal Medicine and Rheumatology, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Masahiro Izumi
- Department of Orthopedic surgery, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Kenji Kumagai
- Department of Orthopedic surgery, Nagasaki medical Center, Omura City, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Rheumatology, Nagasaki University Hospital, Sakamoto, Nagasaki, Japan
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Nonaka F, Migita K, Jiuchi Y, Shimizu T, Umeda M, Iwamoto N, Fujikawa K, Izumi Y, Mizokami A, Nakashima M, Ueki Y, Yasunami M, Kawakami A, Eguchi K. Increased prevalence of MEFV exon 10 variants in Japanese patients with adult-onset Still's disease. Clin Exp Immunol 2015; 179:392-7. [PMID: 25286988 DOI: 10.1111/cei.12463] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2014] [Indexed: 12/01/2022] Open
Abstract
Autoinflammatory diseases include a large spectrum of monogenic diseases, e.g. familial Mediterranean fever (FMF), as well as complex genetic trait diseases, e.g. adult-onset Still's disease (AOSD). In populations where FMF is common, an increased MEFV mutation rate is found in patients with rheumatic diseases. The aim of this study was to examine MEFV mutations in Japanese patients with AOSD. Genomic DNA was isolated from 49 AOSD patients and 105 healthy controls, and exons 1, 2, 3 and 10 of the MEFV gene genotyped by direct sequencing. MEFV mutation frequencies in AOSD patients were compared with controls. We found no significant difference in overall allele frequencies of MEFV variants between AOSD patients and controls. However, MEFV exon 10 variants (M694I and G632S) were significantly higher in AOSD patients than controls (6.1 versus 0%). In addition, there was no significant difference between MEFV variant carriers and non-carriers with clinical manifestations, but the monocyclic clinical course of the AOSD disease phenotype was observed less frequently in patients without MEFV variants. AOSD patients had significantly higher frequencies of MEFV exon 10 mutations, suggesting that low-frequency variants of MEFV gene may be one of the susceptibility factors of AOSD.
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Affiliation(s)
- F Nonaka
- Department of Internal Medicine, Sasebo City General Hospital, Sasebo, Japan
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The myths we believed in familial Mediterranean fever: what have we learned in the past years? Semin Immunopathol 2015; 37:363-9. [PMID: 25832989 DOI: 10.1007/s00281-015-0484-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/23/2015] [Indexed: 12/18/2022]
Abstract
Familial Mediterranean fever is the most common monogenic periodic fever syndrome over the world especially in the eastern Mediterranean. It presents with recurrent and self-limited inflammatory attacks of fever and polyserositis along with high acute-phase reactants. The disease is associated with mutations in the MEFV gene that encodes pyrin, a component of inflammasome, which leads to exaggerated inflammatory response through uncontrolled production of interleukin 1. With the identification of the gene associated with the disease, we believed that everything was solved and that this was an ordinary monogenic disease with autosomal recessive inheritance. However, through the breathtaking progress in the basic research field as well as the clinical care of these patients, we have understood that the picture for this monogenic disorder was more complicated than we had anticipated. In this review, we have discussed the myths we believed in familial Mediterranean fever and how they have evolved during the past years.
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IŞIKAY S, IŞIKAY N, KOCAMAZ H. THE PREVALENCE OF CELIAC DISEASE AMONG PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER. ARQUIVOS DE GASTROENTEROLOGIA 2015; 52:55-8. [DOI: 10.1590/s0004-28032015000100012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 10/01/2014] [Indexed: 01/01/2023]
Abstract
Background Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Methods Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA). Results Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81). Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. Conclusions We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.
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Deniz R, Ozen G, Yilmaz-Oner S, Alibaz-Oner F, Erzik C, Aydin SZ, Inanc N, Eren F, Bayalan F, Direskeneli H, Atagunduz P. Familial Mediterranean fever gene (MEFV) mutations and disease severity in systemic lupus erythematosus (SLE): implications for the role of the E148Q MEFV allele in inflammation. Lupus 2014; 24:705-11. [PMID: 25413357 DOI: 10.1177/0961203314560203] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 10/28/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Observed low prevalence of SLE among familial Mediterranean fever (FMF) patients in several large cohorts suggests a possible protective effect of the MEFV mutations from SLE. In contrast, SLE patient carriers for the common MEFV mutations had rather complex disease expression with an increased frequency of febrile episodes and pleurisy and a decreased renal complication rate. Our aim was to investigate the prevalence of MEFV gene mutations in patients with SLE and their effect on organ involvement in a well-defined group of biopsy-proven SLE nephritis patients. MATERIAL AND METHOD The prevalence of four MEFV gene mutations (M694V, M680I, V726A and E148Q) was investigated in 114 SLE patients and effect on disease severity was analyzed in patients with biopsy-proven SLE nephritis. RESULTS None of the SLE patients fulfilled the revised Tel-Hashomer criteria. Fourteen of 114 SLE patients (12.2%) were found to carry at least one MEFV mutation. A single patient in the SLE-Nephritis group was compound heterozygous for M694V/M680I mutations and only one patient in the SLE-Mild group was homozygous for E148Q mutation. Carrier frequency was similar to controls in SLE patients (12.2 vs 18.8%, p = 0.34). After the exclusion of the less penetrant E148Q mutation, re-analysis revealed an association between exon 10 mutations and SLE nephritis (p = 0.050, odds ratio (OR) = 4.16, 95% confidence interval (CI) = 1.04-16.6). Carrier rate for the E148Q mutation decreased in the SLE group (controls vs. SLE = 20/186 vs. 3/114, p = 0.08) and E148Q mutation was absent in SLE nephritis (controls vs. SLE nephritis = 20/186 vs. 0/47, p = 0.016, OR = 11.69, 95% CI = 0.69-197.13). CONCLUSIONS Carrier rate for the studied MEFV mutations was slightly lower in the SLE group, which is in agreement with previous observations that FMF may confer some protection from SLE. Exon 10 mutations were associated with SLE nephritis after the exclusion of the E148Q mutation. The significance of the E148Q as a disease-causing mutation is controversial, and whether E148Q substitution is a polymorphism generally affecting inflammatory pathways is not addressed in the current literature. In this regard, absence of the E148Q mutation in SLE nephritis may serve as a clue for further investigation into its role as a general modulatory polymorphism for inflammation. This clarification is necessary to conclude whether other more penetrant MEFV gene mutations confer susceptibility to nephritis in SLE.
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Affiliation(s)
- R Deniz
- Marmara University Faculty of Medicine, Istanbul, Turkey
| | - G Ozen
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - S Yilmaz-Oner
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - F Alibaz-Oner
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - C Erzik
- Marmara University Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - S Z Aydin
- Goztepe Training and Research Hospital, Department of Rheumatology, Istanbul, Turkey
| | - N Inanc
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - F Eren
- Marmara University Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey
| | - F Bayalan
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - H Direskeneli
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
| | - P Atagunduz
- Marmara University Faculty of Medicine, Department of Rheumatology, Istanbul, Turkey
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Affiliation(s)
- Peter A. Nigrovic
- Boston Children's Hospital; Brigham and Women's Hospital and Harvard Medical School Boston MA
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Migita K, Abiru S, Sasaki O, Miyashita T, Izumi Y, Nishino A, Jiuchi Y, Kawakami A, Yasunami M. Coexistence of familial Mediterranean fever and rheumatoid arthritis. Mod Rheumatol 2014; 24:212-6. [PMID: 24261781 DOI: 10.3109/14397595.2013.852843] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disorder characterized by recurrent febrile polyserositis and arthritis. Although accompanying seronegative spondyloarthropathy has been reported in FMF, coexistence with rheumatoid arthritis (RA) is very rare. This case report describes a Japanese female RA patient who presented with periodic fever. Genetic analysis revealed compound heterozygous mutations in exon 2 and 3 of the MEFV gene (E148Q/G304R/P369S/R408Q). The patient was successfully treated with colchicine with 3-year follow-up.
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Affiliation(s)
- Kiyoshi Migita
- Department of Rheumatology, Clinical Research Center, NHO National Nagasaki Medical Center , Kubara 2-1001-1, Omura 856-8652 , Japan
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Basar N, Kisacik B, Ercan S, Pehlivan Y, Yilmaz S, Simsek I, Erdem H, Ozer O, Pay S, Onat AM, Dinc A. Familial Mediterranean fever gene mutations as a risk factor for early coronary artery disease. Int J Rheum Dis 2014; 20:2113-2117. [PMID: 24702757 DOI: 10.1111/1756-185x.12356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cardiovascular diseases (CVD) are very common in the general population. Atherosclerosis is the main pathogenesis. Familial Mediterranean fever (FMF) is an autosomal recessive disease. The gene causing FMF, designated MEFV, encodes a protein called pyrin or marenostrin that is expressed mainly in myeloid bone marrow precursors, neutrophils and monocytes. We herein aimed to determine the prevalence of MEFV mutations (all exon 2, 10 mutations) in patients with early coronary heart disease (early CHD) and coronary heart disease (CHD) with multiple risk factors and among the healthy subjects as controls. METHODS A total of 197 patients and 119 healthy subjects were recruited and enrolled into three groups in terms of inclusion criteria. Ninety-one patients diagnosed with early CHD enrolled into group one (men < 45 years of age, women < 40 years of age), 106 patients with CHD (men > 50 years of age) to group two and 119 healthy controls enrolled into group three. None of patients was diagnosed with FMF. The diagnosis of CHD was established on electrocardiographic changes, echocardiography and coronary angiography. RESULTS Thirty-eight patients (41.8%) with early CHD, 17 patients (16%) with CHD and 24 healthy controls (20.2%) carried at least one mutated MEFV allele. Young patients with CHD have different risk factor profiles, clinical presentations and prognoses than older patients. Young patients with CHD usually have multiple risk factors. CONCLUSION This study suggests that MEFV mutations in early CHD patients had significantly increased in contrast to CHD patients and healthy controls.
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Affiliation(s)
- Nurcan Basar
- Department of Cardiology, Yuksek Ihtisas Hastanesi, Ankara, Turkey
| | - Bunyamin Kisacik
- Faculty of Medicine, Department of Internal Medicine Division of Rheumatology, Gaziantep University, Gaziantep, Turkey
| | - Suleyman Ercan
- Faculty of Medicine, Department of Cardiology, Gaziantep University, Gaziantep, Turkey
| | - Yavuz Pehlivan
- Faculty of Medicine, Department of Internal Medicine Division of Rheumatology, Gaziantep University, Gaziantep, Turkey
| | - Sedat Yilmaz
- Department of Internal Medicine, Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Ismail Simsek
- Department of Internal Medicine, Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Hakan Erdem
- Department of Internal Medicine, Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Orhan Ozer
- Faculty of Medicine, Department of Cardiology, Gaziantep University, Gaziantep, Turkey
| | - Salih Pay
- Department of Internal Medicine, Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Ahmet M Onat
- Faculty of Medicine, Department of Internal Medicine Division of Rheumatology, Gaziantep University, Gaziantep, Turkey
| | - Ayhan Dinc
- Department of Internal Medicine, Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
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Matsuoka N, Iwanaga J, Ichinose Y, Fujiyama K, Tsuboi M, Kawakami A, Migita K. Two elderly cases of familial mediterranean fever with rheumatoid arthritis. Int J Rheum Dis 2014; 21:1873-1877. [PMID: 24661635 DOI: 10.1111/1756-185x.12354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder that usually develops before 20 years of age and is characterized by periodic fever with serositis and arthritis. Both FMF and rheumatoid arthritis (RA) involve arthritis; however, their coexistence is rare. We describe two RA patients with an MEFV mutation in exon 2, who were diagnosed with FMF at an age of over 50 years. We also discuss the possibility that MEFV mutations could modulate RA disease activity.
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Affiliation(s)
- Naoki Matsuoka
- Nagasaki Medical Hospital of Rheumatology, Nagasaki, Japan
| | - Junko Iwanaga
- Nagasaki Medical Hospital of Rheumatology, Nagasaki, Japan
| | | | - Kaoru Fujiyama
- Nagasaki Medical Hospital of Rheumatology, Nagasaki, Japan
| | | | - Atsushi Kawakami
- Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kiyoshi Migita
- Department of Rheumatology, Clinical Research Center, NHO National Nagasaki Medical Center, Omura, Japan
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Arslan Taş D, Erken E, Yildiz F, Dinkçi S, Sakalli H. Mevalonate kinase gene mutations and their clinical correlations in Behçet's disease. Int J Rheum Dis 2014; 17:435-43. [PMID: 24411001 DOI: 10.1111/1756-185x.12243] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Genetics is suggested to play a role in the development of Behçet's disease (BD). Shared phenotipic features requires an approach to differential diagnosis from periodic febrile syndromes. We planned to study for mevalonate kinase (MVK) as a candidate for a susceptibility gene for Behçet's disease. METHOD Consecutive Behçet patients and apperently healthy subjects were included. Severity score of Behçet disease was calculated. Genotyping of mevalonate kinase gene was performed by polymerase chain reaction/sequence-based typing technique. RESULTS Fifty BD patients (median age: 38.30 ± 11.06 years) and 51 controls (median age: 33.88 ± 12.47 years) were recruited. Three types of mutations have been found: first, a single nucleotide polymorphism (SNP) c.769-38C>T (rs35191208) in 21 of 50 BD patients and in 15 of 51 controls. Both groups were comparable for the frequency of c.769-38C>T (P > 0.05). In all of the cases with c.769-38C>T, a second SNP, c885+24G>A (rs2270374) was also present (previously reported to be in linkage disequilibrium with the first SNP). A third SNP, c.769-7T>G (rs104895331) was found in three of 50 BD patients and in one of the control group. We found this SNP together with c769-38C>T and c.885+24G>A. The neurological involvement was found to be more frequent in the BD patients with c.769-3C>T when compared to the BD patients without this polymorphism (P = 0.012). CONCLUSION Our results suggested that the effects of MVK mutations in Behçet's disease could be an additional genetic susceptibility factor for the patients with neurological involvement. However, these results need confirmation in larger study populations and in different ethnic groups.
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Affiliation(s)
- Didem Arslan Taş
- Rheumatology-Immunology Department, Faculty of Medicine, Cukurova University, Adana, Turkey
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Şahin A, Yetişgin A, Şahin M. Rheumatoid Arthritis and Familial Mediterranean Fever or Sacroiliitis Accompanied by FMF. Case Rep Rheumatol 2013; 2013:636713. [PMID: 24455383 PMCID: PMC3881508 DOI: 10.1155/2013/636713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 12/08/2013] [Indexed: 11/18/2022] Open
Abstract
The coexistence of rheumatoid arthritis (RA) and familial Mediterranean fever (FMF) has been rarely seen in case reports in the literature. Herein, we wanted to present a patient who had been followed up and treated as RA, but on investigation we concluded that he really had FMF and its joint complaints associated with sacroiliitis. Recovery was achieved by etanercept administered as if he was an RA patient.
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Affiliation(s)
- Ali Şahin
- Division of Rheumatology, Sanliurfa Education and Research Hospital, 63100 Sanliurfa, Turkey
| | - Alparslan Yetişgin
- Division of Physical Therapy and Medicine, Sanliurfa Education and Research Hospital, 63100 Sanliurfa, Turkey
| | - Mehtap Şahin
- Physical Therapy and Medicine Unit, Sanliurfa Education and Research Hospital, 63100 Sanliurfa, Turkey
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Kukuy O, Livneh A, Ben-David A, Kopolovic J, Volkov A, Shinar Y, Holtzman E, Dinour D, Ben-Zvi I. Familial Mediterranean fever (FMF) with proteinuria: clinical features, histology, predictors, and prognosis in a cohort of 25 patients. J Rheumatol 2013; 40:2083-7. [PMID: 24128782 DOI: 10.3899/jrheum.130520] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Reactive (AA) amyloidosis may complicate familial Mediterranean fever (FMF), the prototype of autoinflammatory diseases. Thus, proteinuria in FMF is commonly viewed as resulting from amyloidosis, and kidney biopsy is deemed superfluous. However, nephropathy other than amyloidosis has been described in FMF, but its rate and distinctive characteristics are unknown. Our aim was to determine the rate and underlying pathology of FMF-related nonamyloidotic proteinuria and compare its clinical course, demographic, and genetic features to those of FMF-amyloid nephropathy. METHODS This study is a retrospective analysis of data from patients with FMF undergoing kidney biopsy for proteinuria above 0.5 g/24 h, over 10 years (2001-2011). Clinical, laboratory, genetic, and pathology data were abstracted from patient files. Biopsies were viewed by an experienced pathologist, as necessary. RESULTS Of the 25 patients referred for kidney biopsy, only 15 (60%) were diagnosed with amyloid kidney disease (AKD), and 10 were diagnosed with another nephropathy. The AKD and nonamyloid kidney disease (NAKD) groups were comparable on most variables, but showed distinct characteristics with regard to the degree of proteinuria (6.45 ± 4.3 g vs 2.14 ± 1.6 g, p = 0.006), rate of severe FMF (14 vs 5 patients, p = 0.022), and rate of development of end stage renal disease (73.3% vs 20%, p = 0.015), respectively. CONCLUSION NAKD is common in FMF and, compared to amyloidosis, it is featured with milder course and better prognosis. Contrary to common practice, it is highly recommended to obtain a kidney biopsy from patients with FMF and proteinuria more than 0.5 g/24 h.
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Affiliation(s)
- Olga Kukuy
- From the Institute of Nephrology and Hypertension, Sheba Medical Center, Tel Hashomer; Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer; Department of Pathology, Sheba Medical Center, Tel Hashomer; Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2012, Chaim Sheba Medical Center, Tel Hashomer, Israel
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Yilmaz S, Erdem H, Tunay S, Torun D, Genc H, Tunca Y, Karadag O, Simsek I, Bahce M, Pay S, Dinc A. The presence of MEFV gene mutations in patients with primary osteoarthritis who require surgery. Korean J Intern Med 2013; 28:594-8. [PMID: 24009456 PMCID: PMC3759766 DOI: 10.3904/kjim.2013.28.5.594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 11/29/2012] [Accepted: 03/15/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Chronic arthritis of familial Mediterranean fever (FMF) involves weight-bearing joints and can occur in patients without a history of acute attack. Our aim was to investigate a possible causal relationship between FMF and osteoarthritis in a population in which FMF is quite common. METHODS Patients with late stage primary osteoarthritis were enrolled, and five MEFV gene mutations were investigated. The frequency of MEFV gene mutations was compared among patients with osteoarthritis and a previous healthy group from our center. RESULTS One hundred patients with primary osteoarthritis and 100 healthy controls were studied. The frequency of MEFV gene mutations was significantly lower in the osteoarthritis group (9% vs. 19%). M694V was the most frequent mutation (5%) in the osteoarthritis group, whereas in the control group, E148Q was the most common (16%). In subgroup analyses, the mutation frequency of patients with hip osteoarthritis was not different from that of patients with knee osteoarthritis and controls (7.1%, 9.7%, and 19%, respectively). There were no differences among the three groups with respect to MEFV gene mutations other than E148Q (8.1% vs. 3.6%). E148Q was significantly lower in the osteoarthritis group than in the controls (16% vs. 1%), although the mutations did not differ between patients with knee osteoarthritis and controls. CONCLUSIONS In a population with a high prevalence of MEFV gene mutations, we did not find an increased mutation rate in patients with primary osteoarthritis. Furthermore, we found that some mutations were significantly less frequent in patients with osteoarthritis. Although the number of patients studied was insufficient to claim that E148Q gene mutation protects against osteoarthritis, the potential of this gene merits further investigation.
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Affiliation(s)
- Sedat Yilmaz
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Hakan Erdem
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Servet Tunay
- Department of Orthopedic Surgery, Gulhane School of Medicine, Ankara, Turkey
| | - Deniz Torun
- Department of Medical Genetics, Gulhane School of Medicine, Ankara, Turkey
| | - Halil Genc
- Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
| | - Yusuf Tunca
- Department of Medical Genetics, Gulhane School of Medicine, Ankara, Turkey
| | - Omer Karadag
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Ismail Simsek
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Muhterem Bahce
- Department of Medical Genetics, Gulhane School of Medicine, Ankara, Turkey
| | - Salih Pay
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
| | - Ayhan Dinc
- Division of Rheumatology, Gulhane School of Medicine, Ankara, Turkey
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MEFV gene mutations in Turkish children with juvenile idiopathic arthritis. Eur J Pediatr 2013; 172:1061-7. [PMID: 23588594 DOI: 10.1007/s00431-013-2003-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/27/2013] [Accepted: 03/28/2013] [Indexed: 10/27/2022]
Abstract
UNLABELLED Mutations of the Mediterranean fever (MEFV) gene, which encodes pyrin protein, leads to familial Mediterranean fever (FMF) and a connection between MEFV mutations and rheumatic diseases has been suggested. The aim of this study was to explore the frequency and clinical significance of MEFV mutations in children with juvenile idiopathic arthritis (JIA). In this study, children with JIA, who had no typical symptoms of FMF, were screened for the mutations in exons 2 and 10 of the MEFV gene by direct sequencing. A total of 96 children, 56 girls (58.3%), with a median age of 11 years (2-18 years) were included. Patients were classified according to JIA subgroups as oligoarthritis in 43 (44.8%), rheumatoid factor-negative polyarthritis in 22 (22.9%), rheumatoid factor-positive polyarthritis in 2 (2.1%), systemic arthritis in 12 (12.5%) patients, enthesitis-related arthritis in 16 (16.7%), and psoriatic arthritis 1 (1.04%). A total of 31 children (32.3%) had MEFV mutations: 25 heterozygous, 2 homozygous, and 4 compound heterozygous. There were 22 (11.4%) exon 10 mutations (M694V, R761H, K695R, V726A, R653H) and 15 (7.8%) exon 2 mutations (E148Q, G304R, E148V, T267I). The allele frequencies of MEFV mutations were found to be 19.27%, which is higher than the general population [p = 0.03, (odds ratio (OR):1.93, 95% confidence interval (CI): 1.09-3.41)]. MEFV mutation carrier rates were significantly higher in antinuclear antibody (ANA) negative than in ANA positive patients [p = 0.01, (OR: 0.25, 95% CI: 0.085-0.74)] and in males than in females [p = 0.001, (OR: 0.197, 95% CI: 0.078-0.495)]. Also, there was a statistically significant difference between the MEFV mutation carrier rates and the subgroups of JIA (p = 0.005). CONCLUSION These findings suggest that mutations of the MEFV gene may be responsible for rheumatic diseases other than FMF, and patients with JIA especially males, ANA negatives, and ERA subgroups should be screened for MEFV gene mutations in countries where FMF is frequent.
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Kalkan G, Yigit S, Karakus N, Baş Y, Pancar GŞ, Balta I. Association between MEFV gene mutations and recurrent aphthous stomatitis in a cohort of Turkish patients. J Dermatol 2013; 40:516-21. [PMID: 23663176 DOI: 10.1111/1346-8138.12159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 03/04/2013] [Indexed: 11/28/2022]
Abstract
Recurrent aphthous stomatitis (RAS) has a multifactorial etiopathogenesis, an interaction between predisposing factors and/or systemic conditions and immunological components in genetically predisposed subjects. The Mediterranean fever (MEFV) gene has already been identified as being responsible for familial Mediterranean fever. Because the association between MEFV gene mutations and Behçet's disease has been reported before in several studies, we considered that the role of MEFV gene mutations should be studied in patients with RAS, because of the clinical similarities of both diseases. The aim of this study was to explore the frequency and clinical significance of MEFV gene mutations in a cohort of Turkish patients with RAS. The study population comprised 100 unrelated patients with a clinical diagnosis of RAS and 156 healthy controls. Genomic DNA was isolated and genotyped using polymerase chain reaction and restriction fragment length polymorphism for the four MEFV gene mutations (M694V, M680I, V726A and E148Q). There were statistically significant differences of the MEFV gene mutation carrier rates and allele frequencies between RAS patients and healthy controls (P = 0.042, odds ratio [OR] = 1.9, 95% confidence interval [CI] = 1.01-3.41; and P = 0.039, OR = 1.8, 95% CI = 1.02-3.14, respectively). Even if it is not statistically significant, the E148Q allele frequency was higher in patients with RAS than the control group. A statistically significant increased prevalence of MEFV variants in RAS patients was found. This is the first study to report that missense mutations of MEFV is associated with RAS in the Turkish population.
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Affiliation(s)
- Göknur Kalkan
- Department of Dermatovenerology, Gaziosmanpasa University, Tokat, Turkey.
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Yigit S, Karakus N, Kurt SG, Ates O. Association of Missense Mutations of Mediterranean Fever (MEFV) Gene with Multiple Sclerosis in Turkish Population. J Mol Neurosci 2013; 50:275-9. [DOI: 10.1007/s12031-012-9947-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
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Cosan F, Emrence Z, Erbag G, Azakli H, Yilmazer B, Yazici A, Ekmekci SS, Abaci N, Ustek D, Cefle A. The association of TNFRSF1A gene and MEFV gene mutations with adult onset Still's disease. Rheumatol Int 2012; 33:1675-80. [PMID: 23269568 DOI: 10.1007/s00296-012-2609-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 12/08/2012] [Indexed: 11/30/2022]
Abstract
Adult onset Still's disease (ASD) is a systemic inflammatory disorder of unknown etiology. ASD is characterized by fever with unknown etiology, rash, arthritis, and involvement of several organ systems. FMF and TRAPS are two important autoinflammatory diseases which characterized with recurrent inflammatory attacks. We aimed in this study to investigate the MEFV gene and TNFRSF1A gene variations in ASD. Twenty consecutive Turkish ASD patients (14 female and 6 male; mean age 38.45 ± 14; mean disease duration 3.3 ± 2.3; mean age of the disease onset 35.1 ± 14.4) and 103 healthy controls of Turkish origin were analyzed. All ASD patients were genotyped for the 4 MEFV mutations (M694V, E148Q, V726A, M680I) and TNFRSF1A gene exon 2-3 and exon 4-5 by using sequence analysis. The healthy controls are genotyped using PCR-RFLP method for intron 4 variation. The results of MEFV gene mutations screening show an increase in the MEFV mutation rate in ASD group, but it was not significantly different (p = 0.442, OR 1.64, 95 % CI 0.409-6.589). T-C polymorphism (rs1800692) was the only variation in the intron 4 of TNFRSF1A gene that we observed at the ASD patients. The frequency of TT genotype was 15 %, TC: 45 %, and CC: 40 % in ASD patients and the frequencies were 22, 41, and 37 % in healthy controls, respectively. When we analyzed the allele difference between both groups, there was no difference (p = 0.54, OR 1.24, 0.619-2.496-2.654). The variations in MEFV may have role in ASD pathogenesis. Our findings suggest that there is no significant association between ASD and TNFRSF1A variations.
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Affiliation(s)
- Fulya Cosan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, 42000 Kocaeli, Turkey.
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Karakus N, Yigit S, Inanir A, Inanir S, Toprak H, Okan S. Association between sequence variations of the Mediterranean fever gene and fibromyalgia syndrome in a cohort of Turkish patients. Clin Chim Acta 2012; 414:36-40. [DOI: 10.1016/j.cca.2012.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 07/20/2012] [Accepted: 07/27/2012] [Indexed: 10/28/2022]
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