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Birk-Bachar M, Cohen H, Sofrin-Drucker E, Kropach-Gilad N, Orenstein N, Lidzbarsky G, Kornreich L, Tal R, Amarilyo G, Levinsky Y, Sokolov M, Raveh E, Gerlic M, Harel L. Discovery of a Novel Missense Variant in NLRP3 Causing Atypical Cryopyrin-Associated Periodic Syndromes With Hearing Loss as the Primary Presentation, Responsive to Anti-Interleukin-1 Therapy. Arthritis Rheumatol 2024; 76:444-454. [PMID: 37738164 DOI: 10.1002/art.42721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/15/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Cryopyrin-associated periodic syndromes (CAPS), also known as NLRP3-associated autoinflammatory diseases, are a spectrum of rare autoinflammatory diseases caused by gain-of-function variants in the NLRP3 gene, resulting in inflammasome hyperactivation and dysregulated release of interleukin-1β (IL-1β). Many patients with CAPS develop progressive sensorineural hearing loss (SNHL) because of cochlear autoinflammation, which may be the sole manifestation in rare cases. This study was undertaken to establish the suspected diagnosis of CAPS in a family presenting with autosomal-dominant progressive/acute SNHL and a novel missense variant in the NLRP3 gene of unknown significance (NM_001079821.3:c.1784G>A p.Ser595Asn). METHODS We conducted an ex vivo functional assessment of the NLRP3 inflammasome in heterozygous individuals (n = 10) and healthy family members (n = 5). RESULTS The assay revealed hyperactivation of the inflammasome among heterozygous individuals, supporting the hypothesis that this missense variant is a pathogenic gain-of-function variant. Administration of IL-1 receptor antagonist resulted in a substantial clinical improvement among pediatric patients, who exhibited near resolution of hearing impairment within 1 to 3 months of treatment. CONCLUSION Our findings highlight the crucial role of early diagnosis and treatment with an anti-IL-1 agent in reversing cochlear damage. Furthermore, our results suggest that high- and ultrahigh-frequency ranges need to be included in the auditory assessment to enable early detection of subclinical SNHL. Finally, incorporating functional inflammasome assessment as part of the clinical evaluation could establish the diagnosis in inconclusive cases.
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Affiliation(s)
| | | | - Efrat Sofrin-Drucker
- Schneider Children's Medical Center of Israel and Recanati Genetic Institute, Rabin Medical Center-Beilinson Hospital, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Nesia Kropach-Gilad
- Schneider Children's Medical Center of Israel and Recanati Genetic Institute, Rabin Medical Center-Beilinson Hospital, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Naama Orenstein
- Schneider Children's Medical Center of Israel and Recanati Genetic Institute, Rabin Medical Center-Beilinson Hospital, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Gabriel Lidzbarsky
- Recanati Genetic Institute, Rabin Medical Center-Beilinson Hospital, Petach-Tikva, Israel
| | - Liora Kornreich
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Rotem Tal
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Gil Amarilyo
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Yoel Levinsky
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Meirav Sokolov
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | - Eyal Raveh
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
| | | | - Liora Harel
- Schneider Children's Medical Center of Israel, Petach-Tikva, and Tel-Aviv University, Tel-Aviv, Israel
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Jatavallabhula K, Onyia O, Chung DD, Williams D, Wang K, Aldave AJ. Keratitis Fugax Hereditaria Associated With a Novel NLRP3 Mutation in a Non-Finnish Patient. Cornea 2024; 43:253-256. [PMID: 37823852 DOI: 10.1097/ico.0000000000003399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/21/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE The aim of this study was to report a novel heterozygous variant c.1712G>T (p.Gly571Val) in the nucleotide-binding domain, leucine-rich repeat family, pyrin domain-containing 3 gene ( NLRP3 ) in a previously unreported non-Finnish individual with keratitis fugax hereditaria (KFH). METHODS Ophthalmologic examination of the proband was performed with slit-lamp biomicroscopy and anterior segment optical coherence tomography. Saliva was collected as a source of DNA, after which targeted exome sequencing of candidate genes was performed using a commercially available panel. Identified presumed pathogenic variants were confirmed by Sanger sequencing. RESULTS Slit-lamp examination of the 52-year-old female proband revealed peripheral arcus-like degeneration and bilateral central corneal opacification, observed on anterior segment optical coherence tomography to involve the anterior half of the corneal stroma. Examination of the proband's parents revealed clear corneas in each eye. Genetic testing of the proband identified the presence of a novel heterozygous NLRP3 missense mutation (c.1712G>T, p.Gly571Val), which was confirmed by Sanger sequencing. This mutation was absent in the proband's parents. CONCLUSIONS Although KFH has been reported only in individuals of Finnish descent and only in association with a missense mutation in exon 1 of NLRP3 , we report an individual of non-Finnish descent with KFH associated with a novel heterozygous variant in exon 2 of NLRP3 . Thus, ophthalmologists should be aware of the ethnic and genetic heterogeneity associated with KFH.
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Affiliation(s)
- Kavya Jatavallabhula
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
| | - Onyinye Onyia
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
| | - Doug D Chung
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
| | - Dominic Williams
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
| | - Kaidi Wang
- Virginia Mason Medical Center, Seattle, WA
| | - Anthony J Aldave
- Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA; and
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Yuan Z, Yu D, Gou T, Tang G, Guo C, Shi J. Research progress of NLRP3 inflammasome and its inhibitors with aging diseases. Eur J Pharmacol 2023; 957:175931. [PMID: 37495038 DOI: 10.1016/j.ejphar.2023.175931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
In recent years, a new target closely linked to a variety of diseases has appeared in the researchers' vision, which is the NLRP3 inflammasome. With the deepening of the study of NLRP3 inflammasome, it was found that it plays an extremely important role in a variety of physiological pathological processes, and NLRP3 inflammasome was also found to be associated with some age-related diseases. It is associated with the development of insulin resistance, Alzheimer's disease, Parkinson's, cardiovascular aging, hearing and vision loss. At present, the only clinical approach to the treatment of NLRP3 inflammasome-related diseases is to use anti-IL-1β antibodies, but NLRP3-specific inhibitors may be better than the IL-1β antibodies. This article reviews the relationship between NLRP3 inflammasome and aging diseases: summarizes some of the relevant experimental results reported in recent years, and introduces the biological signals or pathways closely related to the NLRP3 inflammasome in a variety of aging diseases, and also introduces some promising small molecule inhibitors of NLRP3 inflammasome for clinical treatment, such as: ZYIL1, DFV890 and OLT1177, they have excellent pharmacological effects and good pharmacokinetics.
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Affiliation(s)
- Zhuo Yuan
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Dongke Yu
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
| | - Tingting Gou
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Guoyuan Tang
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Chun Guo
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
| | - Jianyou Shi
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
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