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2017 ; 130
(5
): 586-593
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A Novel Mutation in the Pyrin Domain of the NOD-like Receptor Family Pyrin Domain
Containing Protein 3 in Muckle-Wells Syndrome
#MMPMID28229991
Hu J
; Zhu Y
; Zhang JZ
; Zhang RG
; Li HM
Chin Med J (Engl)
2017[Mar]; 130
(5
): 586-593
PMID28229991
show ga
BACKGROUND: Cryopyrin-associated periodic syndrome (CAPS) is a group of rare,
heterogeneous autoinflammatory disease characterized by interleukin
(IL)-1?-mediated systemic inflammation and clinical symptoms involving skin,
joints, central nervous system, and eyes. It encompasses a spectrum of three
clinically overlapping autoinflammatory syndromes including familial cold
autoinflammatory syndrome, Muckle-Wells syndrome (MWS), and neonatal-onset
multisystem inflammatory disease. CAPS is associated with gain-of-function
missense mutations in NOD-like receptor family pyrin domain-containing protein 3
(NLRP3), the gene encoding NLRP3. Moreover, most mutations leading to MWS
occurred in exon 3 of NLRP3 gene. Here, we reported a novel mutation occurred in
exon 1 of NLRP3 gene in an MWS patient and attempted to explore the pathogenic
mechanism. METHODS: Genetic sequence analysis of NLRP3 was performed in an MWS
patient who presented with periodic fever, arthralgia, and multiform skin
lesions. NLRP3 was also analyzed in this patient's parents and 50 healthy
individuals. Clinical examinations including X-ray examination, skin biopsy, bone
marrow aspiration smear, and blood test of C-reactive protein (CRP), erythrocyte
sedimentation rate (ESR), serum levels of IL-1?, immunoglobulin E (IgE),
antineutrophil cytoplasmic antibodies, antinuclear antibodies, and extractable
nuclear antigen were also analyzed. The protein structure of mutant NLRP3
inflammasome was calculated by SWISS-MODEL software. Proteins of wild type and
mutant components of NLRP3 inflammasome were expressed and purified, and the
interaction abilities between these proteins were tested by surface plasmon
resonance (SPR) assay. RESULTS: X-ray examination showed no abnormality in the
patient's knees. Laboratory tests indicated an elevation of CRP (233.24 mg/L) and
ESR (67 mm/h) when the patient had fever. Serum IL-1? increased to 24.37 pg/ml,
and serum IgE was higher than 2500.00 IU/ml. Other blood tests were normal. Bone
marrow aspiration smear was normal. A novel point mutation c.92A>T in exon 1 of
NLRP3 gene was identified, which caused a p.D31V mutation in pyrin domain (PYD)
of NLRP3. SPR assay showed that this point mutation may strengthen the
interaction between the PYD of NLRP3 and the PYD of the apoptosis-associated
speck-like protein. The mutation c.92A>T in exon 1 of the NLRP3 gene was not
found in the patient's parents and 50 healthy individuals. CONCLUSIONS: The
mutation c.92A>T in exon 1 of the NLRP3 gene is a novel mutation associated with
MWS. The p.D31V mutation might promote the activation of NLRP3 inflammasome and
induce MWS in this patient.