NLRP3-associated autoinflammatory diseases: Phenotypic and molecular characteristics of germline versus somatic mutations - 06/04/20
, Irina Giurgea, MD, PhD a, b, ⁎ Abstract |
Background |
NLRP3-associated autoinflammatory diseases (NLRP3-AIDs) include conditions of various severities, due to germline or somatic mosaic NLRP3 mutations.
Objective |
To identify mosaic- versus germline-specific NLRP3 mutations’ characteristics, we reinterpreted all the mutations reported in NLRP3-AIDs and performed an in-depth study of 3 novel patients.
Methods |
The pathogenicity of all reported mosaic/germline mutations was reassessed according to international recommendations and their location on the NLRP3 3-dimensional structure. Deep-targeted sequencing and NLRP3-inflammasome-activation assays were used to identify the disease-causing mutation in 3 patients.
Results |
We identified, in 3 patients, mosaic mutations affecting the same NLRP3 amino acid (Glu569). This residue belongs to 1 of the 2 mosaic mutational hot spots that face each other in the core of the NLRP3 ATPase domain. The review of the 90 NLRP3 mutations identified in 277 patients revealed that those hot spots account for 68.5% of patients (37 of 54) with mosaic mutations. Glu569 is affected in 22% of the patients (12 of 54) with mosaic mutations and in 0.4% of patients (1 of 223) with germline mutations. Only 8 of 90 mutations were found in mosaic and germinal states. All of the germline mutations were associated with a severe phenotype. These data suggest that mutations found only in mosaic state could be incompatible with life if present in germinal state. None of the 5 most frequent germline mutations was identified in mosaic state. Mutations found only in germinal state could, therefore, be asymptomatic in mosaic state.
Conclusions |
The phenotypic spectrum of NLRP3-AIDs appears to be related to the germinal/mosaic status and localization of the underlying mutations.
Le texte complet de cet article est disponible en PDF.Key words : NLRP3-associated autoinflammatory diseases, NLRP3, somatic mosaic mutations, NLRP3-inflammasome activation, mutational hot spot
Abbreviations used : AID, ASC, CAPS, CINCA, CpG, EV, FCAS, GFP, HD1 (2), LRR, MAP, MWS, NACHT domain, NBD, NGS, NLRP3-AID, OMIM, WT
Plan
| This study was funded by the Agence Nationale de la Recherche, France (ANR-17-CE17-0021-01), and a European Union Grant Agreement (H2020, 779295). C. Louvrier was supported by Institut National de la Santé et de la Recherche Medicalé (INSERM), France (Poste d’Accueil, 00552404). |
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| Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. |
Vol 145 - N° 4
P. 1254-1261 - avril 2020 Retour au numéro
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