NLRP3-associated autoinflammatory diseases: phenotypic and molecular characteristics of germline versus somatic mutations

dc.contributor.authorLouvrier, Camille
dc.contributor.authorAssrawi, Eman
dc.contributor.authorEl Khouri, Elma
dc.contributor.authorMelki, Isabelle
dc.contributor.authorCopin, Bruno
dc.contributor.authorBourrat, Emmanuelle
dc.contributor.authorLachaume, Noemie
dc.contributor.authorCador-Rousseau, Berengere
dc.contributor.authorDuquesnoy, Philippe
dc.contributor.authorPiterboth, William
dc.contributor.authorAwad, Fawaz
dc.contributor.authorJumeau, Claire
dc.contributor.authorLegendre, Marie
dc.contributor.authorGrateau, Gilles
dc.contributor.authorGeorgin-Lavialle, Sophie
dc.contributor.authorKarabina, Sonia A.
dc.contributor.authorAmselem, Serge
dc.contributor.authorGiurgea, Irina
dc.description.abstractBackground: 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. (J Allergy Clin Immunol 2020;145:1254-61.)en_US
dc.subjectNLRP3-associated autoinflammatory diseasesen_US
dc.subjectsomatic mosaic mutationsen_US
dc.subjectNLRP3-inflammasome activationen_US
dc.subjectmutational hot spoten_US
dc.titleNLRP3-associated autoinflammatory diseases: phenotypic and molecular characteristics of germline versus somatic mutationsen_US
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