The spectrum of autoinflammatory diseases: recent bench to bedside observations.
OBJECTIVE
The autoinflammatory diseases are a group of conditions that include the hereditary fever syndromes, and result from upregulated innate immune responses. The discovery of the genetic basis for these conditions led to the description of novel intracellular receptors for infectious and noninfectious danger signals. This article focuses on recent progress in our understanding of autoinflammatory syndromes, and how insights into these conditions have triggered the exploration of the role of innate immunity in common rheumatologic diseases.


RESULTS
New models for the pathogenesis of several autoinflammatory syndromes have been proposed, including the role of pyrin and cryopyrin in regulating inflammation. Robust evidence has emerged that IL-1beta oversecretion is pivotal in cryopyrin-associated periodic syndromes, and that IL-1 inhibition ameliorates the clinical features of these syndromes. Monosodium urate crystals stimulate IL-1beta secretion via cryopyrin, which led to the addition of gout to the spectrum of autoinflammatory diseases.


CONCLUSIONS
Advances in our understanding of the autoinflammatory diseases have led to renewed interest in the innate immune system, and its role in the pathogenesis of more common rheumatic diseases.
Ryan
John G
JG
Genetics and Genomics Branch, Office of the Clinical Director, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
Goldbach-Mansky
Raphaela
R
D001327:Autoimmune Diseases / Q000235:genetics* / Q000276:immunology; D002352:Carrier Proteins / Q000235:genetics; D003598:Cytoskeletal Proteins / Q000235:genetics; D005334:Fever / Q000235:genetics / Q000276:immunology; D030342:Genetic Diseases, Inborn / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000235:genetics; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; D000071198:Pyrin
D002352:Carrier Proteins; D003598:Cytoskeletal Proteins; C000604192:MEFV protein, human; D000071199:NLR Family, Pyrin Domain-Containing 3 Protein; C453881:NLRP3 protein, human; D000071198:Pyrin