title: Concerted action of wild-type and mutant TNF receptors enhances inflammation in TNF receptor 1-associated periodic fever syndrome.
abstract: TNF, acting through p55 tumor necrosis factor receptor 1 (TNFR1), contributes to the pathogenesis of many inflammatory diseases. TNFR-associated periodic syndrome (TRAPS, OMIM 142680) is an autosomal dominant autoinflammatory disorder characterized by prolonged attacks of fevers, peritonitis, and soft tissue inflammation. TRAPS is caused by missense mutations in the extracellular domain of TNFR1 that affect receptor folding and trafficking. These mutations lead to loss of normal function rather than gain of function, and thus the pathogenesis of TRAPS is an enigma. Here we show that mutant TNFR1 accumulates intracellularly in peripheral blood mononuclear cells of TRAPS patients and in multiple cell types from two independent lines of knockin mice harboring TRAPS-associated TNFR1 mutations. Mutant TNFR1 did not function as a surface receptor for TNF but rather enhanced activation of MAPKs and secretion of proinflammatory cytokines upon stimulation with LPS. Enhanced inflammation depended on autocrine TNF secretion and WT TNFR1 in mouse and human myeloid cells but not in fibroblasts. Heterozygous TNFR1-mutant mice were hypersensitive to LPS-induced septic shock, whereas homozygous TNFR1-mutant mice resembled TNFR1-deficient mice and were resistant to septic shock. Thus WT and mutant TNFR1 act in concert from distinct cellular locations to potentiate inflammation in TRAPS. These findings establish a mechanism of pathogenesis in autosomal dominant diseases where full expression of the disease phenotype depends on functional cooperation between WT and mutant proteins and also may explain partial responses of TRAPS patients to TNF blockade.
authors.affiliation: Inflammatory Biology Section, Laboratory of Clinical Investigation and Immunoregulation Section, Autoimmunity Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Simon
authors.forename: Heiyoung
authors.initials: H
authors.lastname: Park
authors.forename: Ravikanth
authors.initials: R
authors.lastname: Maddipati
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Lobito
authors.forename: Ariel C
authors.initials: AC
authors.lastname: Bulua
authors.forename: Adrianna J
authors.initials: AJ
authors.lastname: Jackson
authors.forename: Jae Jin
authors.initials: JJ
authors.lastname: Chae
authors.forename: Rachel
authors.initials: R
authors.lastname: Ettinger
authors.forename: Heleen D
authors.initials: HD
authors.lastname: de Koning
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Cruz
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Kastner
authors.forename: Hirsh
authors.initials: H
authors.lastname: Komarow
authors.forename: Richard M
authors.initials: RM
authors.lastname: Siegel
mesh_terms: D000818:Animals; D056660:Hereditary Autoinflammatory Diseases / Q000235:genetics / Q000276:immunology* / Q000378:metabolism*; D006801:Humans; D008070:Lipopolysaccharides / Q000276:immunology; D048670:MAP Kinase Kinase 4 / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D008822:Mice, Transgenic; D009154:Mutation; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000172:deficiency / Q000235:genetics / Q000378:metabolism*; D048051:p38 Mitogen-Activated Protein Kinases / Q000378:metabolism
chemical_list: D008070:Lipopolysaccharides; D047888:Receptors, Tumor Necrosis Factor, Type I; C506236:Tnfrsf1a protein, mouse; D048051:p38 Mitogen-Activated Protein Kinases; D048670:MAP Kinase Kinase 4
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