autoinflammatory disorder ͉ ASC ͉ siRNA ͉ anakinra ͉ structure

Pityriasis rubra pilaris (PRP) is a papulosquamous disorder phenotypically related to psoriasis. The disease has been occasionally shown to be inherited in an autosomal-dominant fashion. To identify the genetic cause of familial PRP, we ascertained four unrelated families affected by autosomal-dominant PRP. We initially mapped PRP to 17q25.3, a region overlapping with psoriasis susceptibility locus 2 (PSORS2 [MIM 602723]). Using a combination of linkage analysis followed by targeted whole-exome sequencing and candidate-gene screening, we identified three different heterozygous mutations in CARD14, which encodes caspase recruitment domain family, member 14. CARD14 was found to be specifically expressed in the skin. CARD14 is a known activator of nuclear factor kappa B signaling, which has been implicated in inflammatory disorders. Accordingly, CARD14 levels were increased, and p65 was found to be activated in the skin of PRP-affected individuals. The present data demonstrate that autosomal-dominant PRP is allelic to familial psoriasis, which was recently shown to also be caused by mutations in CARD14.

Familial Mediterranean fever (FMF) is an autoinflammatory disease caused by mutations in MEFV, which encodes a 781-amino acid protein denoted pyrin. We have previously shown that pyrin regulates caspase-1 activation and IL-1beta production through interaction of its N-terminal PYD motif with the ASC adapter protein, and also modulates IL-1beta production by interaction of its C-terminal B30.2 domain with the catalytic domains of caspase-1. We now asked whether pyrin might itself be a caspase-1 substrate, and found that pyrin is cleaved by caspase-1 at Asp330, a site remote from the B30.2 domain. Pyrin variants harboring FMF-associated B30.2 mutations were cleaved more efficiently than wild-type pyrin. The N-terminal cleaved fragment interacted with the p65 subunit of NF-kappaB and with IkappaB-alpha through its 15-aa bZIP basic domain and adjacent sequences, respectively, and translocated to the nucleus. The interaction of the N-terminal fragment with p65 enhanced entrance of p65 into the nucleus. The interaction of N-terminal pyrin with IkappaB-alpha induced calpain-mediated degradation of IkappaB-alpha, thus potentiating NF-kappaB activation. Absolute and relative quantities of cleaved pyrin and IkappaB-alpha degradation products were substantially increased in leukocytes from FMF patients compared with healthy controls. Our data support a new pyrin/caspase-1 pathway for NF-kappaB activation.

Apoptosis constitutes the primary mechanism by which noncycling plasma cells are eliminated after the secretion of Ag-specific Abs in a humoral immune response. The underlying mechanism is not known. Here, we demonstrate that the expression of both TRAIL/Apo-2 ligand and the death receptors (DR) DR5 and DR4, but not Fas, are sustained in IL-6-differentiated Ig-secreting human plasma cells as well as primary mouse plasma cells generated in a T-dependent immune response. Plasma cell apoptosis is induced by both endogenous and exogenous TRAIL ex vivo, suggesting that TRAIL-mediated killing may, in part, be plasma cell autonomous. By contrast, resting and activated B cells are resistant to TRAIL killing despite comparable expression of TRAIL and DRs. The preferential killing of plasma cells by TRAIL correlates with decreased expression of CD40 and inactivation of NF-κB. These results provide the first evidence that primary plasma cells synthesize TRAIL and are direct targets of TRAIL-mediated apoptosis, which may relate to the inactivation of the NF-κB survival pathway.