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Inflammasomes and Childhood Autoimmune Diseases: A Review of Current Knowledge

Authors
  • Yang, Chin-An1, 2
  • Chiang, Bor-Luen3, 3
  • 1 China Medical University Hsinchu Hospital,
  • 2 China Medical University,
  • 3 National Taiwan University,
Type
Published Article
Journal
Clinical Reviews in Allergy & Immunology
Publisher
Springer-Verlag
Publication Date
Nov 25, 2020
Pages
1–15
Identifiers
DOI: 10.1007/s12016-020-08825-2
PMID: 33236284
PMCID: PMC7685913
Source
PubMed Central
Keywords
License
Unknown

Abstract

Inflammasomes are multiprotein complexes capable of sensing pathogen-associated molecular patterns (PAMPs), danger-associated molecular patterns (DAMPs), and cellular perturbations. Upon stimulation, the inflammasomes activate the production of the pro-inflammatory cytokines IL-1β and IL-18 and induce gasdermin D-mediated pyroptosis. Dysregulated inflammasome signaling could lead to hyperinflammation in response to environmental triggers, thus contributing to the pathogenesis of childhood autoimmune/autoinflammatory diseases. In this review, we group childhood rheumatic diseases into the autoinflammation to autoimmunity spectrum and discuss about the involvement of inflammasomes in disease mechanisms. Genetic mutations in inflammasome components cause monogenic autoinflammatory diseases, while inflammasome-related genetic variants have been implicated in polygenic childhood rheumatic diseases. We highlight the reported associations of inflammasome signaling-related genetic polymorphisms/protein levels with pediatric autoimmune disease susceptibility and disease course. Furthermore, we discuss about the use of IL-1 receptor antagonist as an adjunctive therapy in several childhood autoimmune diseases, including macrophage activation syndrome (MAS) and multisystem inflammatory syndrome in children (MIS-C) related to COVID-19. A comprehensive multi-cohort comparison on inflammasome gene expression profile in different pediatric rheumatic diseases is needed to identify patient subsets that might benefit from the adjunctive therapy of IL-1β inhibitors.

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