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Geoepidemiology and Immunologic Features of Autoinflammatory Diseases: a Comprehensive Review

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Abstract

The knowledge on systemic autoinflammatory disorders (SAID) is expanding rapidly and new signalling pathways are being decrypted. The concept of autoinflammation has been proposed since 1999, to define a group of diseases with abnormal innate immunity activation. Since then, more than 30 monogenic SAID have been described. In this review, we first describe inflammasomopathies and SAID related to the interleukin-1 pathway. Recent insights into the pathogenesis of familial Mediterranean fever and the function of Pyrin are detailed. In addition, complex or polygenic SAID, such as Still’s disease or PFAPA syndrome, are also discussed. Then, major players driving autoinflammation, such as type-1 interferonopathies (including the recently described haploinsuffiency in A20 and otulipenia), TNF-associated periodic syndromes, defects in ubiquitination, and SAID with overlapping features of autoimmunity or immunodeficiency. Discoveries of the pathogenic role of mosaicism, intronic defects coupled to the likelihood to identify digenic or polygenic diseases are providing new challenges for physicians and geneticists. This comprehensive review depicts the various SAID, presenting them according to their predominant pathophysiological mechanism, with a particular emphasis on recent findings. Epidemiologic data are also presented. Finally, we propose a practical diagnostic approach to the most common monogenic SAID, based on the most characteristic clinical presentation of these disorders.

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Acknowledgments

This work was supported by the Société Nationale Française de Médecine Interne (SNFMI), the Foundation for the Development of Internal Medicine in Europe, and a « poste d’accueil INSERM » (to Y.J.).

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Authors and Affiliations

  1. CIRI - Centre International de Recherche en Infectiologie, Inserm U1111, Université Lyon 1, CNRS UMR5308, ENS Lyon, Lyon, France

    Yvan Jamilloux, Alexandre Belot, Flora Magnotti, Sarah Benezech, Emilie Bourdonnay, Thierry Walzer & Thomas Henry

  2. Department of Internal Medicine, Hopital de la Croix Rousse, Hospices Civils de Lyon, Université Lyon 1, Lyon, France

    Yvan Jamilloux, Mathieu Gerfaud-Valentin & Pascal Sève

  3. Service de Médecine Interne, Hopital de la Croix-Rousse, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France

    Yvan Jamilloux

  4. Department of paediatric rheumatology and nephrology, Hopital Femme-Mère-Enfant, Hospices Civils de Lyon, Université Lyon 1, Lyon, France

    Alexandre Belot & Sarah Benezech

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  1. Yvan Jamilloux
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Jamilloux, Y., Belot, A., Magnotti, F. et al. Geoepidemiology and Immunologic Features of Autoinflammatory Diseases: a Comprehensive Review. Clinic Rev Allerg Immunol 54, 454–479 (2018). https://doi.org/10.1007/s12016-017-8613-8

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