Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
Department of Medical Biology, The University of Melbourne, Parkville, Australia.
Clin Sci (Lond). 2018 Sep 5;132(17):1901-1924. doi: 10.1042/CS20171498. Print 2018 Sep 14.
Monogenic autoinflammatory disorders are an increasingly heterogeneous group of conditions characterised by innate immune dysregulation. Improved genetic sequencing in recent years has led not only to the discovery of a plethora of conditions considered to be 'autoinflammatory', but also the broadening of the clinical and immunological phenotypic spectra seen in these disorders. This review outlines the classification strategies that have been employed for monogenic autoinflammatory disorders to date, including the primary innate immune pathway or the dominant cytokine implicated in disease pathogenesis, and highlights some of the advantages of these models. Furthermore, the use of the term 'autoinflammatory' is discussed in relation to disorders that cross the innate and adaptive immune divide. The utilisation of next-generation sequencing (NGS) in this population is examined, as are potential and methods of modelling to determine pathogenicity of novel genetic findings. Finally, areas where our understanding can be improved are highlighted, such as phenotypic variability and genotype-phenotype correlations, with the aim of identifying areas of future research.
单基因自身炎症性疾病是一组日益多样化的疾病,其特征为固有免疫失调。近年来,遗传测序技术的改进不仅导致了大量被认为是“自身炎症性”疾病的发现,还拓宽了这些疾病的临床和免疫学表型谱。这篇综述概述了迄今为止用于单基因自身炎症性疾病的分类策略,包括主要的先天免疫途径或疾病发病机制中涉及的优势细胞因子,并强调了这些模型的一些优势。此外,还讨论了与先天免疫和适应性免疫分界相关的疾病中“自身炎症性”一词的使用。本文还探讨了下一代测序(NGS)在该人群中的应用,以及确定新型遗传发现致病性的潜在和可能的建模方法。最后,突出了一些我们可以进一步研究的领域,例如表型变异性和基因型-表型相关性,旨在确定未来的研究领域。