Microbiology, Parasitology and Pathology Program, Universidade Federal do Parana (UFPR), Curitiba, Brazil.
Program of Internal Medicine, Universidade Federal do Parana (UFPR), Curitiba, Brazil.
Immunol Invest. 2023 Apr;52(3):364-397. doi: 10.1080/08820139.2023.2168554. Epub 2023 Feb 6.
Gout is a disease caused by uric acid (UA) accumulation in the joints, causing inflammation. Two UA forms - monosodium urate (MSU) and soluble uric acid (sUA) have been shown to interact physically with inflammasomes, especially with the nod-like receptor (NLR) family pyrin domain containing 3 (NLRP3), albeit the role of the immune response to UA is poorly understood, given that asymptomatic hyperuricemia does also exist. Macrophage phagocytosis of UA activate NLRP3, lead to cytokines release, and ultimately, lead to chemoattract neutrophils and lymphocytes to the gout flare joint spot. Genetic variants of inflammasome genes and of genes encoding their molecular partners may influence hyperuricemia and gout susceptibility, while also influencing other comorbidities such as metabolic syndrome and cardiovascular diseases. In this review, we summarize the inflammatory responses in acute and chronic gout, specifically focusing on innate immune cell mechanisms and genetic and epigenetic characteristics of participating molecules. Unprecedently, a novel UA binding protein - the neuronal apoptosis inhibitor protein (NAIP) - is suggested as responsible for the asymptomatic hyperuricemia paradox. β2-integrins: leukocyte-specific adhesion molecules; ABCG2: ATP-binding cassete family/breast cancer-resistant protein; ACR: American college of rheumatology; AIM2: absent in melanoma 2, type of pattern recognition receptor; ALPK1: alpha-protein kinase 1; ANGPTL2: angiopoietin-like protein 2; ASC: apoptosis-associated speck-like protein; BIR: baculovirus inhibitor of apoptosis protein repeat; BIRC1: baculovirus IAP repeat-containing protein 1; BIRC2: baculoviral IAP repeat-containing protein 2; C5a: complement anaphylatoxin; cAMP: cyclic adenosine monophosphate; CARD: caspase activation and recruitment domains; CARD8: caspase recruitment domain-containing protein 8; CASP1: caspase 1; CCL3: chemokine (C-C motif) ligand 3; CD14: cluster of differentiation 14; CD44: cluster of differentiation 44; Cg05102552: DNA-methylation site, usually cytosine followed by guanine nucleotides; contains arbitrary identification code; CIDEC: cell death-inducing DNA fragmentation factor-like effector family; CKD: chronic kidney disease; CNV: copy number variation; CPT1A: carnitine palmitoyl transferase - type 1a; CXCL1: chemokine (CXC motif) ligand 1; DAMPs: damage associated molecular patterns; DC: dendritic cells; DNMT(1): maintenance DNA methyltransferase; eQTL: expression quantitative trait loci; ERK1: extracellular signal-regulated kinase 1; ERK2: extracellular signal-regulated kinase 2; EULAR: European league against rheumatism; GMCSF: granulocyte-macrophage colony-stimulating factor; GWAS: global wide association studies; H3K27me3: tri-methylation at the 27th lysine residue of the histone h3 protein; H3K4me1: mono-methylation at the 4th lysine residue of the histone h3 protein; H3K4me3: tri-methylation at the 4th lysine residue of the histone h3 protein; HOTAIR: human gene located between hoxc11 and hoxc12 on chromosome 12; IκBα: cytoplasmatic protein/Nf-κb transcription inhibitor; IAP: inhibitory apoptosis protein; IFNγ: interferon gamma; IL-1β: interleukin 1 beta; IL-12: interleukin 12; IL-17: interleukin 17; IL18: interleukin 18; IL1R1: interleukin-1 receptor; IL-1Ra: interleukin-1 receptor antagonist; IL-22: interleukin 22; IL-23: interleukin 23; IL23R: interleukin 23 receptor; IL-33: interleukin 33; IL-6: interleukin 6; IMP: inosine monophosphate; INSIG1: insulin-induced gene 1; JNK1: c-jun n-terminal kinase 1; lncRNA: long non-coding ribonucleic acid; LRR: leucine-rich repeats; miR: mature non-coding microRNAs measuring from 20 to 24 nucleotides, animal origin; miR-1: miR followed by arbitrary identification code; miR-145: miR followed by arbitrary identification code; miR-146a: miR followed by arbitrary identification code, "a" stands for mir family; "a" family presents similar mir sequence to "b" family, but different precursors; miR-20b: miR followed by arbitrary identification code; "b" stands for mir family; "b" family presents similar mir sequence to "a" family, but different precursors; miR-221: miR - followed by arbitrary identification code; miR-221-5p: miR followed by arbitrary identification code; "5p" indicates different mature miRNAs generated from the 5' arm of the pre-miRNA hairpin; miR-223: miR followed by arbitrary identification code; miR-223-3p: mir followed by arbitrary identification code; "3p" indicates different mature miRNAs generated from the 3' arm of the pre-miRNA hairpin; miR-22-3p: miR followed by arbitrary identification code, "3p" indicates different mature miRNAs generated from the 3' arm of the pre-miRNA hairpin; MLKL: mixed lineage kinase domain-like pseudo kinase; MM2P: inductor of m2-macrophage polarization; MSU: monosodium urate; mTOR: mammalian target of rapamycin; MyD88: myeloid differentiation primary response 88; n-3-PUFAs: n-3-polyunsaturated fatty-acids; NACHT: acronym for NAIP (neuronal apoptosis inhibitor protein), C2TA (MHC class 2 transcription activator), HET-E (incompatibility locus protein from podospora anserina) and TP1 (telomerase-associated protein); NAIP: neuronal apoptosis inhibitory protein (human); Naip1: neuronal apoptosis inhibitory protein type 1 (murine); Naip5: neuronal apoptosis inhibitory protein type 5 (murine); Naip6: neuronal apoptosis inhibitory protein type 6 (murine); NBD: nucleotide-binding domain; Nek7: smallest NIMA-related kinase; NET: neutrophil extracellular traps; Nf-κB: nuclear factor kappa-light-chain-enhancer of activated b cells; NFIL3: nuclear-factor, interleukin 3 regulated protein; NIIMA: network of immunity in infection, malignancy, and autoimmunity; NLR: nod-like receptor; NLRA: nod-like receptor NLRA containing acidic domain; NLRB: nod-like receptor NLRA containing BIR domain; NLRC: nod-like receptor NLRA containing CARD domain; NLRC4: nod-like receptor family CARD domain containing 4; NLRP: nod-like receptor NLRA containing PYD domain; NLRP1: nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain containing 1; NLRP12: nucleotide-binding oligomerization domain, leucine-rich repeat, and pyrin domain containing 12; NLRP3: nod-like receptor family pyrin domain containing 3; NOD2: nucleotide-binding oligomerization domain; NRBP1: nuclear receptor-binding protein; Nrf2: nuclear factor erythroid 2-related factor 2; OR: odds ratio; P2X: group of membrane ion channels activated by the binding of extracellular; P2X7: p2x purinoceptor 7 gene; p38: member of the mitogen-activated protein kinase family; PAMPs: pathogen associated molecular patters; PBMC: peripheral blood mononuclear cells; PGGT1B: geranylgeranyl transferase type-1 subunit beta; PHGDH: phosphoglycerate dehydrogenase; PI3-K: phospho-inositol; PPARγ: peroxisome proliferator-activated receptor gamma; PPARGC1B: peroxisome proliferative activated receptor, gamma, coactivator 1 beta; PR3: proteinase 3 antigen; Pro-CASP1: inactive precursor of caspase 1; Pro-IL1β: inactive precursor of interleukin 1 beta; PRR: pattern recognition receptors; PYD: pyrin domain; RAPTOR: regulatory associated protein of mTOR complex 1; RAS: renin-angiotensin system; REDD1: regulated in DNA damage and development 1; ROS: reactive oxygen species; rs000*G: single nuclear polymorphism, "*G" is related to snp where replaced nucleotide is guanine, usually preceded by an id number; SLC2A9: solute carrier family 2, member 9; SLC7A11: solute carrier family 7, member 11; SMA: smooth muscular atrophy; Smac: second mitochondrial-derived activator of caspases; SNP: single nuclear polymorphism; Sp3: specificity protein 3; ST2: serum stimulation-2; STK11: serine/threonine kinase 11; sUA: soluble uric acid; Syk: spleen tyrosine kinase; TAK1: transforming growth factor beta activated kinase; Th1: type 1 helper T cells; Th17: type 17 helper T cells; Th2: type 2 helper T cells; Th22: type 22 helper T cells; TLR: tool-like receptor; TLR2: toll-like receptor 2; TLR4: toll-like receptor 4; TNFα: tumor necrosis factor alpha; TNFR1: tumor necrosis factor receptor 1; TNFR2: tumor necrosis factor receptor 2; UA: uric acid; UBAP1: ubiquitin associated protein; ULT: urate-lowering therapy; URAT1: urate transporter 1; VDAC1: voltage-dependent anion-selective channel 1.
痛风是一种尿酸(UA)在关节中积累引起的疾病,导致炎症。两种 UA 形式——单钠尿酸盐(MSU)和可溶性尿酸(sUA)已被证明与炎症小体物理相互作用,特别是与 NOD 样受体(NLR)家族吡喃结构域包含 3(NLRP3),尽管免疫反应对 UA 的作用知之甚少,因为无症状高尿酸血症也存在。巨噬细胞吞噬 UA 激活 NLRP3,导致细胞因子释放,并最终导致趋化性中性粒细胞和淋巴细胞向痛风发作关节部位。炎症小体基因和其分子伴侣的基因变体可能影响高尿酸血症和痛风易感性,同时也影响其他合并症,如代谢综合征和心血管疾病。在这篇综述中,我们总结了急性和慢性痛风中的炎症反应,特别是关注先天免疫细胞机制和参与分子的遗传和表观遗传特征。以前从未有过的是,一种新的 UA 结合蛋白——神经元凋亡抑制蛋白(NAIP)——被认为是无症状高尿酸血症悖论的原因。β2-整合素:白细胞特异性黏附分子;ABCG2:三磷酸腺苷结合盒家族/乳腺癌耐药蛋白;ACR:美国风湿病学会;AIM2:黑色素瘤缺乏 2,一种模式识别受体;ALPK1:丝氨酸/苏氨酸蛋白激酶 1;ANGPTL2:血管生成素样蛋白 2;ASC:凋亡相关斑点样蛋白;BIR:杆状病毒凋亡抑制剂蛋白重复序列;BIRC1:杆状病毒 IAP 重复蛋白 1;BIRC2:杆状病毒 IAP 重复蛋白 2;C5a:补体过敏毒素;cAMP:环腺苷酸单磷酸;CARD:半胱氨酸天冬氨酸蛋白酶募集结构域;CARD8:半胱氨酸天冬氨酸蛋白酶募集结构域蛋白 8;CASP1:半胱氨酸天冬氨酸蛋白酶 1;CCL3:趋化因子(C-C 基序)配体 3;CD14:分化群 14;CD44:分化群 44;Cg05102552:DNA-甲基化位点,通常是胞嘧啶后跟鸟嘌呤核苷酸;包含任意识别码;CIDEC:细胞死亡诱导 DNA 片段化因子样效应蛋白家族;CKD:慢性肾脏疾病;CNV:拷贝数变异;CPT1A:肉碱棕榈酰转移酶-1a;CXCL1:趋化因子(CXC 基序)配体 1;DAMPs:损伤相关分子模式;DC:树突细胞;DNMT(1):维持 DNA 甲基转移酶;eQTL:表达数量性状基因座;ERK1:细胞外信号调节激酶 1;ERK2:细胞外信号调节激酶 2;EULAR:欧洲抗风湿联盟;GMCSF:粒细胞-巨噬细胞集落刺激因子;GWAS:全基因组关联研究;H3K27me3:组蛋白 h3 蛋白第 27 赖氨酸残基的三甲基化;H3K4me1:组蛋白 h3 蛋白第 4 赖氨酸残基的单甲基化;H3K4me3:组蛋白 h3 蛋白第 4 赖氨酸残基的三甲基化;HOTAIR:位于染色体 12 上 hoxc11 和 hoxc12 之间的人类基因;IκBα:胞浆蛋白/NF-κB 转录抑制剂;IAP:抑制凋亡蛋白;IFNγ:干扰素 γ;IL-1β:白细胞介素 1β;IL-12:白细胞介素 12;IL-17:白细胞介素 17;IL18:白细胞介素 18;IL-1R1:白细胞介素 1 受体;IL-1Ra:白细胞介素 1 受体拮抗剂;IL-22:白细胞介素 22;IL-23:白细胞介素 23;IL23R:白细胞介素 23 受体;IL-33:白细胞介素 33;IL-6:白细胞介素 6;IMP:肌苷单磷酸;INSIG1:胰岛素诱导基因 1;JNK1:c-jun N-末端激酶 1;lncRNA:长度超过 20 至 24 个核苷酸的非编码 RNA,动物来源;miR:成熟的非编码 microRNAs,测量从 20 到 24 个核苷酸,动物来源;miR-1:miR 后跟任意识别码;miR-145:miR 后跟任意识别码;miR-146a:miR 后跟任意识别码,“a”代表 mir 家族;“a”家族与“b”家族具有相似的 mir 序列,但前体不同;miR-20b:miR 后跟任意识别码;“b”代表 mir 家族;“b”家族与“a”家族具有相似的 mir 序列,但前体不同;miR-221:miR-后跟任意识别码;miR-221-5p:miR 后跟任意识别码;“5p”表示前体 miRNA 发夹的 5'臂产生不同的成熟 miRNA;miR-223:miR 后跟任意识别码;miR-223-3p:mir 后跟任意识别码;“3p”表示前体 miRNA 发夹的 3'臂产生不同的成熟 miRNA;miR-22-3p:miR 后跟任意识别码,“3p”表示前体 miRNA 发夹的 3'臂产生不同的成熟 miRNA;MLKL:混合谱系激酶结构域样伪激酶;MM2P:诱导 m2-巨噬细胞极化的分子;MSU:单钠尿酸盐;mTOR:雷帕霉素哺乳动物靶标;MyD88:髓样分化初级反应 88;n-3-PUFAs:n-3-多不饱和脂肪酸;NACHT:NAIP(神经元凋亡抑制蛋白)、C2TA(MHC 类 2 转录激活物)、HET-E(Podospora anserina 中的不兼容基因蛋白)和 TP1(端粒酶相关蛋白)的缩写;NAIP:神经元凋亡抑制蛋白(人);Naip1:神经元凋亡抑制蛋白 1(鼠);Naip5:神经元凋亡抑制蛋白 5(鼠);Naip6:神经元凋亡抑制蛋白 6(鼠);NBD:核苷酸结合域;Nek7:最小 NIMA 相关激酶;NET:中性粒细胞胞外陷阱;NF-κB:核因子 kappa 轻链增强子的 B 细胞;NFIL3:NF-κB 调节蛋白白细胞介素 3 ;NIIMA:感染、恶性肿瘤和自身免疫网络;NLR:NOD 样受体;NLRA:NOD 样受体 NLRA 含有酸性结构域;NLRB:NOD 样受体 NLRA 含有 BIR 结构域;NLRC:NOD 样受体 NLRA 含有 CARD 结构域;NLRC4:NOD 样受体家族 CARD 结构域包含 4 个结构域;NLRP:NOD 样受体 NLRA 含有 PYD 结构域;NLRP1:核苷酸结合寡聚化结构域、富含亮氨酸重复和吡喃结构域包含 1;NLRP12:核苷酸结合寡聚化结构域、富含亮氨酸重复和吡喃结构域包含 12;NLRP3:NOD 样受体家族吡喃结构域包含 3;NOD2:核苷酸结合寡聚化结构域;NRBP1:核受体结合蛋白;Nrf2:核因子红细胞 2 相关因子 2;OR:比值比;P2X:一组与细胞外结合的膜离子通道;P2X7:嘌呤能受体 P2X7 基因;P2Y:嘌呤能受体 P2Y;P2X7:嘌呤能受体 P2X7 基因;PAMPs:病原体相关分子模式;PBMC:外周血单个核细胞;PGGT1B: geranylgeranyl 转移酶类型-1 亚基β;PHGDH:磷酸甘油酸脱氢酶;PI3-K:磷酸肌醇;PPARγ:过氧化物酶体增殖物激活受体γ;PPARGC1B:过氧化物酶体增殖物激活受体