Hecker Julia, Plattner Christina, Cancino Camila A, Löscher Britt-Sabina, Saurenbach Judith, Letizia Marilena, Rieder Dietmar, Freise Inka, Koop Kristina, Neufert Clemens, Kunkel Désirée, Al Khatim Zainab, Schaafs Lars-Arne, Schütz Anja, Becker Christoph, Atreya Raja, Trajanoski Zlatko, Franke Andre, Sonnenberg Elena, Hegazy Ahmed N, Siegmund Britta, Weidinger Carl
Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
Biocenter, Institute of Bioinformatics, Medical University of Innsbruck, Innsbruck, Austria.
EMBO Mol Med. 2025 May 30. doi: 10.1038/s44321-025-00245-z.
The IL-36 signaling pathway has recently been identified as a key regulator of intestinal homeostasis and inflammation. However, the role of mutations in the IL-36R signaling pathway in the pathogenesis of inflammatory bowel disease remains unclear. We here identified four Crohn's disease patients with heterozygous missense mutations in the IL-36 receptor antagonist (IL36RN, IL-36RA). Experimental overexpression and functional assays demonstrated that two identified mutations resulted in reduced expression of IL-36RA. In-depth immune profiling of one IL36RN-mutated patient revealed an increased response of PBMCs to IL-36 stimulation and elevated serum levels of IL-36-regulated cytokines. Administration of the IL-36R-blocking antibody spesolimab to this patient resulted in a reduction of intestinal inflammation and alterations in immune cell composition and function. Our findings indicate that pathogenic IL36RN mutations may contribute to the pathogenesis of Crohn's disease in a subset of patients and that inhibiting IL-36 signaling could offer a personalized therapeutic approach for these patients.
白细胞介素-36(IL-36)信号通路最近被确定为肠道稳态和炎症的关键调节因子。然而,IL-36R信号通路突变在炎症性肠病发病机制中的作用仍不清楚。我们在此鉴定出4例克罗恩病患者,其白细胞介素-36受体拮抗剂(IL36RN,IL-36RA)存在杂合错义突变。实验性过表达和功能分析表明,所鉴定的两个突变导致IL-36RA表达降低。对一名IL36RN突变患者进行的深入免疫分析显示,外周血单核细胞(PBMC)对IL-36刺激的反应增强,且血清中IL-36调节的细胞因子水平升高。给该患者使用IL-36R阻断抗体司帕索利单抗后,肠道炎症减轻,免疫细胞组成和功能发生改变。我们的研究结果表明,致病性IL36RN突变可能在一部分患者中导致克罗恩病的发病机制,并且抑制IL-36信号通路可为这些患者提供个性化的治疗方法。
EMBO Mol Med. 2025-5-30
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