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Human RELA haploinsufficiency results in autosomal-dominant chronic mucocutaneous ulceration.


ABSTRACT: The treatment of chronic mucocutaneous ulceration is challenging, and only some patients respond selectively to inhibitors of tumor necrosis factor-? (TNF). TNF activates opposing pathways leading to caspase-8-mediated apoptosis as well as nuclear factor ?B (NF-?B)-dependent cell survival. We investigated the etiology of autosomal-dominant, mucocutaneous ulceration in a family whose proband was dependent on anti-TNF therapy for sustained remission. A heterozygous mutation in RELA, encoding the NF-?B subunit RelA, segregated with the disease phenotype and resulted in RelA haploinsufficiency. The patients' fibroblasts exhibited increased apoptosis in response to TNF, impaired NF-?B activation, and defective expression of NF-?B-dependent antiapoptotic genes. Rela+/- mice have similarly impaired NF-?B activation, develop cutaneous ulceration from TNF exposure, and exhibit severe dextran sodium sulfate-induced colitis, ameliorated by TNF inhibition. These findings demonstrate an essential contribution of biallelic RELA expression in protecting stromal cells from TNF-mediated cell death, thus delineating the mechanisms driving the effectiveness of TNF inhibition in this disease.

SUBMITTER: Badran YR 

PROVIDER: S-EPMC5502421 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Human <i>RELA</i> haploinsufficiency results in autosomal-dominant chronic mucocutaneous ulceration.

Badran Yousef R YR   Dedeoglu Fatma F   Leyva Castillo Juan Manuel JM   Bainter Wayne W   Ohsumi Toshiro K TK   Bousvaros Athos A   Goldsmith Jeffrey D JD   Geha Raif S RS   Chou Janet J  

The Journal of experimental medicine 20170609 7


The treatment of chronic mucocutaneous ulceration is challenging, and only some patients respond selectively to inhibitors of tumor necrosis factor-α (TNF). TNF activates opposing pathways leading to caspase-8-mediated apoptosis as well as nuclear factor κB (NF-κB)-dependent cell survival. We investigated the etiology of autosomal-dominant, mucocutaneous ulceration in a family whose proband was dependent on anti-TNF therapy for sustained remission. A heterozygous mutation in <i>RELA</i>, encodin  ...[more]

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