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Blood, 1 April 2004, Vol. 103, No. 7, pp. 2809-2815.
Prepublished online as a Blood First Edition Paper on November 20, 2003; DOI 10.1182/blood-2003-07-2531.

Submitted July 29, 2003
Accepted November 13, 2003
Molecular basis of the spectral expression of CIAS1 mutations associated with phagocytic cell-mediated auto-inflammatory disorders (CINCA/NOMID, MWS, FCU)
Benedicte Neven, Isabelle Callebaut, Anne-Marie Prieur, Jerome Feldmann, Christine Bodemer, Loredana Lepore, Beata Derfalvi, Suata Benjaponpitak, Richard Vesely, Marie Jose Sauvain, Stefan Oertle, Roger Allen, Gareth Morgan, Arndt Borkhardt, Clare Hill, Janet Gardner-Medwin, Alain Fischer, and Genevieve de Saint Basile*
Unite de Recherche sur le Developpement Normal et Pathologique du Systeme Immunitaire, INSERM, Unite 429, Paris, France
Departement de Biologie Structurale, LMCP, CNRS UMR7590, Universites Paris 6 & Paris 7, Paris, France
Unite d'Immuno-Hematologie et Rhumatologie Pediatriques, Hopital Necker-Enfantes Malades, Paris, France
Service de Dermatologie, Hopital Necker-Enfantes Malades, Paris, France
Department of Pediatrics, IRCCS Burlo Garofolo Children's Hospital, Trieste, Italy
Department of Pediatrics, Semmelweis University of Medicine, Budapest, Hungary
Pediatric Allergy Ramathibodi Hospice, Bangkok, Thailand
Pediatric Rheumatology Unit, Faculty Hospital, Kosice, Slovakia (Slovak Republic)
Department of Pediatrics, University of Bern (Inselspital), Bern, Switzerland
Department of Rheumatology and Clinical Immunology/Allergology, University of Bern (Inselspital), Bern, Switzerland
Rheumatology and General Practice, Royal Children's Hospital, Melbourne, Australia
Developmental Medicine (Paediatrics/Immunology), University of Wales, Sweansea, United Kingdom
Department of Pediatric Hematology and Oncology, University of Giessen, Giessen, Germany
Institute of Medical Genetics, University Hospital of Wales, Cardiff, United Kingdom
Depatment of Child Health, Glasgow University, Glasgow, United Kingdom
* Corresponding author; email: sbasile{at}necker.fr.
NALPs proteins are recently identified members of the CATERPILLER family of proteins thought to function in apoptotic and inflammatory signalling pathways. Mutations in the CIAS1 gene which encodes a member of the NALP family, the cryopyrin/NALP3/PYPAF1 protein, expressed primarily in phagocytic cells, were recently found to be associated with a spectrum of autoinflammatory disorders: chronic infantile neurological cutaneous and articular (CINCA) syndrome (also known as Neonatal-onset multisystem inflammatory disease (NOMID)), Muckle-Wells syndrome (MWS) and familial cold urticaria (FCU). We describe herein seven new mutations in 13 unrelated patients with CINCA syndrome and identify mutational hotspots in CIAS1 on the basis of all mutations described to date. We also provide evidences of genotype/phenotype correlation. A three-dimensional model of the nucleotide-binding domain (NBD) of cryopyrin suggested that this molecule is structurally and functionally similar to members of the AAA+ protein family of ATPases. According to this model, most of the mutations known to affect residues of the NBD are clustered on one side of this domain in a region predicted to participate in intermolecular contacts. This suggests that this model is likely to be biologically relevant and that defects in nucleotide binding, nucleotide hydrolysis or protein oligomerization may lead to the functional dysregulation of cryopyrin in the MWS, FCU and CINCA/NOMID disorders.

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