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AP1S3 Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production

Identifieur interne : 000C03 ( Pmc/Checkpoint ); précédent : 000C02; suivant : 000C04

AP1S3 Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production

Auteurs : Satveer K. Mahil [Royaume-Uni] ; Sophie Twelves [Royaume-Uni] ; Katalin Farkas [Hongrie] ; Niovi Setta-Kaffetzi [Royaume-Uni] ; A. David Burden [Royaume-Uni] ; Joanna E. Gach [Royaume-Uni] ; Alan D. Irvine [Irlande (pays)] ; Lászl Képír [Hongrie] ; Maja Mockenhaupt [Allemagne] ; Hazel H. Oon [Singapour] ; Jason Pinner [Australie] ; Annamari Ranki [Finlande] ; Marieke M. B. Seyger [Pays-Bas] ; Pere Soler-Palacin [Espagne] ; Eoin R. Storan [Irlande (pays)] ; Eugene S. Tan [Singapour] ; Laurence Valeyrie-Allanore [France] ; Helen S. Young [Royaume-Uni] ; Richard C. Trembath [Royaume-Uni] ; Siew-Eng Choon [Malaisie] ; Marta Szell [Hongrie] ; Zsuzsanna Bata-Csorgo [Hongrie] ; Catherine H. Smith [Royaume-Uni] ; Paola Di Meglio [Royaume-Uni] ; Jonathan N. Barker [Royaume-Uni] ; Francesca Capon [Royaume-Uni]

Source :

RBID : PMC:5070969

Abstract

Prominent skin involvement is a defining characteristic of autoinflammatory disorders caused by abnormal IL-1 signaling. However, the pathways and cell types that drive cutaneous autoinflammatory features remain poorly understood. We sought to address this issue by investigating the pathogenesis of pustular psoriasis, a model of autoinflammatory disorders with predominant cutaneous manifestations. We specifically characterized the impact of mutations affecting AP1S3, a disease gene previously identified by our group and validated here in a newly ascertained patient resource. We first showed that AP1S3 expression is distinctively elevated in keratinocytes. Because AP1S3 encodes a protein implicated in autophagosome formation, we next investigated the effects of gene silencing on this pathway. We found that AP1S3 knockout disrupts keratinocyte autophagy, causing abnormal accumulation of p62, an adaptor protein mediating NF-κB activation. We showed that as a consequence, AP1S3-deficient cells up-regulate IL-1 signaling and overexpress IL-36α, a cytokine that is emerging as an important mediator of skin inflammation. These abnormal immune profiles were recapitulated by pharmacological inhibition of autophagy and verified in patient keratinocytes, where they were reversed by IL-36 blockade. These findings show that keratinocytes play a key role in skin autoinflammation and identify autophagy modulation of IL-36 signaling as a therapeutic target.


Url:
DOI: 10.1016/j.jid.2016.06.618
PubMed: 27388993
PubMed Central: 5070969


Affiliations:


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PMC:5070969

Le document en format XML

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Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production</title>
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<name sortKey="Irvine, Alan D" sort="Irvine, Alan D" uniqKey="Irvine A" first="Alan D." last="Irvine">Alan D. Irvine</name>
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<name sortKey="Mockenhaupt, Maja" sort="Mockenhaupt, Maja" uniqKey="Mockenhaupt M" first="Maja" last="Mockenhaupt">Maja Mockenhaupt</name>
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<name sortKey="Oon, Hazel H" sort="Oon, Hazel H" uniqKey="Oon H" first="Hazel H." last="Oon">Hazel H. Oon</name>
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<name sortKey="Ranki, Annamari" sort="Ranki, Annamari" uniqKey="Ranki A" first="Annamari" last="Ranki">Annamari Ranki</name>
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<name sortKey="Seyger, Marieke M B" sort="Seyger, Marieke M B" uniqKey="Seyger M" first="Marieke M. B." last="Seyger">Marieke M. B. Seyger</name>
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<nlm:aff id="aff13">Department of Dermatology, University Hospital, Galway, Ireland</nlm:aff>
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<name sortKey="Tan, Eugene S" sort="Tan, Eugene S" uniqKey="Tan E" first="Eugene S." last="Tan">Eugene S. Tan</name>
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<wicri:regionArea>National Skin Centre</wicri:regionArea>
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<name sortKey="Valeyrie Allanore, Laurence" sort="Valeyrie Allanore, Laurence" uniqKey="Valeyrie Allanore L" first="Laurence" last="Valeyrie-Allanore">Laurence Valeyrie-Allanore</name>
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<nlm:aff id="aff14">Department of Dermatology, Henri Mondor Hospital, Paris, France</nlm:aff>
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<name sortKey="Young, Helen S" sort="Young, Helen S" uniqKey="Young H" first="Helen S." last="Young">Helen S. Young</name>
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<name sortKey="Trembath, Richard C" sort="Trembath, Richard C" uniqKey="Trembath R" first="Richard C." last="Trembath">Richard C. Trembath</name>
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<name sortKey="Choon, Siew Eng" sort="Choon, Siew Eng" uniqKey="Choon S" first="Siew-Eng" last="Choon">Siew-Eng Choon</name>
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<name sortKey="Szell, Marta" sort="Szell, Marta" uniqKey="Szell M" first="Marta" last="Szell">Marta Szell</name>
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<nlm:aff id="aff17">Institute of Medical Genetics, University of Szeged, Hungary</nlm:aff>
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<name sortKey="Bata Csorgo, Zsuzsanna" sort="Bata Csorgo, Zsuzsanna" uniqKey="Bata Csorgo Z" first="Zsuzsanna" last="Bata-Csorgo">Zsuzsanna Bata-Csorgo</name>
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<nlm:aff id="aff2">MTA-SZTE Dermatological Research Group, Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
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<wicri:noRegion>Szeged</wicri:noRegion>
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<nlm:aff id="aff6">Department of Dermatology and Allergology, University of Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Department of Dermatology and Allergology, University of Szeged</wicri:regionArea>
<wicri:noRegion>University of Szeged</wicri:noRegion>
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<name sortKey="Smith, Catherine H" sort="Smith, Catherine H" uniqKey="Smith C" first="Catherine H." last="Smith">Catherine H. Smith</name>
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<name sortKey="Di Meglio, Paola" sort="Di Meglio, Paola" uniqKey="Di Meglio P" first="Paola" last="Di Meglio">Paola Di Meglio</name>
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<name sortKey="Barker, Jonathan N" sort="Barker, Jonathan N" uniqKey="Barker J" first="Jonathan N." last="Barker">Jonathan N. Barker</name>
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<name sortKey="Capon, Francesca" sort="Capon, Francesca" uniqKey="Capon F" first="Francesca" last="Capon">Francesca Capon</name>
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Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production</title>
<author>
<name sortKey="Mahil, Satveer K" sort="Mahil, Satveer K" uniqKey="Mahil S" first="Satveer K." last="Mahil">Satveer K. Mahil</name>
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<name sortKey="Twelves, Sophie" sort="Twelves, Sophie" uniqKey="Twelves S" first="Sophie" last="Twelves">Sophie Twelves</name>
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<name sortKey="Farkas, Katalin" sort="Farkas, Katalin" uniqKey="Farkas K" first="Katalin" last="Farkas">Katalin Farkas</name>
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<nlm:aff id="aff2">MTA-SZTE Dermatological Research Group, Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>MTA-SZTE Dermatological Research Group, Szeged</wicri:regionArea>
<wicri:noRegion>Szeged</wicri:noRegion>
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<author>
<name sortKey="Setta Kaffetzi, Niovi" sort="Setta Kaffetzi, Niovi" uniqKey="Setta Kaffetzi N" first="Niovi" last="Setta-Kaffetzi">Niovi Setta-Kaffetzi</name>
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<nlm:aff id="aff1">Division of Genetics and Molecular Medicine, King’s College London, London, UK</nlm:aff>
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<wicri:regionArea>Division of Genetics and Molecular Medicine, King’s College London, London</wicri:regionArea>
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<settlement type="city">Londres</settlement>
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<region type="région" nuts="1">Grand Londres</region>
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<name sortKey="Burden, A David" sort="Burden, A David" uniqKey="Burden A" first="A. David" last="Burden">A. David Burden</name>
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<nlm:aff id="aff3">Department of Dermatology, University of Glasgow, Glasgow, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Dermatology, University of Glasgow, Glasgow</wicri:regionArea>
<orgName type="university">Université de Glasgow</orgName>
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<settlement type="city">Glasgow</settlement>
<region type="country">Écosse</region>
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<author>
<name sortKey="Gach, Joanna E" sort="Gach, Joanna E" uniqKey="Gach J" first="Joanna E." last="Gach">Joanna E. Gach</name>
<affiliation wicri:level="3">
<nlm:aff id="aff4">Department of Dermatology, Birmingham Children’s Hospital, Birmingham, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Dermatology, Birmingham Children’s Hospital, Birmingham</wicri:regionArea>
<placeName>
<settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Midlands de l'Ouest</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Irvine, Alan D" sort="Irvine, Alan D" uniqKey="Irvine A" first="Alan D." last="Irvine">Alan D. Irvine</name>
<affiliation wicri:level="1">
<nlm:aff id="aff5">Paediatric Dermatology, Our Lady’s Children’s Hospital, Dublin, Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Paediatric Dermatology, Our Lady’s Children’s Hospital, Dublin</wicri:regionArea>
<wicri:noRegion>Dublin</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kepir, Laszl" sort="Kepir, Laszl" uniqKey="Kepir L" first="Lászl" last="Képír">Lászl Képír</name>
<affiliation wicri:level="1">
<nlm:aff id="aff6">Department of Dermatology and Allergology, University of Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Department of Dermatology and Allergology, University of Szeged</wicri:regionArea>
<wicri:noRegion>University of Szeged</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Mockenhaupt, Maja" sort="Mockenhaupt, Maja" uniqKey="Mockenhaupt M" first="Maja" last="Mockenhaupt">Maja Mockenhaupt</name>
<affiliation wicri:level="3">
<nlm:aff id="aff7">Dokumentationszentrum schwerer Hautreaktionen (dZh) and RegiSCAR-study, Department of Dermatology, Medical Center–University of Freiburg, Freiburg, Germany</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>Dokumentationszentrum schwerer Hautreaktionen (dZh) and RegiSCAR-study, Department of Dermatology, Medical Center–University of Freiburg, Freiburg</wicri:regionArea>
<placeName>
<region type="land" nuts="1">Bade-Wurtemberg</region>
<region type="district" nuts="2">District de Fribourg-en-Brisgau</region>
<settlement type="city">Fribourg-en-Brisgau</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Oon, Hazel H" sort="Oon, Hazel H" uniqKey="Oon H" first="Hazel H." last="Oon">Hazel H. Oon</name>
<affiliation wicri:level="1">
<nlm:aff id="aff8">National Skin Centre, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>National Skin Centre</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Pinner, Jason" sort="Pinner, Jason" uniqKey="Pinner J" first="Jason" last="Pinner">Jason Pinner</name>
<affiliation wicri:level="1">
<nlm:aff id="aff9">Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown</wicri:regionArea>
<wicri:noRegion>Camperdown</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ranki, Annamari" sort="Ranki, Annamari" uniqKey="Ranki A" first="Annamari" last="Ranki">Annamari Ranki</name>
<affiliation wicri:level="1">
<nlm:aff id="aff10">Department of Skin and Allergic Diseases, Helsinki University Central Hospital, Helsinki, Finland</nlm:aff>
<country xml:lang="fr">Finlande</country>
<wicri:regionArea>Department of Skin and Allergic Diseases, Helsinki University Central Hospital, Helsinki</wicri:regionArea>
<wicri:noRegion>Helsinki</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Seyger, Marieke M B" sort="Seyger, Marieke M B" uniqKey="Seyger M" first="Marieke M. B." last="Seyger">Marieke M. B. Seyger</name>
<affiliation wicri:level="3">
<nlm:aff id="aff11">Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen</wicri:regionArea>
<placeName>
<settlement type="city">Nimègue</settlement>
<region type="province" nuts="2">Gueldre</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Soler Palacin, Pere" sort="Soler Palacin, Pere" uniqKey="Soler Palacin P" first="Pere" last="Soler-Palacin">Pere Soler-Palacin</name>
<affiliation wicri:level="3">
<nlm:aff id="aff12">Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona</wicri:regionArea>
<placeName>
<settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Storan, Eoin R" sort="Storan, Eoin R" uniqKey="Storan E" first="Eoin R." last="Storan">Eoin R. Storan</name>
<affiliation wicri:level="1">
<nlm:aff id="aff13">Department of Dermatology, University Hospital, Galway, Ireland</nlm:aff>
<country xml:lang="fr">Irlande (pays)</country>
<wicri:regionArea>Department of Dermatology, University Hospital, Galway</wicri:regionArea>
<wicri:noRegion>Galway</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Tan, Eugene S" sort="Tan, Eugene S" uniqKey="Tan E" first="Eugene S." last="Tan">Eugene S. Tan</name>
<affiliation wicri:level="1">
<nlm:aff id="aff8">National Skin Centre, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>National Skin Centre</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Valeyrie Allanore, Laurence" sort="Valeyrie Allanore, Laurence" uniqKey="Valeyrie Allanore L" first="Laurence" last="Valeyrie-Allanore">Laurence Valeyrie-Allanore</name>
<affiliation wicri:level="3">
<nlm:aff id="aff14">Department of Dermatology, Henri Mondor Hospital, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Dermatology, Henri Mondor Hospital, Paris</wicri:regionArea>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Young, Helen S" sort="Young, Helen S" uniqKey="Young H" first="Helen S." last="Young">Helen S. Young</name>
<affiliation wicri:level="4">
<nlm:aff id="aff15">Department of Dermatology, University of Manchester</nlm:aff>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Manchester</settlement>
<region type="nation">Angleterre</region>
<region nuts="2" type="region">Grand Manchester</region>
</placeName>
<orgName type="university">Université de Manchester</orgName>
</affiliation>
</author>
<author>
<name sortKey="Trembath, Richard C" sort="Trembath, Richard C" uniqKey="Trembath R" first="Richard C." last="Trembath">Richard C. Trembath</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Division of Genetics and Molecular Medicine, King’s College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Genetics and Molecular Medicine, King’s College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Choon, Siew Eng" sort="Choon, Siew Eng" uniqKey="Choon S" first="Siew-Eng" last="Choon">Siew-Eng Choon</name>
<affiliation wicri:level="1">
<nlm:aff id="aff16">Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru</wicri:regionArea>
<wicri:noRegion>Johor Bahru</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Szell, Marta" sort="Szell, Marta" uniqKey="Szell M" first="Marta" last="Szell">Marta Szell</name>
<affiliation wicri:level="1">
<nlm:aff id="aff2">MTA-SZTE Dermatological Research Group, Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>MTA-SZTE Dermatological Research Group, Szeged</wicri:regionArea>
<wicri:noRegion>Szeged</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff17">Institute of Medical Genetics, University of Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Institute of Medical Genetics, University of Szeged</wicri:regionArea>
<wicri:noRegion>University of Szeged</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Bata Csorgo, Zsuzsanna" sort="Bata Csorgo, Zsuzsanna" uniqKey="Bata Csorgo Z" first="Zsuzsanna" last="Bata-Csorgo">Zsuzsanna Bata-Csorgo</name>
<affiliation wicri:level="1">
<nlm:aff id="aff2">MTA-SZTE Dermatological Research Group, Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>MTA-SZTE Dermatological Research Group, Szeged</wicri:regionArea>
<wicri:noRegion>Szeged</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1">
<nlm:aff id="aff6">Department of Dermatology and Allergology, University of Szeged, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>Department of Dermatology and Allergology, University of Szeged</wicri:regionArea>
<wicri:noRegion>University of Szeged</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Smith, Catherine H" sort="Smith, Catherine H" uniqKey="Smith C" first="Catherine H." last="Smith">Catherine H. Smith</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Division of Genetics and Molecular Medicine, King’s College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Genetics and Molecular Medicine, King’s College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Di Meglio, Paola" sort="Di Meglio, Paola" uniqKey="Di Meglio P" first="Paola" last="Di Meglio">Paola Di Meglio</name>
<affiliation wicri:level="3">
<nlm:aff id="aff18">Mill Hill Laboratory, The Francis Crick Institute, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Mill Hill Laboratory, The Francis Crick Institute, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Barker, Jonathan N" sort="Barker, Jonathan N" uniqKey="Barker J" first="Jonathan N." last="Barker">Jonathan N. Barker</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Division of Genetics and Molecular Medicine, King’s College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Genetics and Molecular Medicine, King’s College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Capon, Francesca" sort="Capon, Francesca" uniqKey="Capon F" first="Francesca" last="Capon">Francesca Capon</name>
<affiliation wicri:level="3">
<nlm:aff id="aff1">Division of Genetics and Molecular Medicine, King’s College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Genetics and Molecular Medicine, King’s College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j">The Journal of Investigative Dermatology</title>
<idno type="ISSN">0022-202X</idno>
<idno type="eISSN">1523-1747</idno>
<imprint>
<date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>Prominent skin involvement is a defining characteristic of autoinflammatory disorders caused by abnormal IL-1 signaling. However, the pathways and cell types that drive cutaneous autoinflammatory features remain poorly understood. We sought to address this issue by investigating the pathogenesis of pustular psoriasis, a model of autoinflammatory disorders with predominant cutaneous manifestations. We specifically characterized the impact of mutations affecting
<italic>AP1S3</italic>
, a disease gene previously identified by our group and validated here in a newly ascertained patient resource. We first showed that
<italic>AP1S3</italic>
expression is distinctively elevated in keratinocytes. Because
<italic>AP1S3</italic>
encodes a protein implicated in autophagosome formation, we next investigated the effects of gene silencing on this pathway. We found that
<italic>AP1S3</italic>
knockout disrupts keratinocyte autophagy, causing abnormal accumulation of p62, an adaptor protein mediating NF-κB activation. We showed that as a consequence,
<italic>AP1S3</italic>
-deficient cells up-regulate IL-1 signaling and overexpress IL-36α, a cytokine that is emerging as an important mediator of skin inflammation. These abnormal immune profiles were recapitulated by pharmacological inhibition of autophagy and verified in patient keratinocytes, where they were reversed by IL-36 blockade. These findings show that keratinocytes play a key role in skin autoinflammation and identify autophagy modulation of IL-36 signaling as a therapeutic target.</p>
</div>
</front>
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</TEI>
<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">J Invest Dermatol</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Invest. Dermatol</journal-id>
<journal-title-group>
<journal-title>The Journal of Investigative Dermatology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-202X</issn>
<issn pub-type="epub">1523-1747</issn>
<publisher>
<publisher-name>Elsevier</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">27388993</article-id>
<article-id pub-id-type="pmc">5070969</article-id>
<article-id pub-id-type="publisher-id">S0022-202X(16)32094-2</article-id>
<article-id pub-id-type="doi">10.1016/j.jid.2016.06.618</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
<subj-group>
<subject>Keratinocytes/Epidermis</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>
<italic>AP1S3</italic>
Mutations Cause Skin Autoinflammation by Disrupting Keratinocyte Autophagy and Up-Regulating IL-36 Production</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Mahil</surname>
<given-names>Satveer K.</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Twelves</surname>
<given-names>Sophie</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Farkas</surname>
<given-names>Katalin</given-names>
</name>
<xref rid="aff2" ref-type="aff">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Setta-Kaffetzi</surname>
<given-names>Niovi</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Burden</surname>
<given-names>A. David</given-names>
</name>
<xref rid="aff3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Gach</surname>
<given-names>Joanna E.</given-names>
</name>
<xref rid="aff4" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Irvine</surname>
<given-names>Alan D.</given-names>
</name>
<xref rid="aff5" ref-type="aff">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Képíró</surname>
<given-names>László</given-names>
</name>
<xref rid="aff6" ref-type="aff">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mockenhaupt</surname>
<given-names>Maja</given-names>
</name>
<xref rid="aff7" ref-type="aff">7</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Oon</surname>
<given-names>Hazel H.</given-names>
</name>
<xref rid="aff8" ref-type="aff">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Pinner</surname>
<given-names>Jason</given-names>
</name>
<xref rid="aff9" ref-type="aff">9</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ranki</surname>
<given-names>Annamari</given-names>
</name>
<xref rid="aff10" ref-type="aff">10</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Seyger</surname>
<given-names>Marieke M.B.</given-names>
</name>
<xref rid="aff11" ref-type="aff">11</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Soler-Palacin</surname>
<given-names>Pere</given-names>
</name>
<xref rid="aff12" ref-type="aff">12</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Storan</surname>
<given-names>Eoin R.</given-names>
</name>
<xref rid="aff13" ref-type="aff">13</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tan</surname>
<given-names>Eugene S.</given-names>
</name>
<xref rid="aff8" ref-type="aff">8</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Valeyrie-Allanore</surname>
<given-names>Laurence</given-names>
</name>
<xref rid="aff14" ref-type="aff">14</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Young</surname>
<given-names>Helen S.</given-names>
</name>
<xref rid="aff15" ref-type="aff">15</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Trembath</surname>
<given-names>Richard C.</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Choon</surname>
<given-names>Siew-Eng</given-names>
</name>
<xref rid="aff16" ref-type="aff">16</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Szell</surname>
<given-names>Marta</given-names>
</name>
<xref rid="aff2" ref-type="aff">2</xref>
<xref rid="aff17" ref-type="aff">17</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bata-Csorgo</surname>
<given-names>Zsuzsanna</given-names>
</name>
<xref rid="aff2" ref-type="aff">2</xref>
<xref rid="aff6" ref-type="aff">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Smith</surname>
<given-names>Catherine H.</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Di Meglio</surname>
<given-names>Paola</given-names>
</name>
<xref rid="aff18" ref-type="aff">18</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Barker</surname>
<given-names>Jonathan N.</given-names>
</name>
<xref rid="aff1" ref-type="aff">1</xref>
<xref rid="fn1" ref-type="fn">19</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Capon</surname>
<given-names>Francesca</given-names>
</name>
<email>francesca.capon@kcl.ac.uk</email>
<xref rid="aff1" ref-type="aff">1</xref>
<xref rid="fn1" ref-type="fn">19</xref>
<xref rid="cor1" ref-type="corresp"></xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>1</label>
Division of Genetics and Molecular Medicine, King’s College London, London, UK</aff>
<aff id="aff2">
<label>2</label>
MTA-SZTE Dermatological Research Group, Szeged, Hungary</aff>
<aff id="aff3">
<label>3</label>
Department of Dermatology, University of Glasgow, Glasgow, UK</aff>
<aff id="aff4">
<label>4</label>
Department of Dermatology, Birmingham Children’s Hospital, Birmingham, UK</aff>
<aff id="aff5">
<label>5</label>
Paediatric Dermatology, Our Lady’s Children’s Hospital, Dublin, Ireland</aff>
<aff id="aff6">
<label>6</label>
Department of Dermatology and Allergology, University of Szeged, Hungary</aff>
<aff id="aff7">
<label>7</label>
Dokumentationszentrum schwerer Hautreaktionen (dZh) and RegiSCAR-study, Department of Dermatology, Medical Center–University of Freiburg, Freiburg, Germany</aff>
<aff id="aff8">
<label>8</label>
National Skin Centre, Singapore</aff>
<aff id="aff9">
<label>9</label>
Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, Australia</aff>
<aff id="aff10">
<label>10</label>
Department of Skin and Allergic Diseases, Helsinki University Central Hospital, Helsinki, Finland</aff>
<aff id="aff11">
<label>11</label>
Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands</aff>
<aff id="aff12">
<label>12</label>
Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain</aff>
<aff id="aff13">
<label>13</label>
Department of Dermatology, University Hospital, Galway, Ireland</aff>
<aff id="aff14">
<label>14</label>
Department of Dermatology, Henri Mondor Hospital, Paris, France</aff>
<aff id="aff15">
<label>15</label>
Department of Dermatology, University of Manchester</aff>
<aff id="aff16">
<label>16</label>
Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia</aff>
<aff id="aff17">
<label>17</label>
Institute of Medical Genetics, University of Szeged, Hungary</aff>
<aff id="aff18">
<label>18</label>
Mill Hill Laboratory, The Francis Crick Institute, London, UK</aff>
<author-notes>
<corresp id="cor1">
<label></label>
Correspondence: Francesca Capon, Division of Genetics and Molecular Medicine, 9th floor Tower Wing, Guy’s Hospital, Great Maze Pond, London SE1 9RT, UK.Division of Genetics and Molecular Medicine9th floor Tower WingGuy’s HospitalGreat Maze PondLondon SE1 9RTUK
<email>francesca.capon@kcl.ac.uk</email>
</corresp>
<fn id="fn1">
<label>19</label>
<p id="ntpara0010">These authors contributed equally to this work.</p>
</fn>
</author-notes>
<pub-date pub-type="pmc-release">
<day>1</day>
<month>11</month>
<year>2016</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub">
<month>11</month>
<year>2016</year>
</pub-date>
<volume>136</volume>
<issue>11</issue>
<fpage>2251</fpage>
<lpage>2259</lpage>
<history>
<date date-type="received">
<day>23</day>
<month>3</month>
<year>2016</year>
</date>
<date date-type="rev-recd">
<day>15</day>
<month>6</month>
<year>2016</year>
</date>
<date date-type="accepted">
<day>25</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions>
<copyright-statement>© 2016 The Authors</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="CC BY" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).</license-p>
</license>
</permissions>
<abstract id="abs0010">
<p>Prominent skin involvement is a defining characteristic of autoinflammatory disorders caused by abnormal IL-1 signaling. However, the pathways and cell types that drive cutaneous autoinflammatory features remain poorly understood. We sought to address this issue by investigating the pathogenesis of pustular psoriasis, a model of autoinflammatory disorders with predominant cutaneous manifestations. We specifically characterized the impact of mutations affecting
<italic>AP1S3</italic>
, a disease gene previously identified by our group and validated here in a newly ascertained patient resource. We first showed that
<italic>AP1S3</italic>
expression is distinctively elevated in keratinocytes. Because
<italic>AP1S3</italic>
encodes a protein implicated in autophagosome formation, we next investigated the effects of gene silencing on this pathway. We found that
<italic>AP1S3</italic>
knockout disrupts keratinocyte autophagy, causing abnormal accumulation of p62, an adaptor protein mediating NF-κB activation. We showed that as a consequence,
<italic>AP1S3</italic>
-deficient cells up-regulate IL-1 signaling and overexpress IL-36α, a cytokine that is emerging as an important mediator of skin inflammation. These abnormal immune profiles were recapitulated by pharmacological inhibition of autophagy and verified in patient keratinocytes, where they were reversed by IL-36 blockade. These findings show that keratinocytes play a key role in skin autoinflammation and identify autophagy modulation of IL-36 signaling as a therapeutic target.</p>
</abstract>
<kwd-group id="kwrds0010">
<title>Abbreviations</title>
<kwd>3-MA, 3-methyladenine</kwd>
<kwd>AID, autoinflammatory disorder</kwd>
<kwd>CRISPR, clustered regularly-interspaced short palindromic repeats</kwd>
<kwd>Cas9, CRISPR-associated endonuclease 9</kwd>
<kwd>GFP, green fluorescent protein</kwd>
<kwd>MALP-2, macrophage-activating lipopeptide 2</kwd>
<kwd>siRNA, small interfering RNA</kwd>
<kwd>TLR-2/6, Toll-like receptor 2/6</kwd>
</kwd-group>
</article-meta>
<notes>
<p id="misc0010">accepted manuscript published online 5 July 2016; corrected proof published online 12 August 2016</p>
</notes>
</front>
<floats-group>
<fig id="fig1">
<label>Figure 1</label>
<caption>
<p>
<bold>
<italic>AP1S3</italic>
loss-of-function mutations are most likely to affect skin keratinocytes.</bold>
(
<bold>a</bold>
) Schematic representation of AP-1 structure. (
<bold>b</bold>
) HEK293 cells were transfected with wild-type and mutant
<italic>AP1S3</italic>
constructs. Lysates were subjected to the indicated temperature gradient, and soluble (nondenatured) proteins were analyzed by Western blotting. The densitometry shows the fraction of nondenatured protein (mean ± standard error of the mean of the results obtained in two experiments). (
<bold>c</bold>
) HEK293 cells were transfected with myc-tagged
<italic>AP1S3</italic>
and FLAG-tagged
<italic>AP1M1</italic>
constructs. Lysates were subjected to immune precipitation (IP) and immune blotting (IB) as indicated. The image is representative of results obtained in two experiments. (
<bold>d</bold>
) Real-time PCR analysis showing abundant
<italic>AP1S3</italic>
expression in keratinocytes. The data show the mean ± standard error of the mean of measurements obtained in two donors.
<sup></sup>
<italic>P</italic>
≤ 0.05. IB, immune blotting; IP, immune precipitation; WCE, whole cell extracts; wt, wild type.</p>
</caption>
<graphic xlink:href="gr1"></graphic>
</fig>
<fig id="fig2">
<label>Figure 2</label>
<caption>
<p>
<bold>
<italic>AP1S3</italic>
deficiency results in impaired autophagy.</bold>
(
<bold>a</bold>
) After the generation of a HaCaT
<italic>AP1S3</italic>
knockdown cell line, gene silencing was measured by real-time PCR, because of cross-reactivity of the anti-AP1σ1c antibody with the proteins encoded by
<italic>AP1S1</italic>
and
<italic>AP1S2</italic>
. (
<bold>b</bold>
) Starvation-induced LC3-II accumulation was measured by Western blotting and densitometry. The data are presented as mean ± standard error of the mean of measurements obtained in four independent experiments. (
<bold>c</bold>
) HEK293
<italic>AP1S3</italic>
knockout cell lines harboring a c.124delC change (highlighted by a red asterisk in the chromatogram) were generated by CRISPR/Cas-9 editing. (
<bold>d</bold>
) Cells were starved to induce autophagy, and LC3-II accumulation was measured by Western blotting. The data are presented as described. (
<bold>e</bold>
) Control and
<italic>AP1S3</italic>
KO HEK293 cells were transfected with GFP-LC3 and either an empty vector (control and KO panels) or a rescue construct (wild-type
<italic>AP1S3</italic>
in KO/wt panel and p.Arg33Trp
<italic>AP1S3</italic>
in KO/mut). Starvation-induced LC3 punctae were visualized by confocal fluorescence microscopy. The data are presented as mean ± standard error of the mean of measurements obtained in at least 15 cells per experiment. Scale bar = 5 μm.
<sup></sup>
<italic>P</italic>
≤ 0.05,
<sup>∗∗∗∗</sup>
<italic>P</italic>
≤ 0.0001. Cas9, CRISPR-associated protein-9; CRISPR, clustered regularly interspaced short palindromic repeats; GFP, green fluorescent protein; KD, knockdown; KO, knockout; mut, mutated; ns, not significant; wt, wild-type.</p>
</caption>
<graphic xlink:href="gr2"></graphic>
</fig>
<fig id="fig3">
<label>Figure 3</label>
<caption>
<p>
<bold>Abnormal p62 accumulation and enhanced TLR-2/6 signaling in
<italic>AP1S3</italic>
-deficient keratinocytes.</bold>
(
<bold>a</bold>
) p62 levels were measured in patient and control subject keratinocytes by Western blotting and densitometry. (
<bold>b</bold>
) After the transfection of silencing (
<italic>AP1S3</italic>
siRNA) and nonsilencing (control) siRNA pools into primary keratinocytes, (
<bold>c</bold>
) baseline p62 levels were measured by Western blotting and densitometry. (
<bold>d</bold>
) Alternatively, cells were stimulated with MALP-2 in triplicate, and the induction of TLR2/6-dependent genes was measured by real-time PCR. The data are representative of results obtained in at least two independent experiments and are presented as mean ± standard error of the mean of duplicate stimulations.
<sup></sup>
<italic>P</italic>
≤ 0.05,
<sup>∗∗</sup>
<italic>P</italic>
≤ 0.01,
<sup>∗∗∗</sup>
<italic>P</italic>
≤ 0.001. c, control; ns, not significant; siRNA, small interfering RNA; TLR, Toll-like receptor.</p>
</caption>
<graphic xlink:href="gr3"></graphic>
</fig>
<fig id="fig4">
<label>Figure 4</label>
<caption>
<p>
<bold>
<italic>AP1S3</italic>
-deficient primary keratinocytes exhibit an abnormal immune profile, which can be recapitulated by autophagy inhibition.</bold>
(
<bold>a</bold>
) After siRNA-mediated
<italic>AP1S3</italic>
silencing, primary keratinocytes were stimulated with IL-1β, and gene expression was determined by real-time PCR. (
<bold>b</bold>
) Alternatively, cells were cultured for a further 48 hours in the absence of stimuli, and cytokine production was measured by ELISA. (
<bold>c</bold>
) Normal primary keratinocytes were cultured in the presence or absence of 3-MA and subsequently stimulated with IL-1β. Gene expression was determined by real-time PCR. All data are representative of results obtained in two independent experiments and are presented as mean ± standard error of the mean of (
<bold>a</bold>
) duplicate or (
<bold>b, c</bold>
) triplicate measurements.
<sup></sup>
<italic>P</italic>
 ≤ 0.05,
<sup>∗∗</sup>
<italic>P</italic>
≤ 0.01. 3-MA, 3-methyladenine; siRNA, small interfering RNA.</p>
</caption>
<graphic xlink:href="gr4"></graphic>
</fig>
<fig id="fig5">
<label>Figure 5</label>
<caption>
<p>
<bold>Abnormal cytokine expression in the keratinocytes of patients harboring
<italic>AP1S3</italic>
mutations.</bold>
(
<bold>a</bold>
) Primary keratinocytes were stimulated with IL-1β, and cytokine induction was measured by real-time PCR. The data are presented as mean ± standard error of the mean of duplicate stimulations carried out in the cells of two unrelated patients and two healthy control subjects. (
<bold>b</bold>
) IL-36α and IL-8 production was measured in culture supernatants by ELISA. Data are presented as mean ± standard error of the mean of triplicate measurements. (
<bold>c</bold>
) Primary keratinocytes were starved to induce autophagy or cultured in the presence of IL-36Ra. Gene expression was measured by real-time PCR. The data are presented as mean ± standard error of the mean of triplicate measurements, obtained in one patient and two healthy control subjects.
<sup></sup>
<italic>P</italic>
< 0.05,
<sup>∗∗</sup>
<italic>P</italic>
< 0.01,
<sup>∗∗∗</sup>
<italic>P</italic>
< 0.001. ns, not significant.</p>
</caption>
<graphic xlink:href="gr5"></graphic>
</fig>
<table-wrap id="tbl1" position="float">
<label>Table 1</label>
<caption>
<p>Clinical phenotype of affected individuals bearing
<italic>AP1S3</italic>
disease alleles</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th>Patient ID</th>
<th>Sex</th>
<th>Ethnicity</th>
<th>Diagnosis</th>
<th>Concurrent PV</th>
<th>Age of Onset, years</th>
<th>
<italic>IL36RN</italic>
Genotype</th>
<th>
<italic>AP1S3</italic>
Genotype</th>
</tr>
</thead>
<tbody>
<tr>
<td>T010091</td>
<td>F</td>
<td>European</td>
<td>GPP</td>
<td>U</td>
<td align="char">68</td>
<td>p.Ser113Leu/–</td>
<td>p.Phe4Cys/–</td>
</tr>
<tr>
<td>T030865</td>
<td>F</td>
<td>European</td>
<td>GPP</td>
<td>N</td>
<td align="char"><1</td>
<td>p.Ser113Leu/–</td>
<td>p.Phe4Cys/–</td>
</tr>
<tr>
<td>T016713</td>
<td>F</td>
<td>European</td>
<td>PPP</td>
<td>N</td>
<td align="char">55</td>
<td>–/–</td>
<td>p.Arg33Trp/–</td>
</tr>
<tr>
<td>T026517</td>
<td>F</td>
<td>European</td>
<td>PPP</td>
<td>N</td>
<td align="char">50</td>
<td>–/–</td>
<td>p.Arg33Trp/–</td>
</tr>
<tr>
<td>T028754</td>
<td>F</td>
<td>European</td>
<td>PPP</td>
<td>N</td>
<td align="char">49</td>
<td>–/–</td>
<td>p.Arg33Trp/–</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Abbreviations: F, female; GPP, generalized pustular psoriasis; ID, identifier; N, no; PPP, palmar plantar pustulosis; PV, psoriasis vulgaris; U, unknown.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Espagne</li>
<li>Finlande</li>
<li>France</li>
<li>Hongrie</li>
<li>Irlande (pays)</li>
<li>Malaisie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Singapour</li>
</country>
<region>
<li>Angleterre</li>
<li>Bade-Wurtemberg</li>
<li>Catalogne</li>
<li>District de Fribourg-en-Brisgau</li>
<li>Grand Londres</li>
<li>Grand Manchester</li>
<li>Gueldre</li>
<li>Midlands de l'Ouest</li>
<li>Écosse</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Barcelone</li>
<li>Birmingham</li>
<li>Fribourg-en-Brisgau</li>
<li>Glasgow</li>
<li>Londres</li>
<li>Manchester</li>
<li>Nimègue</li>
<li>Paris</li>
</settlement>
<orgName>
<li>Université de Glasgow</li>
<li>Université de Manchester</li>
</orgName>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Mahil, Satveer K" sort="Mahil, Satveer K" uniqKey="Mahil S" first="Satveer K." last="Mahil">Satveer K. Mahil</name>
</region>
<name sortKey="Barker, Jonathan N" sort="Barker, Jonathan N" uniqKey="Barker J" first="Jonathan N." last="Barker">Jonathan N. Barker</name>
<name sortKey="Burden, A David" sort="Burden, A David" uniqKey="Burden A" first="A. David" last="Burden">A. David Burden</name>
<name sortKey="Capon, Francesca" sort="Capon, Francesca" uniqKey="Capon F" first="Francesca" last="Capon">Francesca Capon</name>
<name sortKey="Di Meglio, Paola" sort="Di Meglio, Paola" uniqKey="Di Meglio P" first="Paola" last="Di Meglio">Paola Di Meglio</name>
<name sortKey="Gach, Joanna E" sort="Gach, Joanna E" uniqKey="Gach J" first="Joanna E." last="Gach">Joanna E. Gach</name>
<name sortKey="Setta Kaffetzi, Niovi" sort="Setta Kaffetzi, Niovi" uniqKey="Setta Kaffetzi N" first="Niovi" last="Setta-Kaffetzi">Niovi Setta-Kaffetzi</name>
<name sortKey="Smith, Catherine H" sort="Smith, Catherine H" uniqKey="Smith C" first="Catherine H." last="Smith">Catherine H. Smith</name>
<name sortKey="Trembath, Richard C" sort="Trembath, Richard C" uniqKey="Trembath R" first="Richard C." last="Trembath">Richard C. Trembath</name>
<name sortKey="Twelves, Sophie" sort="Twelves, Sophie" uniqKey="Twelves S" first="Sophie" last="Twelves">Sophie Twelves</name>
<name sortKey="Young, Helen S" sort="Young, Helen S" uniqKey="Young H" first="Helen S." last="Young">Helen S. Young</name>
</country>
<country name="Hongrie">
<noRegion>
<name sortKey="Farkas, Katalin" sort="Farkas, Katalin" uniqKey="Farkas K" first="Katalin" last="Farkas">Katalin Farkas</name>
</noRegion>
<name sortKey="Bata Csorgo, Zsuzsanna" sort="Bata Csorgo, Zsuzsanna" uniqKey="Bata Csorgo Z" first="Zsuzsanna" last="Bata-Csorgo">Zsuzsanna Bata-Csorgo</name>
<name sortKey="Bata Csorgo, Zsuzsanna" sort="Bata Csorgo, Zsuzsanna" uniqKey="Bata Csorgo Z" first="Zsuzsanna" last="Bata-Csorgo">Zsuzsanna Bata-Csorgo</name>
<name sortKey="Kepir, Laszl" sort="Kepir, Laszl" uniqKey="Kepir L" first="Lászl" last="Képír">Lászl Képír</name>
<name sortKey="Szell, Marta" sort="Szell, Marta" uniqKey="Szell M" first="Marta" last="Szell">Marta Szell</name>
<name sortKey="Szell, Marta" sort="Szell, Marta" uniqKey="Szell M" first="Marta" last="Szell">Marta Szell</name>
</country>
<country name="Irlande (pays)">
<noRegion>
<name sortKey="Irvine, Alan D" sort="Irvine, Alan D" uniqKey="Irvine A" first="Alan D." last="Irvine">Alan D. Irvine</name>
</noRegion>
<name sortKey="Storan, Eoin R" sort="Storan, Eoin R" uniqKey="Storan E" first="Eoin R." last="Storan">Eoin R. Storan</name>
</country>
<country name="Allemagne">
<region name="Bade-Wurtemberg">
<name sortKey="Mockenhaupt, Maja" sort="Mockenhaupt, Maja" uniqKey="Mockenhaupt M" first="Maja" last="Mockenhaupt">Maja Mockenhaupt</name>
</region>
</country>
<country name="Singapour">
<noRegion>
<name sortKey="Oon, Hazel H" sort="Oon, Hazel H" uniqKey="Oon H" first="Hazel H." last="Oon">Hazel H. Oon</name>
</noRegion>
<name sortKey="Tan, Eugene S" sort="Tan, Eugene S" uniqKey="Tan E" first="Eugene S." last="Tan">Eugene S. Tan</name>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Pinner, Jason" sort="Pinner, Jason" uniqKey="Pinner J" first="Jason" last="Pinner">Jason Pinner</name>
</noRegion>
</country>
<country name="Finlande">
<noRegion>
<name sortKey="Ranki, Annamari" sort="Ranki, Annamari" uniqKey="Ranki A" first="Annamari" last="Ranki">Annamari Ranki</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Gueldre">
<name sortKey="Seyger, Marieke M B" sort="Seyger, Marieke M B" uniqKey="Seyger M" first="Marieke M. B." last="Seyger">Marieke M. B. Seyger</name>
</region>
</country>
<country name="Espagne">
<region name="Catalogne">
<name sortKey="Soler Palacin, Pere" sort="Soler Palacin, Pere" uniqKey="Soler Palacin P" first="Pere" last="Soler-Palacin">Pere Soler-Palacin</name>
</region>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Valeyrie Allanore, Laurence" sort="Valeyrie Allanore, Laurence" uniqKey="Valeyrie Allanore L" first="Laurence" last="Valeyrie-Allanore">Laurence Valeyrie-Allanore</name>
</region>
</country>
<country name="Malaisie">
<noRegion>
<name sortKey="Choon, Siew Eng" sort="Choon, Siew Eng" uniqKey="Choon S" first="Siew-Eng" last="Choon">Siew-Eng Choon</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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