What Is Neonatal Onset Multisystem Inflammatory Disease?
Source: Genetic and Rare Diseases (GARD) Information Center
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Neonatal Onset Multisystem Inflammatory Disease
NOMID; Chronic Infantile Neurological Cutaneous Articular syndrome; CINCA syndrome; CINCA; Infantile Onset Multisystem Inflammatory Disease; IOMID; Prieur Griscelli syndrome
Neonatal onset multisystem inflammatory disease (NOMID) is an inflammatory disorder present from birth (congenital) characterized by tissue damage of the nervous system, skin, and joints. It is the most severe form of a group of conditions called cryopyrin-associated periodic syndromes (CAPS). Learn more.
Neonate at birth
Image by Bonnie Urquhart Gruenberg/Wikimedia
Mast Cell
Image by TheVisualMD
Source: Genetic and Rare Diseases (GARD) Information Center
Meningitis-MRI
Image by MBq Disk
Source: Genetic and Rare Diseases (GARD) Information Center
Genetic mutations
Image by NIAID
Source: Genetic and Rare Diseases (GARD) Information Center
Ideogram of human chromosome 1
Image by Office of Biological and Environmental Research of the U.S. Department of Energy Office of Science, the Biological and Environmental Research Information System, Oak Ridge National Laboratory.
The NLRP3 gene provides instructions for making a protein called cryopyrin. Cryopyrin is a member of a family of proteins called intracellular "NOD-like" receptor (NLR) proteins. Cryopyrin is found mainly in white blood cells and in cartilage-forming cells (chondrocytes).
NLR proteins are involved in the immune system, helping to start and regulate the immune system's response to injury, toxins, or foreign invaders. NLR proteins recognize specific molecules and respond by helping to turn on (activate) certain parts of the immune system. Cryopyrin recognizes bacteria; chemicals such as asbestos, silica, and uric acid crystals; and compounds released by injured cells.
Cryopyrin molecules assemble themselves, along with other proteins, into structures called inflammasomes, which help trigger the process of inflammation. Inflammation occurs when the immune system sends signaling molecules as well as white blood cells to a site of injury or disease to fight foreign invaders and help repair damaged tissues. Once the threat is over, the body stops (inhibits) the inflammatory response, to prevent damage to its own cells and tissues.
Several variants (also known as mutations) in the NLRP3 gene have been found to cause cryopyrin-associated periodic syndromes (CAPS). CAPS are a group of conditions that have overlapping signs and symptoms. The conditions are generally characterized by periodic episodes of skin rash, fever, and joint pain. CAPS include three conditions known as familial cold autoinflammatory syndrome type 1 (FCAS1), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disorder (NOMID). These conditions were once thought to be distinct disorders but are now considered to be part of the same condition spectrum. FCAS1 is the least severe form of CAPS, MWS is intermediate in severity, and NOMID is the most severe form.
Many of the variants that cause CAPS are in a region of the NLRP3 gene known as exon 3. All of the variants likely result in the cryopyrin protein being overactive. Inflammasomes made with abnormal cryopyrin proteins trigger inflammatory responses even when there is no injury or disease. Impairment of the body's mechanisms for controlling inflammation results in episodes of fever and widespread damage to the body’s cells and tissues.
While the CAPS spectrum shares similar signs and symptoms, it is unclear why variants in different parts of the NLRP3 gene cause the patterns of features that distinguish FCAS1, MWS, and NOMID.
Source: MedlinePlus Genetics
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