Periodic Fever Syndrome Treatment Possible With FDA-Approved Tumor Necrosis Factor Medicine

The lack of a protein that's activating the body's antiviral defenses can result in a treatable autoinflammatory disease like the periodic fever syndrome, akin to a rare rheumatoid condition.

According to a global research team led by Mount Sinai, the said treatment is a class of drugs approved by the Food and Drug Administration known as tumor necrosis factor or TNF inhibitors.

A Medical Xpress report specified that the said condition, now called TBK1 deficiency, was formerly known to scientists although its name, cause, and treatment "were identified for the first time" in their study.

Describing their work, the scientists reported that the lack of protein, identified as TBK1 tor TANK-binding kinase 1, extracts cells susceptible to a jarring form of programmed cell death in reaction to TNF, although that this genetic defect can be addressed quickly and effectively by therapeutic agents that block the inflammation's source.

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Mutations in TBK1

As indicated in this report, homozygous mutations in TBK1, which occur when both parents pass on copies of the irregular or unusual gene encoding, are extremely infrequent.

Based on previous research in mouse models and human cell cultures, researchers implicit that such mutations would leave individuals vulnerable to a great range of viral infections.

In their study, Human TBK1 deficiency leads to autoinflammation driven by TNF-induced cell death, published in the Cell journal; the study authors discovered that none of the four individuals aged 7 to 32 years old in the cohort they investigated exhibited signs of insufficient antiviral immunity.

Instead, they all had a systemic autoinflammatory condition caused by a dysregulated response to TNF, an essential protein involved in regulating inflammation and cell death.

Use of Anti-TNF Therapeutics

According to the study's lead author and an investigator in the Department of Microbiology, the Precision Immunology Institute, and the Center for Inborn Errors of Immunity at the Icahn School of Medicine at Mount Sinai, Justin Taft, Ph.D., the TBK1 signaling activates the antiviral mechanisms of the body to combat infection and block different viral replication stages and regulate TNF-mediated inflammation.

However, the lead author continued that if a mutation prevents the TBK1 gene's expression or upsets its function, cells turn extremely sensitive to TNF.

That then can activate an uneven amount of cell death, setting off a violent flow of remains from dying cells inflaming surrounding tissues and fueling the inflammation.

In a similar report, Newswise specified that by treating TBK1-deficient individuals using anti-TNF therapeutics, the research team verified its doubts about the genetically driven condition's underlying biology.

New Disease Defined

Senior author of the study, Dusan Bogunovic, Ph.D. said, they had essentially defined a new disease, including its associated mechanism of autoinflammation, which was managed before, with steroid treatments, non-steroidal anti-inflammatory medicines, or other non-particular therapeutics clinicians believed worth trying.

Bogunovic, also the Director of the Center for Inborn Errors of Immunity, Associated Professor of Oncological Sciences, Microbiology and Pediatrics, and a Precision Immunology Institute and The Mindich Child Health and Development Institute member added they were able to target the condition effectively and directly with TNF inhibitors once they knew the inflammation's causative factors. More so, the clinical improvement was fast, not to mention substantial.

Related information about tumor necrosis factor is shown on the University of Rochester Introductory Biochemistry's YouTube video below: