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PAD4-generated citrullinated histones are triggers for autoinflammation in cryopyrin-associated periodic syndrome.

Created on 16 Jul 2026

Authors

Bregje Christiaenssen, Silke Mortelmans, Siham Baghli, Fleur Boone, Wei Xie, Arinna Bertoni, My Ha, Benson Ogunjimi, Vito Sabato, Marco Gattorno, Peter Vandenabeele, Geert van Loo, Esther Hoste, Andy Wullaert

Published in

Cell death and differentiation. Jul 15, 2026. Epub Jul 15, 2026.

Abstract

Cryopyrin-associated periodic syndromes (CAPS) are autoinflammatory disorders caused by gain-of-function NLRP3 variants. Although NLRP3 inflammasomes mediate IL-1β secretion through Gasdermin D (GSDMD), we show that GSDMD deletion did not prevent autoinflammation in mice ubiquitously expressing the Nlrp3A350V variant. Inflamed skin of Nlrp3A350V-expressing GSDMD-deficient mice displayed citrullinated histone 3-containing neutrophil extracellular traps (CitH3-NETs). CitH3-NETs induced IL-1β secretion from murine Nlrp3A350V-expressing GSDMD-deficient macrophages as well as from human CAPS patient monocytes and macrophages. Blocking protein arginine deiminase-4 (PAD4) prevented CitH3 release and disabled the IL-1β-inducing NET effects, identifying CitH3 as crucial trigger. Mechanistically, CitH3-NETs activated GSDME in GSDMD-deficient Nlrp3A350V macrophages, and GSDME deletion prevented pathology in Nlrp3A350V-expressing GSDMD-deficient mice. In addition to this GSDME-dependent autoinflammation axis, PAD4 deletion also prevented autoinflammation in mice with neutrophil-specific Nlrp3A350V expression that develop CAPS in a GSDMD-dependent manner. These observations support a CAPS model in which PAD4-mediated CitH3-NET release can trigger both GSDMD-dependent and GSDME-dependent autoinflammation.

PMID:
42457925
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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