MUNC13-4 gene Polymorphisms in Macrophage Activation syndrome and Systemic Juveni

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DESCRIPTION (provided by applicant): Macrophage activation syndrome (MAS) is a serious, potentially fatal complication of Systemic Juvenile Idiopathic Arthritis. In clinical practice, there is a strong need for reliable biomarkers that would identify patients at risk for this complication. MAS is caused by the exaggerated inflammatory response involving mainly two types of immune cells - macrophages and T lymphocytes. In clinically similar genetic conditions the development of the exaggerated immune response has been linked to defective function of cytolytic cells. These cells typically kill abnormal cells such as tumor cells or cells infected with viruses. There is some evidence that cytolytic cells may also be involved in the elimination of overly activated immune cells. Therefore, if they do not function properly, the immune response may not be terminated in a timely manner. This would lead to uncontrolled inflammation seen in MAS. Previously, we have identified several genetic markers within the MUNC13-4 gene inherited as a single haplotype. Since MUNC13-4 protein is involved with the cytolytic function this observations is important. An important unanswered question is whether the presence of the haplotype in the MUNC 13-4 is associated with abnormal function of the MUNC13-4 protein and, thus, directly contributes to the development of cytolytic dysfunction seen in patients MAS. Another possibility is that the described haplotype may extend either upstream or downstream of the MUNC13-4 gene and involve additional polymorphisms in the neighboring immunologically relevant genes. These two possibilities will be explored in the proposed study.