Vibratory Urticaria Associated with a Missense Variant in ADGRE2

ORIGINAL ARTICLE

BRIEF REPORT

Steven E. Boyden, Ph.D., Avanti Desai, M.S., Glenn Cruse, Ph.D., Michael L. Young, M.S.P.H., Hyejeong C. Bolan, M.S.N., Linda M. Scott, M.S.N., A. Robin Eisch, R.N., R. Daniel Long, B.S., B.A., Chyi-Chia R. Lee, M.D., Ph.D., Colleen L. Satorius, B.S., Andrew J. Pakstis, Ph.D., Ana Olivera, Ph.D., James C. Mullikin, Ph.D., Eliane Chouery, Ph.D., André Mégarbané, M.D., Ph.D., Myrna Medlej-Hashim, Ph.D., Kenneth K. Kidd, Ph.D., Daniel L. Kastner, M.D., Ph.D., Dean D. Metcalfe, M.D., and Hirsh D. Komarow, M.D.

February 3, 2016DOI: 10.1056/NEJMoa1500611

Abstract

Article

References

Patients with autosomal dominant vibratory urticaria have localized hives and systemic manifestations in response to dermal vibration, with coincident degranulation of mast cells and increased histamine levels in serum. We identified a previously unknown missense substitution in ADGRE2 (also known as EMR2), which was predicted to result in the replacement of cysteine with tyrosine at amino acid position 492 (p.C492Y), as the only nonsynonymous variant cosegregating with vibratory urticaria in two large kindreds. The ADGRE2 receptor undergoes autocatalytic cleavage, producing an extracellular subunit that noncovalently binds a transmembrane subunit. We showed that the variant probably destabilizes an autoinhibitory subunit interaction, sensitizing mast cells to IgE-independent vibration-induced degranulation. (Funded by the National Institutes of Health.)

Full Text of ...

Read the Full Article...

MEDIA IN THIS ARTICLE

FIGURE 1Inheritance and Clinical Features of Vibratory Urticaria.

FIGURE 2Vibration-Induced, ADGRE2-Enhanced Degranulation of Mast Cells from Patients.