Mutations that prevent caspase cleavage of RIPK1 cause autoinflammatory disease

Najoua Lalaoui, Steven E. Boyden, Hirotsugu Oda, Geryl M. Wood, Deborah L. Stone, Diep Chau, Lin Liu, Monique Stoffels, Tobias Kratina, Kate E. Lawlor, Kristien J.M. Zaal, Patrycja M. Hoffmann, Nima Etemadi, Kristy Shield-Artin, Christine Biben, Wanxia Li Tsai, Mary D. Blake, Hye Sun Kuehn, Dan Yang, Holly AndertonNatasha Silke, Laurens Wachsmuth, Lixin Zheng, Natalia Sampaio Moura, David B. Beck, Gustavo Gutierrez-Cruz, Amanda K. Ombrello, Gineth P. Pinto-Patarroyo, Andrew J. Kueh, Marco J. Herold, Cathrine Hall, Hongying Wang, Jae Jin Chae, Natalia I. Dmitrieva, Mark McKenzie, Amanda Light, Beverly K. Barham, Anne Jones, Tina M. Romeo, Qing Zhou, Ivona Aksentijevich, James C. Mullikin, Andrew J. Gross, Anthony K. Shum, Edwin D. Hawkins, Seth L. Masters, Michael J. Lenardo, Manfred Boehm, Sergio D. Rosenzweig, Manolis Pasparakis, Anne K. Voss, Massimo Gadina, Daniel L. Kastner, John Silke

Research output: Contribution to journalArticleResearchpeer-review

181 Citations (Scopus)


RIPK1 is a key regulator of innate immune signalling pathways. To ensure an optimal inflammatory response, RIPK1 is regulated post-translationally by well-characterized ubiquitylation and phosphorylation events, as well as by caspase-8-mediated cleavage1–7. The physiological relevance of this cleavage event remains unclear, although it is thought to inhibit activation of RIPK3 and necroptosis8. Here we show that the heterozygous missense mutations D324N, D324H and D324Y prevent caspase cleavage of RIPK1 in humans and result in an early-onset periodic fever syndrome and severe intermittent lymphadenopathy—a condition we term ‘cleavage-resistant RIPK1-induced autoinflammatory syndrome’. To define the mechanism for this disease, we generated a cleavage-resistant Ripk1D325A mutant mouse strain. Whereas Ripk1−/− mice died postnatally from systemic inflammation, Ripk1D325A/D325A mice died during embryogenesis. Embryonic lethality was completely prevented by the combined loss of Casp8 and Ripk3, but not by loss of Ripk3 or Mlkl alone. Loss of RIPK1 kinase activity also prevented Ripk1D325A/D325A embryonic lethality, although the mice died before weaning from multi-organ inflammation in a RIPK3-dependent manner. Consistently, Ripk1D325A/D325A and Ripk1D325A/+ cells were hypersensitive to RIPK3-dependent TNF-induced apoptosis and necroptosis. Heterozygous Ripk1D325A/+ mice were viable and grossly normal, but were hyper-responsive to inflammatory stimuli in vivo. Our results demonstrate the importance of caspase-mediated RIPK1 cleavage during embryonic development and show that caspase cleavage of RIPK1 not only inhibits necroptosis but also maintains inflammatory homeostasis throughout life.

Original languageEnglish
Pages (from-to)103-108
Number of pages6
Issue number7788
Publication statusPublished - 2 Jan 2020

Cite this