Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO)

Area of Science:

• Immunology
• Rheumatology
• Genetics

Background:

• Autoinflammatory bone disorders, including chronic nonbacterial osteomyelitis (CNO) and its severe form chronic recurrent multifocal osteomyelitis (CRMO), are characterized by sterile bone inflammation.
• These conditions arise from a dysregulated innate immune system, leading to bone inflammation and osteoclast activation, and are often linked to skin or intestinal inflammation.
• While some monogenic forms have identified genetic mutations, the molecular basis of CNO/CRMO remains largely unknown.

Purpose of the Study:

• To review the clinical presentation and molecular pathophysiology of human autoinflammatory osteopathies.
• To discuss findings from animal models relevant to these disorders.
• To focus specifically on chronic recurrent multifocal osteomyelitis (CRMO) and chronic nonbacterial osteomyelitis (CNO).

Main Methods:

• Literature review of clinical presentations and molecular pathophysiology.
• Analysis of data from human autoinflammatory osteopathies.
• Examination of relevant animal models.

Main Results:

• Autoinflammatory osteopathies involve sterile bone inflammation due to innate immune dysregulation.
• CNO/CRMO pathogenesis is complex and not fully elucidated.
• Associated conditions include skin and intestinal inflammation.

Conclusions:

• Understanding the molecular pathophysiology of CNO/CRMO is crucial for effective treatment.
• Treatment strategies for monogenic autoinflammatory bone disorders and CRMO are discussed.
• Further research is needed to clarify the molecular mechanisms underlying CNO/CRMO.