Evidence map›Paper›PMID 34326534›Full record

ArticleNature immunology2021

Human autoinflammatory disease reveals ELF4 as a transcriptional regulator of inflammation.

Paul M Tyler, Molly L Bucklin, Mengting Zhao, Timothy J Maher, Andrew J Rice, Weizhen Ji, Neil Warner, Jie Pan, Raffaella Morotti, Paul McCarthy and 8 more

Open access · greenAbstract read
In one paragraph

Article in Nature immunology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed
6.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 98 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. A novel ELF4 gene variant disrupts T and NK cell function in a patient with immune thrombocytopenia (ITP).Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026
    Article
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  6. Article
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  8. A truncatingFrontiers in immunology · 2026
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  9. Roles of endothelial cells during infection.Current opinion in immunology · 2025
    Review
  10. Epithelial pyroptosis-induced TREM1Cell death discovery · 2025
    Article
  11. Review
  12. Review
  13. 12/15-lipoxygenase orchestrates murine wound healing via PPARγ-activating oxylipins acting holistically to dampen inflammation.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  14. Two novel frameshift variations in theTranslational pediatrics · 2025
    Article
  15. Article
  16. Article
  17. A zinc transporter drives glioblastoma progression via extracellular vesicles-reprogrammed microglial plasticity.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  18. Review
  19. Progressive accumulation of circulating CD27Experimental & molecular medicine · 2025
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 3 institutions in 3 countries.

Paul M Tyler *Immunobiology Department, Yale University School of Medicine, New Haven, CT, USA.
Molly L Bucklin *Immunobiology Department, Yale University School of Medicine, New Haven, CT, USA.ORCID http://orcid.org/0000-0003-1388-686X
Mengting Zhao *Immunobiology Department, Yale University School of Medicine, New Haven, CT, USA.
Timothy J MaherImmunobiology Department, Yale University School of Medicine, New Haven, CT, USA.
Andrew J RiceImmunobiology Department, Yale University School of Medicine, New Haven, CT, USA.
Weizhen JiPediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.
Neil WarnerSickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, Hospital for Sick Children, Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada.ORCID http://orcid.org/0000-0002-9207-5979
Jie PanSickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, Hospital for Sick Children, Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada.
Raffaella MorottiDepartment of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Paul McCarthyDepartment of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.
Anne GriffithsSickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, Hospital for Sick Children, Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada.
Annemarie M C van RossumDepartment of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Iris H I M HollinkDepartment of Clinical Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands.
Virgil A S H DalmDepartment of Internal Medicine, Division of Clinical Immunology and Department of Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Jason CatanzaroDepartment of Pediatrics, Yale University School of Medicine, New Haven, CT, USA.ORCID http://orcid.org/0000-0003-2630-8882
Saquib A LakhaniPediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, USA.
Aleixo M MuiseSickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, Hospital for Sick Children, Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada.ORCID http://orcid.org/0000-0001-9624-3346
Carrie L LucasImmunobiology Department, Yale University School of Medicine, New Haven, CT, USA. Carrie.Lucas@yale.edu.ORCID http://orcid.org/0000-0002-5754-0820
Yale University · USUniversity of Toronto · CAErasmus MC · NL

Funding

COngenital Diarrhea and Enteropathy (PediCODE) Consortium and BioRepositoryRC2DK118640 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI James Richard Goldenring, Izumi Kaji · 2019 to 2026
$14.8M
Identifying Immune and Epithelial Network Signatures in Very Early Onset Inflammatory Bowel DiseaseRC2DK122532 · NIDDK · BOSTON CHILDREN'S HOSPITAL · PI KLEIN, CHRISTOPH, MUISE, ALEIXO M · 2020 to 2024
$9.1M
Mechanisms of mucosal autoinflammation elucidated by a novel monogenic transcription factor defectR01AI150913 · NIAID · YALE UNIVERSITY · PI LUCAS, CARRIE L. · 2021 to 2025
$2.9M
CIHRNIAID NIH HHS R01 AI150913NIDDK NIH HHS RC2 DK118640NIDDK NIH HHS RC2 DK122532
6 · The paper itself

Abstract

Transcription factors specialized to limit the destructive potential of inflammatory immune cells remain ill-defined. We discovered loss-of-function variants in the X-linked ETS transcription factor gene ELF4 in multiple unrelated male patients with early onset mucosal autoinflammation and inflammatory bowel disease (IBD) characteristics, including fevers and ulcers that responded to interleukin-1 (IL-1), tumor necrosis factor or IL-12p40 blockade. Using cells from patients and newly generated mouse models, we uncovered ELF4-mutant macrophages having hyperinflammatory responses to a range of innate stimuli. In mouse macrophages, Elf4 both sustained the expression of anti-inflammatory genes, such as Il1rn, and limited the upregulation of inflammation amplifiers, including S100A8, Lcn2, Trem1 and neutrophil chemoattractants. Blockade of Trem1 reversed inflammation and intestine pathology after in vivo lipopolysaccharide challenge in mice carrying patient-derived variants in Elf4. Thus, ELF4 restrains inflammation and protects against mucosal disease, a discovery with broad translational relevance for human inflammatory disorders such as IBD.

Indexed as

AnimalsCalgranulin ADNA-Binding ProteinsFemaleGene Expression RegulationHereditary Autoinflammatory DiseasesHumansInflammatory Bowel DiseasesInterleukin 1 Receptor Antagonist ProteinLipocalin-2LipopolysaccharidesMacrophagesMaleMiceMice, Inbred C57BLMice, KnockoutCalgranulin ADNA-Binding ProteinsELF4 protein, humanIl1rn protein, mouseInterleukin 1 Receptor Antagonist ProteinLcn2 protein, mouseLipocalin-2LipopolysaccharidesS100a8 protein, mouseTranscription FactorsTREM1 protein, mouseTriggering Receptor Expressed on Myeloid Cells-1

Identifiers

PMID34326534
PMCPMC8985851
OpenAlexW3186079455

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.