Evidence map›Paper›PMID 40020677›Full record

ArticleMed (New York, N.Y.)2025

A progranulin variant causing childhood interstitial lung disease responsive to anti-TNF-α biologic therapy.

John C Kennedy, Sara O Vargas, Martha P Fishman, Nicola Alesi, Seung-Han Baek, Damir Khabibillin, Craig D Platt, Carolina Garcia-de-Alba, Pankaj B Agrawal, Nikkola E Carmichael and 12 more

Abstract readCase Reports
In one paragraph

Article in Med (New York, N.Y.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. 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

22 authors.

John C KennedyDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address: john.kennedy@childrens.harvard.edu.
Sara O VargasHarvard Medical School, Boston, MA 02115, USA; Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA.
Martha P FishmanDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
Nicola AlesiHarvard Medical School, Boston, MA 02115, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Seung-Han BaekDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
Damir KhabibillinHarvard Medical School, Boston, MA 02115, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Craig D PlattHarvard Medical School, Boston, MA 02115, USA; Division of Immunology, Boston Children's Hospital, Boston, MA 02115, USA.
Carolina Garcia-de-AlbaDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
Pankaj B AgrawalDivision of Neonatology, Miller School of Medicine, University of Miami, Coral Gables, FL 33124, USA.
Nikkola E CarmichaelDepartment of Medical Science and Education, Boston University, Boston, MA 02115, USA.
Lauren A HendersonHarvard Medical School, Boston, MA 02115, USA; Division of Rheumatology, Boston Children's Hospital, Boston, MA 02115, USA.
Andrew WehrmanHarvard Medical School, Boston, MA 02115, USA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA 02115, USA.
Sebastian BolandDepartment of Molecular Metabolism, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Cell Biology, Harvard Medical School, Boston, MA 02115, USA.
Tobias WaltherCell Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Howard Hughes Medical Institute, Chevy Chase, MD 20815, USA.
Robert V FareseCell Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Alicia M H CaseyDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA.
John P ManisHarvard Medical School, Boston, MA 02115, USA; Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA.
Lauren V CollenDivision of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA 02115, USA.
Maria LvovaDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
Alessandro BarbieriHarvard Medical School, Boston, MA 02115, USA; Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA.
Brendan SullivanDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA.
Benjamin A RabyDivision of Pulmonary Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Instrumenting the Delivery System for a Genomics Research Information CommonsU01TR002623 · NCATS · BOSTON CHILDREN'S HOSPITAL · PI MANDL, KENNETH D. · 2019 to 2024
$8.6M
INTEGRATIVE GENOMICS OF CHILDHOOD INTERSTITIAL LUNG DISEASER01HL170151 · NHLBI · BOSTON CHILDREN'S HOSPITAL · PI Benjamin Alexander Raby, Lisa R. Young · 2024 to 2026
$2.3M
NCATS NIH HHS U01 TR002623NCI NIH HHS P30 CA008748NHLBI NIH HHS L30 HL143743NHLBI NIH HHS R01 HL170151
6 · The paper itself

Abstract

backgroundChildhood interstitial and diffuse lung diseases are a collection of rare disorders with significant associated morbidity. Only a small subset of these diseases have precise diagnostic or therapeutic options identified to date.

methodsWhole-exome sequencing in a family identified a candidate pathogenic variant predicted to be causing fibrotic lung and liver disease in a child. Digital spatial mRNA profiling of clinical lung biopsies was done to identify aberrant signaling pathways. ELISA confirmed low circulating protein levels in the patient.

findingsWe identified homozygosity of the p.Cys139Arg loss-of-function progranulin (GRN) variant and an alveolar macrophage transcriptomic signature consistent with tumor necrosis factor alpha (TNF-α) pathway activation. This motivated treatment with anti-TNF monoclonal antibodies, resulting in dramatic improvement of the patient's lung and liver disease.

conclusionsThese findings demonstrate the clinical utility of convergent multiomics in the evaluation and implementation of precision therapeutics in rare diseases.

fundingThis work was supported by a grant from the Chan Zuckerberg Initiative Patient-Partnered Collaboration for single-cell analysis of rare inflammatory pediatric disease, the Corkin Family Fund for Research, and in part by cooperative agreement U01TR002623 from the National Center for Advancing Translational Sciences/NIH and the PrecisionLink Project at Boston Children's Hospital.

Indexed as

Lung Diseases, InterstitialProgranulinsTumor Necrosis Factor-alphaChildExome SequencingHumansGRN protein, humanProgranulinsTumor Necrosis Factor-alphachildhood interstitial lung diseasefibrotic lung diseasemacrophageprecision medicineprogranulinrare lung diseasespatial transcriptomicsTNF-αTranslation to patients

Identifiers

PMID40020677
PMCPMC13003687

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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.