論文

査読有り 筆頭著者 責任著者 国際誌
2020年11月27日

Human STAT1 Gain-of-Function Heterozygous Mutations: Chronic Mucocutaneous Candidiasis and Type I Interferonopathy

Journal of Clinical Immunology
  • Satoshi Okada
  • ,
  • Takaki Asano
  • ,
  • Kunihiko Moriya
  • ,
  • Stephanie Boisson-Dupuis
  • ,
  • Masao Kobayashi
  • ,
  • Jean-Laurent Casanova
  • ,
  • Anne Puel

40
8
開始ページ
1065
終了ページ
1081
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s10875-020-00847-x
出版者・発行元
Springer Science and Business Media {LLC}

Heterozygous gain-of-function (GOF) mutations in STAT1 in patients with chronic mucocutaneous candidiasis (CMC) and hypothyroidism were discovered in 2011. CMC is the recurrent or persistent mucocutaneous infection by Candida fungi, and hypothyroidism results from autoimmune thyroiditis. Patients with these diseases develop other infectious diseases, including viral, bacterial, and fungal diseases, and other autoimmune manifestations, including enterocolitis, immune cytopenia, endocrinopathies, and systemic lupus erythematosus. STAT1-GOF mutations are highly penetrant with a median age at onset of 1 year and often underlie an autosomal dominant trait. As many as 105 mutations at 72 residues, including 65 recurrent mutations, have already been reported in more than 400 patients worldwide. The GOF mechanism involves impaired dephosphorylation of STAT1 in the nucleus. Patient cells show enhanced STAT1-dependent responses to type I and II interferons (IFNs) and IL-27. This impairs Th17 cell development, which accounts for CMC. The pathogenesis of autoimmunity likely involves enhanced type I IFN responses, as in other type I interferonopathies. The pathogenesis of other infections, especially those caused by intramacrophagic bacteria and fungi, which are otherwise seen in patients with diminished type II IFN immunity, has remained mysterious. The cumulative survival rates of patients with and without severe disease (invasive infection, cancer, and/or symptomatic aneurysm) at 60 years of age are 31% and 87%, respectively. Severe autoimmunity also worsens the prognosis. The treatment of patients with STAT1-GOF mutations who suffer from severe infectious and autoimmune manifestations relies on hematopoietic stem cell transplantation and/or oral JAK inhibitors.

リンク情報
DOI
https://doi.org/10.1007/s10875-020-00847-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32852681
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85089905460&origin=inward
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85089905460&origin=inward
ID情報
  • DOI : 10.1007/s10875-020-00847-x
  • ISSN : 0271-9142
  • eISSN : 1573-2592
  • ORCIDのPut Code : 79437077
  • PubMed ID : 32852681
  • SCOPUS ID : 85089905460

エクスポート
BibTeX RIS