Zhang Yue, Dong Xifeng, Wang Huaquan
Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
Glob Med Genet. 2023 Jul 10;10(3):133-143. doi: 10.1055/s-0043-1770958. eCollection 2023 Sep.
VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly defined refractory adult-onset autoinflammatory syndrome caused by somatic mutations in the ubiquitin-like modifier-activating enzyme 1 (UBA1) gene in hematopoietic stem and progenitor cells, resulting in a shift in UBA1 isoform expression. Thus, patients develop a spectrum of systemic inflammatory manifestations and hematologic symptoms. To date, patients respond poorly to immune suppressive drugs, except high-dose glucocorticoids, and no treatment guidelines have been established. Given the high mortality rate, VEXAS syndrome needs to be taken seriously by physicians in all specialties. This article aims to describe the key features, pathogenesis, and clinical manifestations of VEXAS syndrome to better understand the targeted treatment and improve the prognosis of VEXAS syndrome.
VEXAS(空泡、E1酶、X连锁、自身炎症性、体细胞)综合征是一种新定义的难治性成人起病自身炎症性综合征,由造血干细胞和祖细胞中泛素样修饰激活酶1(UBA1)基因的体细胞突变引起,导致UBA1同工型表达发生改变。因此,患者会出现一系列全身炎症表现和血液学症状。迄今为止,除大剂量糖皮质激素外,患者对免疫抑制药物反应不佳,且尚未建立治疗指南。鉴于高死亡率,各专科医生都应认真对待VEXAS综合征。本文旨在描述VEXAS综合征的关键特征、发病机制和临床表现,以便更好地了解靶向治疗并改善VEXAS综合征的预后。