IL4Rα 和 IL17A 阻断SOCS1 杂合不足所致自身炎症。
IL4Rα and IL17A Blockade Rescue Autoinflammation in SOCS1 Haploinsufficiency.
机构信息
Center for Inborn Errors of Immunity, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
J Clin Immunol. 2023 Dec 29;44(1):36. doi: 10.1007/s10875-023-01635-z.
By inhibition of JAK-STAT signaling, SOCS1 acts as a master regulator of the cytokine response across numerous tissue types and cytokine pathways. Haploinsufficiency of SOCS1 has recently emerged as a monogenic immunodysregulatory disease with marked clinical variability. Here, we describe a patient with severe dermatitis, recurrent skin infections, and psoriatic arthritis that harbors a novel heterozygous mutation in SOCS1. The variant, c.202_203delAC, generates a frameshift in SOCS1, p.Thr68fsAla*49, which leads to complete loss of protein expression. Unlike WT SOCS1, Thr68fs SOCS1 fails to inhibit JAK-STAT signaling when expressed in vitro. The peripheral immune signature from this patient was marked by a redistribution of monocyte sub-populations and hyper-responsiveness to multiple cytokines. Despite this broad hyper-response across multiple cytokine pathways in SOCS1 haploinsufficiency, the patient's clinical disease was markedly responsive to targeted IL4Rα- and IL17-blocking therapy. In accordance, the mutant allele was unable to regulate IL4Rα signaling. Further, patient cells were unresponsive to IL4/IL13 while on monoclonal antibody therapy. Together, this study reports a novel SOCS1 mutation and suggests that IL4Rα blockade may serve as an unexpected, but fruitful therapeutic target for some patients with SOCS1 haploinsufficiency.
通过抑制 JAK-STAT 信号通路,SOCS1 作为多种组织类型和细胞因子途径中细胞因子反应的主调控因子发挥作用。SOCS1 的杂合性缺失最近被认为是一种具有显著临床变异性的单基因免疫调节疾病。在这里,我们描述了一名患有严重皮炎、反复皮肤感染和银屑病关节炎的患者,该患者携带 SOCS1 中的一种新型杂合突变。该变体 c.202_203delAC 导致 SOCS1 中的移码,p.Thr68fsAla*49,导致蛋白质表达完全缺失。与 WT SOCS1 不同,体外表达时 Thr68fs SOCS1 无法抑制 JAK-STAT 信号通路。该患者的外周免疫特征表现为单核细胞亚群的重新分布和对多种细胞因子的超反应性。尽管在 SOCS1 杂合性缺失中存在多种细胞因子途径的广泛超反应,但患者的临床疾病对靶向 IL4Rα 和 IL17 阻断治疗具有明显反应。相应地,突变等位基因无法调节 IL4Rα 信号。此外,在单克隆抗体治疗期间,患者的细胞对 IL4/IL13 无反应。总之,这项研究报告了一种新型 SOCS1 突变,并表明 IL4Rα 阻断可能成为 SOCS1 杂合性缺失患者的一个意外但富有成效的治疗靶点。
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