A Novel Biallelic STING1 Gene Variant Causing SAVI in Two Siblings

Front Immunol. 2021 Jan 8:11:599564. doi: 10.3389/fimmu.2020.599564. eCollection 2020.

Abstract

STING-associated vasculopathy of infantile-onset (SAVI) is one of the newly identified types of interferonopathies. SAVI is caused by heterozygous gain-of-function mutations in the STING1. We herein report for the first time a homozygous variant in the STING1 gene in two siblings that resulted in constitutive activation of STING gene and the SAVI phenotype. Exome sequencing revealed a novel homozygous NM_198282.3: c.841C>T; p.(Arg281Trp) variant in exon 7 of the STING1 gene. The variant segregated in the family to be homozygous in all affected and either heterozygous or wild type in all healthy. Computational structural analysis of the mutants revealed changes in the STING protein structure/function. Elevated serum beta-interferon levels were observed in the patients compared to the control family members. Treatment with Janus kinase inhibitor (JAK-I) Ruxolitinib suppressed the inflammatory process, decreased beta-interferon levels, and stopped the progression of the disease.

Keywords: JAK inhibitor; SAVI; STING-associated vasculopathy of infancy; STING1; cutaneous vasculopathy; interferonopathies; pulmonary inflammation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Alleles*
  • Amino Acid Substitution
  • Child
  • Exome Sequencing
  • Female
  • Genetic Diseases, Inborn / drug therapy
  • Genetic Diseases, Inborn / genetics
  • Genetic Diseases, Inborn / immunology*
  • Genetic Diseases, Inborn / pathology
  • Homozygote*
  • Humans
  • Inflammation / drug therapy
  • Inflammation / genetics
  • Inflammation / immunology
  • Inflammation / pathology
  • Janus Kinase 1 / antagonists & inhibitors
  • Janus Kinase 1 / genetics
  • Janus Kinase 1 / immunology
  • Male
  • Membrane Proteins / genetics*
  • Membrane Proteins / immunology
  • Mutation, Missense*
  • Nitriles
  • Pyrazoles / administration & dosage
  • Pyrimidines
  • Siblings*
  • Vascular Diseases / drug therapy
  • Vascular Diseases / genetics*
  • Vascular Diseases / immunology
  • Vascular Diseases / pathology

Substances

  • Membrane Proteins
  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • STING1 protein, human
  • ruxolitinib
  • JAK1 protein, human
  • Janus Kinase 1