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A germline STAT6 gain-of-function variant is associated with early-onset allergies - 03/02/23

Doi : 10.1016/j.jaci.2022.09.028 
Narissara Suratannon, MD a, j, n, Chupong Ittiwut, PhD b, l, Willem A. Dik, PhD k, n, q, Rungnapa Ittiwut, PhD b, l, Kornvalee Meesilpavikkai, MD, PhD c, n, Nipan Israsena, MD, PhD d, Praewphan Ingrungruanglert, PhD d, Virgil A.S. H. Dalm, MD, PhD n, o, q, Paul L.A. van Daele, MD, PhD n, o, q, Anapat Sanpavat, MD e, Nataruks Chaijitraruch, MD, PhD f, m, Benjamin Schrijver, Bsc k, n, o, q, Supranee Buranapraditkun, PhD g, Thantrira Porntaveetus, PhD h, Sigrid M.A. Swagemakers, BS p, q, r, Hanna IJspeert, PhD k, n, q, Tanapat Palaga, PhD c, i, Kanya Suphapeetiporn, MD, PhD b, l, Peter J. van der Spek, PhD p, q, r, Nattiya Hirankarn, MD, PhD c, , Pantipa Chatchatee, MD a, j, , P. Martin van Hagen, MD, PhD a, j, n, o, q, , Vorasuk Shotelersuk, MD b, l
a Center of Excellence for Allergy and Clinical Immunology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
b Center of Excellence for Medical Genomics, Medical Genomics Cluster, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
c Center of Excellence in Immunology and Immune-mediated Diseases, Immunology Unit, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
d Center of Excellence for Stem Cell and Cell Therapy, Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
e Department of Pathology, Faculty of Medicine, Thai Pediatric Gastroenterology, Hepatology and Immunology Research Unit, Chulalongkorn University, Bangkok, Thailand 
f Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
g Cellular Immunology Laboratory Allergy and Clinical Immunology Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand 
h Center of Excellence in Genomics and Precision Dentistry, Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand 
i Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand 
j King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand 
k Laboratory Medical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 
l Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand 
m Excellence Center for Organ Transplantation, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand 
n Department of Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 
o Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 
p Department of Pathology and Clinical Bioinformatics, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 
q Academic Center for Rare Immunological Diseases (Rare Immunological Disease Center), Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 
r Erasmus Center for Data Analytics, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands 

Corresponding author: Pantipa Chatchatee, MD, Center of Excellence for Allergy and Clinical Immunology, Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, 1873 Rama IV Rd, Pathum Wan, Bangkok 10330, Thailand.Center of Excellence for Allergy and Clinical ImmunologyDivision of Allergy and ImmunologyDepartment of PediatricsFaculty of MedicineChulalongkorn University, and King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkokThailand∗∗Nattiya Hirankarn, MD, PhD, Center of Excellence in Immunology and Immune-Mediated Diseases, Immunology Unit, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Rd, Pathum Wan, Bangkok 10330, Thailand.Center of Excellence in Immunology and Immune-Mediated DiseasesImmunology UnitDepartment of MicrobiologyFaculty of MedicineChulalongkorn UniversityBangkokThailand∗∗∗P. Martin van Hagen, MD, PhD, Department of Immunology, Department of Internal Medicine, Division of Clinical Immunology, Erasmus University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.Department of ImmunologyDepartment of Internal MedicineDivision of Clinical ImmunologyErasmus University Medical Center RotterdamRotterdamthe Netherlands

Abstract

Background

The signal transducer and activator of transcription 6 (STAT6) signaling pathway plays a central role in allergic inflammation. To date, however, there have been no descriptions of STAT6 gain-of-function variants leading to allergies in humans.

Objective

We report a STAT6 gain-of-function variant associated with early-onset multiorgan allergies in a family with 3 affected members.

Methods

Exome sequencing and immunophenotyping of T-helper cell subsets were conducted. The function of the STAT6 protein was analyzed by Western blot, immunofluorescence, electrophoretic mobility shift assays, and luciferase assays. Gastric organoids obtained from the index patient were used to study downstream effector cytokines.

Results

We identified a heterozygous missense variant (c.1129G>A;p.Glu377Lys) in the DNA binding domain of STAT6 that was de novo in the index patient’s father and was inherited by 2 of his 3 children. Severe atopic dermatitis and food allergy were key presentations. Clinical heterogeneity was observed among the affected individuals. Higher levels of peripheral blood TH2 lymphocytes were detected. The mutant STAT6 displayed a strong preference for nuclear localization, increased DNA binding affinity, and spontaneous transcriptional activity. Moreover, gastric organoids showed constitutive activation of STAT6 downstream signaling molecules.

Conclusions

A germline STAT6 gain-of-function variant results in spontaneous activation of the STAT6 signaling pathway and is associated with an early-onset and severe allergic phenotype in humans. These observations enhance our knowledge of the molecular mechanisms underlying allergic diseases and will potentially contribute to novel therapeutic interventions.

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Key words : STAT6, gain of function, primary atopic disorders, food allergy, anaphylaxis, atopic dermatitis

Abbreviations used : AD, AEG, CCL, GOF, Mt, STAT, Wt


Plan


 Supported by the Thailand Science Research and Innovation Fund Chulalongkorn University, Thailand (CU_FRB65_hea (35)_042_30_23, HEA663200060), Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University, Thailand (RA56/009), Health Systems Research Institute, Thailand (65-039, 65-040), National Research Council of Thailand, Thailand (NRCT) (N42A650229), internal grant from Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Netherlands. P. J. van der Spek and S.M.A. Swagemakers received funding from the Horizon 2020 program ImmunAID, EU, for bioinformatics services (779295).
 Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest.


© 2022  American Academy of Allergy, Asthma & Immunology. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 151 - N° 2

P. 565 - février 2023 Retour au numéro
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