Gain-of-function human STAT1 mutations impair IL-17 immunity and underlie chronic mucocutaneous candidiasis

J Exp Med. 2011 Aug 1;208(8):1635-48. doi: 10.1084/jem.20110958. Epub 2011 Jul 4.

Abstract

Chronic mucocutaneous candidiasis disease (CMCD) may be caused by autosomal dominant (AD) IL-17F deficiency or autosomal recessive (AR) IL-17RA deficiency. Here, using whole-exome sequencing, we identified heterozygous germline mutations in STAT1 in 47 patients from 20 kindreds with AD CMCD. Previously described heterozygous STAT1 mutant alleles are loss-of-function and cause AD predisposition to mycobacterial disease caused by impaired STAT1-dependent cellular responses to IFN-γ. Other loss-of-function STAT1 alleles cause AR predisposition to intracellular bacterial and viral diseases, caused by impaired STAT1-dependent responses to IFN-α/β, IFN-γ, IFN-λ, and IL-27. In contrast, the 12 AD CMCD-inducing STAT1 mutant alleles described here are gain-of-function and increase STAT1-dependent cellular responses to these cytokines, and to cytokines that predominantly activate STAT3, such as IL-6 and IL-21. All of these mutations affect the coiled-coil domain and impair the nuclear dephosphorylation of activated STAT1, accounting for their gain-of-function and dominance. Stronger cellular responses to the STAT1-dependent IL-17 inhibitors IFN-α/β, IFN-γ, and IL-27, and stronger STAT1 activation in response to the STAT3-dependent IL-17 inducers IL-6 and IL-21, hinder the development of T cells producing IL-17A, IL-17F, and IL-22. Gain-of-function STAT1 alleles therefore cause AD CMCD by impairing IL-17 immunity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Base Sequence
  • Candidiasis, Chronic Mucocutaneous / genetics*
  • Candidiasis, Chronic Mucocutaneous / immunology*
  • Electrophoretic Mobility Shift Assay
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Flow Cytometry
  • Fluorescent Antibody Technique
  • Germ-Line Mutation / genetics
  • Humans
  • Immunoblotting
  • Interferon-gamma / blood
  • Interferon-gamma / metabolism
  • Interferons
  • Interleukin-17 / immunology*
  • Interleukins / metabolism
  • Male
  • Models, Molecular*
  • Molecular Sequence Data
  • Pedigree
  • Phosphorylation
  • Receptor, Interferon alpha-beta / immunology
  • STAT1 Transcription Factor / chemistry
  • STAT1 Transcription Factor / genetics*
  • STAT1 Transcription Factor / metabolism
  • Sequence Alignment
  • Sequence Analysis, DNA
  • T-Lymphocytes / immunology*

Substances

  • interferon-lambda, human
  • Interleukin-17
  • Interleukins
  • MYDGF protein, human
  • STAT1 Transcription Factor
  • STAT1 protein, human
  • Receptor, Interferon alpha-beta
  • Interferon-gamma
  • Interferons