Abstract
Chronic mucocutaneous candidiasis, characterized by persistent or recurrent fungal infections, represents the clinical hallmark in gain-of-function (GOF) signal transducer and activator of transcription 1 (STAT1) mutation carriers. Several cases of intracranial aneurysms have been reported in patients with GOF STAT1 mutation but the paucity of reported cases likely suggested this association still as serendipity. In order to endorse this association, we link the development of intracranial aneurysms with STAT1 GOF mutation by presenting the two different cases of a patient and her mother, and demonstrate upregulated phosphorylated STAT4 and IL-12 receptor β1 upon stimulation in patient's blood cells. We also detected increased transforming growth factor (TGF)-β type 2 receptor expression, particularly in CD14+ cells, and a slightly higher phosphorylation rate of SMAD3. In addition, the mother of the patient developed disseminated bacille Calmette-Guérin disease after vaccination, speculating that GOF STAT1 mutations may confer a predisposition to weakly virulent mycobacteria.
Keywords:
Aneurysm; Chronic mucocutaneous candidiasis; Gain-of-function mutation; Mendelian susceptibility to mycobacterial disease; SMAD3; STAT1; STAT4; Transforming growth factor-β.
Copyright © 2017 Elsevier Inc. All rights reserved.
MeSH terms
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Adjuvants, Immunologic / adverse effects
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Adult
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Angiography, Digital Subtraction
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BCG Vaccine / adverse effects
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Candidiasis, Chronic Mucocutaneous / complications
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Candidiasis, Chronic Mucocutaneous / genetics*
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Candidiasis, Chronic Mucocutaneous / immunology
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Candidiasis, Chronic Mucocutaneous / metabolism
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Cerebral Angiography
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Female
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Humans
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Intracranial Aneurysm / complications
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Intracranial Aneurysm / diagnostic imaging
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Intracranial Aneurysm / genetics*
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Intracranial Aneurysm / metabolism
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Mothers
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Mutation
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Phosphoproteins / immunology
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Phosphoproteins / metabolism
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Protein Serine-Threonine Kinases / immunology
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Protein Serine-Threonine Kinases / metabolism
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Receptor, Transforming Growth Factor-beta Type II
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Receptors, Interleukin-12 / immunology
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Receptors, Interleukin-12 / metabolism
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Receptors, Transforming Growth Factor beta / immunology
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Receptors, Transforming Growth Factor beta / metabolism
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STAT1 Transcription Factor / genetics*
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STAT4 Transcription Factor / immunology
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STAT4 Transcription Factor / metabolism
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Smad3 Protein / immunology
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Smad3 Protein / metabolism
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Tuberculosis / chemically induced
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Tuberculosis / immunology
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Young Adult
Substances
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Adjuvants, Immunologic
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BCG Vaccine
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IL12RB1 protein, human
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Phosphoproteins
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Receptors, Interleukin-12
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Receptors, Transforming Growth Factor beta
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SMAD3 protein, human
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STAT1 Transcription Factor
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STAT1 protein, human
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STAT4 Transcription Factor
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STAT4 protein, human
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Smad3 Protein
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Protein Serine-Threonine Kinases
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Receptor, Transforming Growth Factor-beta Type II