JAK Inhibitor Therapy in a Child with Inherited USP18 Deficiency
NEW ENGLAND JOURNAL OF MEDICINE
Authors: Alsohime, Fahad; Martin-Fernandez, Marta; Temsah, Mohamad-Hani; Alabdulhafid, Majed; Le Voyer, Tom; Alghamdi, Malak; Qiu, Xueer; Alotaibi, Najla; Alkahtani, Areej; Buta, Sofija; Jouanguy, Emmanuelle; Al-Eyadhy, Ayman; Gruber, Conor; Hasan, Gamal M.; Bashiri, Fahad A.; Halwani, Rabih; Hassan, Hamdy H.; Al-Muhsen, Saleh; Alkhamis, Nouf; Alsum, Zobaida; Casanova, Jean-Laurent; Bustamante, Jacinta; Bogunovic, Dusan; Alangari, Abdullah A.
Abstract
Deficiency of ubiquitin-specific peptidase 18 (USP18) is a severe type I interferonopathy. USP18 down-regulates type I interferon signaling by blocking the access of Janus-associated kinase 1 (JAK1) to the type I interferon receptor. The absence of USP18 results in unmitigated interferon-mediated inflammation and is lethal during the perinatal period. We describe a neonate who presented with hydrocephalus, necrotizing cellulitis, systemic inflammation, and respiratory failure. Exome sequencing identified a homozygous mutation at an essential splice site on USP18. The encoded protein was expressed but devoid of negative regulatory ability. Treatment with ruxolitinib was followed by a prompt and sustained recovery. (Funded by King Saud University and others.) A neonate with a loss-of-function mutation in USP18 and exuberant expression of interferon-stimulated genes was experimentally treated with ruxolitinib, which suppresses interferon signaling. The initiation of treatment was followed by an improvement in the child's clinical course.
MicroRNA-130a inhibits HCV replication by restoring the innate immune response
JOURNAL OF VIRAL HEPATITIS
Authors: Li, S.; Duan, X.; Li, Y.; Liu, B.; McGilvray, I.; Chen, L.
Abstract
Hepatitis C virus (HCV) infection is a major cause of chronic hepatitis and hepatocellular carcinoma. Currently pegylated interferon (IFN) combined with ribavirin remains the best therapeutic approach, although patients infected with HCV genotype I may benefit from adding protease inhibitors as triple therapy'. MicroRNAs (miRNAs) are endogenous small noncoding RNAs that regulate gene expression and have recently been shown to play an important role in human innate immune response and as an antiviral in chimpanzees. We studied the effect of miR-130a on the HCV replication. We found that miR-130a significantly inhibits HCV replication in both HCV replicon and J6-/JFH1-infected cells. Over expression of miR-130a upregulated the expression of type I IFN (IFN-/IFN -), ISG15, USP18 and MxA, which are involved in innate immune response and decreased expression of miR-122, a well-defined miRNA promoting HCV production. In conclusion, miR-130a inhibits HCV replication/production by restoring host innate immune responses and/or downregulating pro-HCV miR-122. miR-130a might be a potential drug target by modulating host innate immune responses to combat HCV infection.