title: Impairment of STAT activation by IL-12 in a patient with atypical mycobacterial and staphylococcal infections.
abstract: IL-12 plays a pivotal role in the stimulation of immune responses against intracellular infections. This role is manifested in the increased susceptibility to atypical mycobacterial and salmonella infections among individuals whose lymphocytes lack expression of IL-12Rbeta1. Here, we report on a patient with Mycobacterium avium infection, recurrent Staphylococcus aureus sinusitis, and multiple adverse drug reactions whose T cells were unable to produce IFN-gamma or proliferate in response to IL-12 despite the expression of wild-type IL-12Rbeta1 and IL-12Rbeta2. The defect in these functional responses to IL-12 was selective, as cytolytic activity induced by IL-12 was intact, and lymphocytes were responsive to stimulation by IL-2. An examination of cytokine signaling revealed that STAT4 and extracellular regulated kinase 1 (ERK1) activation by IL-12 was intact, whereas the activation of STAT1, -3, and -5 by IL-12 was lost. This impairment of STAT activation was specific for IL-12, as STAT activation by IL-2, IL-15, and IFN-gamma was unaffected. These findings demonstrate that the activation of STAT4 alone is not sufficient for IL-12-induced IFN-gamma production and proliferation and suggest that other STATs play a role in these responses to IL-12. While the etiology of the impaired IL-12 signaling in this patient has not yet been elucidated, the absence of mutations in IL-12Rbeta1 or IL-12Rbeta2 and the preservation of STAT4 activation raise the possibility that there may be a mutation in an as yet undiscovered component of the IL-12 signaling complex that is normally required for the recruitment and activation of STAT1, -3, and -5.
authors.affiliation: Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MA 02215, USA. jgollob@caregroup.harvard.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Gollob
authors.forename: K G
authors.initials: KG
authors.lastname: Veenstra
authors.forename: H
authors.initials: H
authors.lastname: Jyonouchi
authors.forename: A M
authors.initials: AM
authors.lastname: Kelly
authors.forename: P
authors.initials: P
authors.lastname: Ferrieri
authors.forename: D J
authors.initials: DJ
authors.lastname: Panka
authors.forename: F
authors.initials: F
authors.lastname: Altare
authors.forename: C
authors.initials: C
authors.lastname: Fieschi
authors.forename: J L
authors.initials: JL
authors.lastname: Casanova
authors.forename: D A
authors.initials: DA
authors.lastname: Frank
authors.forename: J W
authors.initials: JW
authors.lastname: Mier
mesh_terms: D002675:Child, Preschool; D003602:Cytotoxicity, Immunologic; D004268:DNA-Binding Proteins / Q000172:deficiency / Q000378:metabolism*; D004789:Enzyme Activation / Q000276:immunology; D005260:Female; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D007223:Infant; D007371:Interferon-gamma / Q000096:biosynthesis / Q000172:deficiency; D018664:Interleukin-12 / Q000378:metabolism / Q000502:physiology*; D008213:Lymphocyte Activation; D008894:Milk Proteins; D020928:Mitogen-Activated Protein Kinases / Q000378:metabolism; D015270:Mycobacterium avium-intracellulare Infection / Q000276:immunology* / Q000378:metabolism; D018123:Receptors, Interleukin / Q000096:biosynthesis / Q000737:chemistry / Q000235:genetics; D053707:Receptors, Interleukin-12; D050794:STAT1 Transcription Factor; D050796:STAT3 Transcription Factor; D050797:STAT4 Transcription Factor; D050799:STAT5 Transcription Factor; D015398:Signal Transduction / Q000276:immunology*; D013203:Staphylococcal Infections / Q000276:immunology* / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D015534:Trans-Activators / Q000172:deficiency / Q000378:metabolism*
chemical_list: D004268:DNA-Binding Proteins; D008894:Milk Proteins; D018123:Receptors, Interleukin; D053707:Receptors, Interleukin-12; D050794:STAT1 Transcription Factor; C494079:STAT1 protein, human; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human; D050797:STAT4 Transcription Factor; C494090:STAT4 protein, human; D050799:STAT5 Transcription Factor; D015534:Trans-Activators; D018664:Interleukin-12; D007371:Interferon-gamma; D020928:Mitogen-Activated Protein Kinases