Mutations and manifestations: what’s known about VEXAS
August 2024—The recently discovered VEXAS syndrome is caused by somatic mutations in the UBA1 gene arising in bone marrow stem cells. VEXAS (vacuoles, E1-ubiquitin-activating enzyme, X-linked, autoinflammatory, somatic) syndrome was discovered when National Institutes of Health researchers identified deleterious mutations in ubiquitin-related genes. In a retrospective observational study published last year, Beck, et al., evaluated UBA1 variants in exome data from the Geisinger MyCode Community Health Initiative, a health-system-based cohort of patients who provide samples for broad research use. Clinical phenotypes were determined from Geisinger EHR data spanning four to 25 years. UBA1 variants were found in one in 13,591 unrelated individuals, one in 4,269 men older than 50, and one in 26,238 women older than 50.