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Innate DNA sensing via the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) mechanism surveys microbial invasion and cellular damage and thus participates in various human infectious diseases, autoimmune diseases and cancers. However, how DNA sensing rapidly and adaptively shapes cellular physiology is incompletely known. Here we identify the STING-PKR-like endoplasmic reticulum kinase (PERK)-eIF2α pathway, a previously unknown cGAS-STING mechanism, enabling an innate immunity control of cap-dependent messenger RNA translation. Upon cGAMP binding, STING at the ER binds and directly activates the ER-located kinase PERK via their intracellular domains, which precedes TBK1-IRF3 activation and is irrelevant to the unfolded protein response. The activated PERK phosphorylates eIF2α, forming an inflammatory- and survival-preferred translation program. Notably, this STING-PERK-eIF2α pathway is evolutionarily primitive and physiologically critical to cellular senescence and organ fibrosis. Pharmacologically or genetically targeting this non-canonical cGAS-STING pathway attenuated lung and kidney fibrosis. Collectively, the findings identify an alternative innate immune pathway and its critical role in organ fibrosis, report an innate immunity-directed translation program and suggest the therapeutic potential for targeting the STING-PERK pathway in treating fibrotic diseases.
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http://dx.doi.org/10.1038/s41556-022-00894-z | DOI Listing |
Allergol Immunopathol (Madr)
September 2025
Division of Immunology and Allergy, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Türkiye.
Wiskott-Aldrich Syndrome (WAS) is an X-linked immunodeficiency characterized by eczema, microthrombocytopenia, and recurrent infections. Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory disorder involving various organs. We present a 34-year-old male with WAS who developed cervical lymphadenopathy and parotid gland swelling.
View Article and Find Full Text PDFMedicine (Baltimore)
September 2025
Al Mouwasat University Hospital, Damascus University, Damascus, Syria.
Rationale: Systemic sclerosis (SS) is an immune-mediated connective disease characterized by skin fibrosis, microvascular damage, and multisystem manifestations. One of the most important processes in connective tissue disorders is vasculitis. The clinical findings can differ when the disease is presented with an antineutrophil cytoplasmic antibody.
View Article and Find Full Text PDFNat Rev Rheumatol
September 2025
Division of Medicine, Royal Free Campus, University College London, London, UK.
Systemic sclerosis (SSc) is an autoimmune disease in which fibrotic, vascular, autoimmune and fibrotic mechanisms synergize to promote disease progression. SSc is associated with high morbidity and mortality, primarily owing to fibrotic tissue remodelling and subsequent organ failure. Despite progress with the approval of novel therapies, mortality remains high; approximately half of the people diagnosed with SSc will succumb to disease.
View Article and Find Full Text PDFLiver Int
October 2025
The Global NASH Council, Washington, DC, USA.
Background: The Middle East and North Africa (MENA) region is undergoing demographic shifts potentially increasing metabolic dysfunction-associated steatotic liver disease (MASLD) and its complications. We assessed MASLD prevalence and liver disease burden from 2010 to 2021.
Methods: Data from Global Burden of Disease (GBD), United Nations Population Division and NCD Risk Factor Collaboration covering 21 MENA countries were used for annual percent change (APC) trends per Joinpoint regression.
Cureus
August 2025
Rheumatology, King's College Hospital London, Dubai, ARE.
Systemic sclerosis (SSc) is an autoimmune rheumatic disease marked by excessive extracellular matrix deposition, causing fibrosis, endothelial dysfunction, and microvascular injury. There are two major types of SSc, limited and diffuse. SSc can affect any organ, leading to dysfunction and failure.
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