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Mapping VEXAS-associated and rare UBA1 variants in the United Kingdom: Insights from patient cohorts and the general population

Lookup NU author(s): Dr Andrew McGregor

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2025 The Author(s). British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.Somatic mutations in UBA1 are linked to VEXAS syndrome, a late-onset inflammatory disorder with rheumatological and haematological features, primarily affecting elderly men. This study examines the epidemiology of VEXAS in the United Kingdom using genomic databases and patient cohorts to estimate prevalence, identify novel UBA1 variants and predict their pathogenicity. Analysing data from the UK Biobank, 100 000 Genomes Project and clinical diagnostic laboratories, we found that VEXAS prevalence in UK males over 50 is lower than in US-based cohorts. Notably, canonical (Met41) UBA1 mutations appear in ~1% of individuals with autoinflammatory disorders who have not been referred to haematology. However, among those investigated for myeloid malignancies, VEXAS is relatively common, with an estimated incidence of 1.51 per 100 000, or 171 new cases each year. We identified 47 UBA1 non-Met41 variants of uncertain significance, with several showing clonal dominance and clustering in functional domains, suggesting potential pathogenicity. Clinical presentation associated with non-Met41 variants often diverged from classical VEXAS features, underscoring the need for further studies. Our findings highlight the importance of broader screening for both canonical and non-canonical UBA1 mutations to improve understanding of VEXAS syndrome and its underlying mechanisms.


Publication metadata

Author(s): Martinez Rodriguez A, Chang L, Rowczenio D, Smith A, Omoyinmi E, Poulter JA, McGregor A, Francis S, Trikha R, Al-Hakim A, Lok Kong K, Kent DG, Lachmann H, Kulasekararaj A, Cargo C, Savic S

Publication type: Article

Publication status: Published

Journal: British Journal of Haematology

Year: 2025

Pages: epub ahead of print

Online publication date: 25/05/2025

Acceptance date: 13/05/2025

Date deposited: 10/06/2025

ISSN (print): 0007-1048

ISSN (electronic): 1365-2141

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/bjh.20176

DOI: 10.1111/bjh.20176

Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.


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Funding

Funder referenceFunder name
Kennedy Trust Senior Fellowship
Leeds Biomedical Research Centre (BRC) (NIHR203331)
MRC project grant number MR/Y011945/1
National Institute for Health and Care Research (NIHR)
UKRI Future Leaders Fellowship (MR/Y034325/1)

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