Endothelial cell expression of STINGV154M: Gain-of-function mutation delays the resolution of UVB-induced skin injury.

Gain-of-function mutations in STING (STimulator of IFN Genes) cause STING-associated vasculopathy with onset in infancy (SAVI), a rare autoinflammatory disease characterized by debilitating inflammatory lung disease and hallmark skin manifestations, such as chilblains and progressive, nonhealing ulcers. Mice expressing the most common SAVI-associated variant, STINGV154M (denoted as VM), recapitulate many clinical features of SAVI, including inflammatory lung disease, but do not develop spontaneous skin lesions. In this study, we show that a single low-dose of UVB irradiation, which induces only transient skin inflammation in wild-type mice, causes severe and progressive skin injury in VM mice that did not require type I IFNs. Notably, this phenotype persisted in VM mice depleted of hematopoietic cells and reconstituted with wild-type bone marrow, demonstrating that STINGV154M expression in nonhematopoietic cells is sufficient to drive persistent skin inflammation. Further analysis of our VM conditional knock-in mice, crossed to an endothelial specific Cre strain, identified STINGV154M-expressing endothelial cells as the primary driver of the cutaneous phenotype. These findings establish a critical link between endothelial cell STING activation and exacerbated skin inflammation, providing insight into the mechanisms underlying SAVI-associated skin pathology.