UBA1 and VEXAS syndrome: In MDS, the imbalance between regulatory T (Treg) cells and inflammatory T helper type 17 (Th17) cells in early low-risk disease underlies the high prevalence of autoimmune phenomena.[21,40] VEXAS syndrome exemplifies the genomic connection between MDS and autoinflammatory symptoms via somatic mutations in UBA1, disrupting E1 enzyme activity.