STING activation depends on ACBD3 and other phosphatidylinositol 4-phosphate-regulating proteins

STING induces transcription of pro-inflammatory genes upon activation at the Golgi apparatus. Many of the regulators involved in STING activation are unknown. We found that ACBD3 and other phosphatidylinositol 4-phosohate (PI4P) regulating proteins play a critical role in STING activation. We show that proper STING localization and activation at the Golgi depended on ACBD3 and PI4KB expression. Furthermore, depleting PI4P by inactivating PI4KB or overexpressing Sac1 diminished STING activation. STING signalling was also regulated by the lipid-shuttling protein OSBP, which removes PI4P from the Golgi. OSBP inhibition by the FDA-approved antifungal itraconazole and other OSBP inhibitors greatly enhanced STING activation by increasing the levels of STING-activating phospholipids. Itraconazole-enhanced STING activation resulted in a hundred to thousand-fold increased expression of interferon-beta and other cytokines. In conclusion, the phospholipid PI4P is critical for STING activation and manipulating PI4P levels is a promising therapeutic strategy to alter the STING immune response.