Genome instability independent of type I interferon signaling drives neuropathology caused by impaired ribonucleotide excision repair

Aicardi-Goutières syndrome (AGS) is a monogenic type I interferonopathy characterized by neurodevelopmental defects and upregulation of type I interferon signaling and neuroinflammation. Mutations in genes that function in nucleic acid metabolism, including RNASEH2, are linked to AGS. Ribonuclease H2 (RNASEH2) is a genome surveillance factor critical for DNA integrity by removing ribonucleotides incorporated into replicating DNA. Here we show that RNASEH2 is necessary for neurogenesis and to avoid activation of interferon-responsive genes and neuroinflammation. Cerebellar defects after RNASEH2B inactivation are rescued by p53 but not cGAS deletion, suggesting that DNA damage signaling, not neuroinflammation, accounts for neuropathology. Coincident inactivation of Atm and Rnaseh2 further affected cerebellar development causing ataxia, which was dependent upon aberrant activation of non-homologous end-joining (NHEJ). The loss of ATM also markedly exacerbates cGAS-dependent type I interferon signaling. Thus, DNA damage-dependent signaling rather than type I interferon signaling underlies neurodegeneration in this class of neurodevelopmental/neuroinflammatory disease. •RNASEH2 is necessary for neurogenesis and prevention of neuroinflammation•ATM suppresses the neural impact of Rnaseh2 inactivation•Neuropathology from disabled RNASEH2B is rescued by p53 but not cGAS inactivation Mutations in RNASEH2 are linked to Aicardi-Goutières syndrome. Aditi et al. show that RNASEH2 is necessary for neurogenesis and to avoid activation of interferon-responsive genes. These defects are rescued by p53 but not cGAS inactivation, suggesting that DNA damage signaling, not neuroinflammation, accounts for neuropathology in this class of disease.