RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Invasive mucorales sinusitis in a young patient with Emberger syndrome and newly diagnosed AML: A case report and literature review of invasive fungal infections in GATA2 deficiency.
Invasive mucorales sinusitis in a young patient with Emberger syndrome and newly diagnosed AML: A case report and literature review of invasive fungal infections in GATA2 deficiency.
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编码GATA2转录因子的基因发生胚系致病性变异(PVs)可导致单核细胞、树突状细胞、NK 细胞和B细胞的严重减少。GATA2 PVs与髓系恶性肿瘤风险增加相关,并易感非结核分枝杆菌和人乳头瘤病毒感染。
此外,在携带GATA2 PVs的个体中,即使不存在髓系恶性肿瘤,也有侵袭性真菌感染(IFIs)的报道。在本报告中,我们介绍了一例40岁男性Emberger综合征患者(GATA2突变、近期确诊急性髓系白血病[AML]、有伴听力损失的淋巴水肿病史),在接受第一个疗程缓解诱导化疗期间发生毛霉菌目鼻窦炎。
此外,我们回顾了已发表的携带GATA2 PVs患者中确诊IFIs的所有病例文献。临床医生应意识到,携带GATA2 PVs的患者即使没有AML和抗肿瘤治疗,也可能易发生机会性IFIs。
此外,本例患者在AML第一个诱导化疗疗程中发生毛霉菌病这一极不寻常的情况提示,因胚系GATA2 PVs而接受AML诱导化疗的患者可能处于侵袭性机会性霉菌所致早发IFIs的高风险之中。
Germline pathogenic variants (PVs) in the gene encoding the GATA2 transcription factor can result in profound reductions of monocytes, dendritic cells, natural killer cells and B cells. GATA2 PVs are associated with an increased risk of myeloid malignancies and a predisposition to nontuberculous mycobacterial and human papillomavirus infections.
Additionally, invasive fungal infections (IFIs) have been reported in individuals with GATA2 PVs, even in the absence of myeloid malignancies. In this report, we present the case of a 40-year-old man with Emberger syndrome (GATA2 mutation, recently diagnosed acute myeloid leukaemia [AML] and history of lymphedema with hearing loss) who developed Mucorales sinusitis while receiving his first course of remission induction chemotherapy.
Additionally, we review the literature on all published cases of proven IFIs in patients with GATA2 PVs. Clinicians should be aware that patients with GATA2 PVs could be vulnerable to opportunistic IFIs, even in the absence of AML and antineoplastic therapy.
Furthermore, the distinctly unusual occurrence of mucormycosis during the first course of induction chemotherapy for AML in our patient indicates that patients with germline GATA2 PVs receiving induction chemotherapy for AML might be at high risk for early onset of IFIs due to aggressive, opportunistic moulds.
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