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:NK-type large granular lymphocyte leukemia comes of age.
NK-type large granular lymphocyte leukemia comes of age.
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NK-大颗粒淋巴细胞白血病(NK-LGLL)是一种由细胞通路组成性激活和慢性炎症驱动的淋巴系统恶性肿瘤,凸显了微环境在该病发病机制中的核心作用。NK-LGLL患者通常表现为成熟NK细胞扩增,呈现大颗粒淋巴细胞形态、限制性杀伤细胞免疫球蛋白样受体模式以及遗传学病变,包括TET2、CCL22和STAT3突变。NK-LGLL通常呈惰性临床病程,很少进展至需要治疗的阶段。该病的罕见性严重阻碍了精准诊断、对其发病机制的深入理解、适当临床试验的评估,甚至其分类。本综述旨在呈现关于该疾病遗传学、生物学和临床特征的最新见解。特别是,遗传学和表观遗传学的最新进展,以及关于微环境作用的新兴认识,揭示了白血病细胞的新脆弱性。这些发现可能对定义基因组驱动的疾病亚群产生有意义的影响,并有望通过开发个性化、创新性疗法来改善大颗粒淋巴细胞白血病患者的预后。
NK-large granular lymphocyte leukemia (NK-LGLL) is a lymphoid malignancy driven by constitutive activation of cellular pathways and chronic inflammation, underscoring the central role of the microenvironment in the disease's pathogenesis. Patients with NK-LGLL typically present with an expansion of mature NK cells displaying large granular lymphocyte morphology, a restricted killer Immunoglobulin-like receptor pattern and genetic lesions, including TET2 , CCL22 , and STAT3 mutations.
NK-LGLL generally follows an indolent clinical course and rarely progresses to a stage requiring treatment. The rarity of the disease has significantly hampered precise diagnosis, a deeper understanding of its pathogenesis, the assessment of appropriate clinical trials, and even its classification.
This review aims to present the latest insights into genetic, biological, and clinical features of this disorder. In particular, recent advances in genetics and epigenetics, along with emerging knowledge into the role of microenvironment, have uncovered new vulnerabilities in leukemic cells.
These findings may have a meaningful impact on defining genomic-driven disease subsets and hold promise for improving outcomes in large granular lymphocyte leukemia patients through the development of personalized, innovative therapies.
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