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:A Novel GATA2 Splice-Site Mutation Associated with Familial Myelodysplastic Syndrome.
A Novel GATA2 Splice-Site Mutation Associated with Familial Myelodysplastic Syndrome.
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引言:GATA结合蛋白2(GATA2)缺陷是一种常染色体显性遗传病,以免疫缺陷、进行性血细胞减少以及骨髓增生异常综合征(MDS)和急性髓系白血病(AML)风险增加为特征。新的变异不断拓宽该病的临床和遗传谱系。病例介绍:一名11岁女孩因顽固性皮肤疣、反复感染和多系血细胞减少就诊。其父亲有长期白细胞减少和MDS,并进展为AML。实验室检查显示单核细胞减少、B细胞和NK 细胞淋巴细胞减少,以及骨髓发育异常表现。遗传分析发现了一个既往未报道的GATA2杂合剪接位点变异(c.1017 + 1 G > A),并在其已故父亲保存的DNA中得到证实。尽管接受了支持治疗和来自全相合无关供者的异基因造血干细胞移植,她仍发生了严重移植物抗宿主病,并死于移植相关并发症。结论:本报告发现了一个既往未报道的GATA2剪接位点变异,临床和家族证据支持其致病性,为不断扩展的突变谱系做出了贡献,并增进了对GATA2缺陷中基因型-表型相关性的理解。
Introduction: GATA binding protein 2 (GATA2) deficiency is an autosomal dominant disorder characterized by immunodeficiency, progressive cytopenias, and an increased risk of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Novel variants continue to broaden the clinical and genetic spectrum of this condition. Case Presentation: An 11-year-old girl presented with recalcitrant cutaneous warts, recurrent infections, and multilineage cytopenias. Her father had longstanding leukopenia and MDS that progressed to AML. Laboratory evaluation revealed monocytopenia, B- and Natural killer-cell lymphopenia, and dysplastic bone marrow findings.
Genetic analysis identified a previously unreported heterozygous splice-site variant in GATA2 (c. 1017 + 1 G > A), confirmed in stored DNA from her deceased father. Despite supportive care and allogeneic hematopoietic stem cell transplantation from a matched unrelated donor, she developed severe graft-versus-host disease and died from transplant-related complications.
Conclusion: This report identifies a previously unreported GATA2 splice-site variant with clinical and familial evidence supporting pathogenicity, contributing to the expanding mutational spectrum and enhancing understanding of genotype-phenotype correlations in GATA2 deficiency.
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