genetic mutations

基因突变
  • 文章类型: Journal Article
    宫颈癌是女性第四大最常见的癌症。晚期和转移性疾病通常与不良的临床结果相关。这证实了对患者和肿瘤特异性的高通量诊断和治疗平台的绝对必要性。宫颈癌治疗构成多模式干预。全身治疗如化疗和/或局灶性放疗通常作为新辅助和/或辅助策略应用。顺铂构成标准宫颈癌治疗方法的组成部分。然而,尽管最初的患者反应,从头或延迟/获得性治疗抗性经常被报道,毒性令人担忧。化疗耐药与基因组的重大改变有关,代谢组学,表观遗传和蛋白质组景观。这导致与致癌和增殖生存相关的不平衡的体内平衡。抗凋亡的好处,和增强DNA损伤修复过程。尽管在过去的二十年中,癌症的诊断和治疗取得了重大进展,抗药性仍然是需要克服的主要障碍。
    尽管在治疗方面取得了进展,这种疾病的晚期和扩散到身体的其他部位往往会导致不良的结果。这凸显了迫切需要针对每个患者及其特定肿瘤定制的更好的诊断和治疗方法。宫颈癌的治疗通常涉及治疗的组合。化疗和聚焦放射治疗通常在手术前或手术后使用,以改善预后。然而,一些患者对这些治疗产生抗药性,从治疗开始或最初反应后。这种耐药性会使治疗效果降低,并增加副作用的风险。化疗抗性通常与癌细胞的基因和蛋白质的变化有关。这些变化破坏了细胞内的正常平衡,使它们更容易生长和生存,抵抗细胞死亡,修复由治疗引起的DNA损伤。尽管癌症研究和治疗取得了进展,耐药性仍然是一个重大挑战。本文旨在探讨获得性基因突变对宫颈癌耐药的影响。通过更好地理解这些突变,中低收入国家的研究人员和临床医生可以制定更有效的治疗策略,以改善患者的预后.
    Cervical cancer is the fourth most common cancer in women. Advanced stage and metastatic disease are often associated with poor clinical outcomes. This substantiates the absolute necessity for high-throughput diagnostic and treatment platforms that are patient and tumour specific. Cervical cancer treatment constitutes multimodal intervention. Systemic treatments such as chemotherapy and/or focal radiotherapy are typically applied as neoadjuvant and/or adjuvant strategies. Cisplatin constitutes an integral part of standard cervical cancer treatment approaches. However, despite initial patient response, de novo or delayed/acquired treatment resistance is often reported, and toxicity is of concern. Chemotherapy resistance is associated with major alterations in genomic, metabolomic, epigenetic and proteomic landscapes. This results in imbalanced homeostasis associated with pro-oncogenic and proliferative survival, anti-apoptotic benefits, and enhanced DNA damage repair processes. Although significant developments in cancer diagnoses and treatment have been made over the last two decades, drug resistance remains a major obstacle to overcome.
    Despite advances in treatment, the disease’s advanced stages and spread to other parts of the body often lead to poor outcomes. This highlights the urgent need for better diagnostic and treatment methods tailored to each patient and their specific tumour. Treatment for cervical cancer usually involves a combination of therapies. Chemotherapy and focused radiation therapy are commonly used before or after surgery to improve outcomes. However, some patients develop resistance to these treatments, either from the start or after initially responding to therapy. This resistance can make treatment less effective and increase the risk of side effects. Chemotherapy resistance is often linked to changes in the genes and proteins of cancer cells. These changes disrupt the normal balance within the cells, making them more prone to grow and survive, resist cell death, and repair DNA damage caused by treatment. Despite progress in cancer research and treatment, drug resistance remains a significant challenge. This review aims to explore how acquired genetic mutations contribute to drug resistance in cervical cancer. By understanding these mutations better, researchers and clinicians in low- to middle-income countries can develop more effective treatment strategies to improve outcomes for patients.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    边缘性卵巢肿瘤(BOT)显示出有趣的特征,将其与其他卵巢肿瘤区分开。系统评价的目的是分析BOT中发现的分子变化谱,并讨论其在整体治疗方法中的意义。系统评价包括2000年至2023年在数据库中发表的文章:PubMed,EMBASE,还有Cochrane.在详细分析现有出版物后,我们有资格进行系统评价:28篇关于原癌基因的出版物:BRAF,KRAS,NRAS,ERBB2和PIK3CA,20篇关于抑癌基因的出版物:BRCA1/2,ARID1A,CHEK2,PTEN,4对粘附分子:CADM1,8对蛋白质:B-catenin,糖蛋白上的claudin-1和5:E-Cadherin。此外,在系统审查的下一部分,我们纳入了8篇关于微卫星不稳定性的出版物和3篇描述BOT中杂合性丧失的出版物。在BOT中发现的分子变化可以根据具体情况而变化,通过分子分析识别致癌突变和开发靶向治疗代表了卵巢恶性肿瘤诊断和治疗的重大进展.分子研究对我们对BOT发病机制的理解做出了重要贡献,但仍需要大量研究来阐明卵巢肿瘤与外来疾病之间的关系,确定准确的预后指标,并开发有针对性的治疗方法。
    Borderline ovarian tumours (BOTs) show intriguing characteristics distinguishing them from other ovarian tumours. The aim of the systematic review was to analyse the spectrum of molecular changes found in BOTs and discuss their significance in the context of the overall therapeutic approach. The systematic review included articles published between 2000 and 2023 in the databases: PubMed, EMBASE, and Cochrane. After a detailed analysis of the available publications, we qualified for the systematic review: 28 publications on proto-oncogenes: BRAF, KRAS, NRAS, ERBB2, and PIK3CA, 20 publications on tumour suppressor genes: BRCA1/2, ARID1A, CHEK2, PTEN, 4 on adhesion molecules: CADM1, 8 on proteins: B-catenin, claudin-1, and 5 on glycoproteins: E-Cadherin. In addition, in the further part of the systematic review, we included eight publications on microsatellite instability and three describing loss of heterozygosity in BOT. Molecular changes found in BOTs can vary on a case-by-case basis, identifying carcinogenic mutations through molecular analysis and developing targeted therapies represent significant advancements in the diagnosis and treatment of ovarian malignancies. Molecular studies have contributed significantly to our understanding of BOT pathogenesis, but substantial research is still required to elucidate the relationship between ovarian neoplasms and extraneous disease, identify accurate prognostic indicators, and develop targeted therapeutic approaches.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:这项工作的目的是全面回顾和综合与免疫治疗治疗鼻窦粘膜黑色素瘤(SNMM)有关的文献,包括潜在的靶向基因突变,生存结果,和不良事件。
    方法:Embase,科克伦,Scopus,和WebofScience。
    方法:根据系统评价和荟萃分析陈述的首选报告项目设计研究方案。从开始到2023年5月23日搜索数据库。
    结果:共有42项研究符合纳入标准。纳入的研究中有24项报告了787名SNMM合并患者的基因突变。8.1%(95%置信区间,CI:7.6-8.6),18.9%(95%CI:18.1-19.8),8.5%(95%CI:8.1-9.0)的报告患者BRAF阳性,NRAS,和KIT突变,分别。活跃的肿瘤浸润淋巴细胞的存在与无复发生存率和总生存率(OS)的改善有关。6项研究报告辅助免疫疗法治疗后5年OS为42.6%(95%CI:39.4-45.8)。包括117名患者的13项研究报告了辅助或挽救性免疫检查点抑制剂(ICI)免疫疗法的反应率:40.2%(95%CI:36.8-43.6)具有阳性反应(肿瘤体积减少或消退)。11项研究报告了接受或未接受免疫治疗的SNMM患者之间的直接比较;大多数(7/11)报告了其整个队列或选择的SNMM患者亚组的生存益处。随着向现代ICI的过渡,佐剂ICI有更强的生存改善趋势。Ki67<40%的肿瘤可能对ICI的反应更好。
    结论:ICI治疗对特定SNMM患者有效,尤其是那些患有晚期/转移性疾病的患者。
    OBJECTIVE: The aim of this work is to comprehensively review and synthesize the literature related to sinonasal mucosal melanoma (SNMM) treatment with immunotherapy, including potentially targetable genetic mutations, survival outcomes, and adverse events.
    METHODS: Embase, Cochrane, Scopus, and Web of Science.
    METHODS: The study protocol was designed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Databases were searched from inception through May 23, 2023.
    RESULTS: A total of 42 studies met inclusion criteria. Twenty-four of the included studies reported genetic mutations for a combined 787 patients with SNMM. 8.1% (95% confidence interval, CI: 7.6-8.6), 18.9% (95% CI: 18.1-19.8), and 8.5% (95% CI: 8.1-9.0) of reported patients were positive for BRAF, NRAS, and KIT mutations, respectively. The presence of brisk tumor-infiltrating lymphocytes was associated with improved recurrence-free survival and overall survival (OS). Six studies reported a combined 5-year OS after adjuvant immunotherapy treatment of 42.6% (95% CI: 39.4-45.8). Thirteen studies encompassing 117 patients reported adjuvant or salvage immune checkpoint inhibitor (ICI) immunotherapy response rates: 40.2% (95% CI: 36.8-43.6) had a positive response (tumor volume reduction or resolution). Eleven studies reported direct comparisons between SNMM patients treated with or without immunotherapy; the majority (7/11) reported survival benefit for their entire cohort or select subgroups of SNMM patients. With the transition to modern ICIs, there is a stronger trend toward survival improvement with adjuvant ICI. Tumors with Ki67 <40% may respond better to ICI\'s.
    CONCLUSIONS: ICI therapy can be an effective in select SNMM patients, especially those with advanced/metastatic disease.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    我们的大多数遗传性乳腺癌基因不仅增加了患乳腺癌的风险,也增加了其他恶性肿瘤的风险。了解个体是否在遗传性乳腺癌基因中携带致病性变异不仅会影响对患者的筛查,也会影响对他或她的家庭成员的筛查。通过多基因小组识别和适当测试个体可以降低风险并在有风险的个体中进行早期监测。放射科医生可以作为女性的一线识别者,这些女性有患乳腺癌遗传倾向的风险,因为他们正在与所有接受常规筛查乳房X光检查的女性互动,并收集提示突变存在的家族史。我们在这里概述了国家综合癌症网络遗传/家族高风险:乳腺和卵巢(版本3.2019)中讨论的与高乳腺癌风险相关的11个基因,作为年度乳房X线照相术之外的额外乳腺癌筛查建议,作为乳腺癌筛查和降低风险的指南。以及非乳腺癌监测的建议。
    The majority of our hereditary breast cancer genes incur not only an increased risk for breast cancer but for other malignancies as well. Knowing whether an individual carries a pathogenic variant in a hereditary breast cancer gene can affect not only screening for the patient but for his or her family members as well. Identifying and appropriately testing individuals via multigene panels allows for risk reduction and early surveillance in at-risk individuals. Radiologists can serve as first-line identifiers of women who are at risk of having an inherited predisposition to breast cancer because they are interacting with all women receiving routine screening mammograms, and collecting family history suggestive of the presence of a mutation. We outline here the 11 genes associated with high breast cancer risk discussed in the National Comprehensive Cancer Network Genetic/Familial High-Risk: Breast and Ovarian (version 3.2019) as having additional breast cancer screening recommendations outside of annual mammography to serve as a guide for breast cancer screening and risk reduction, as well as recommendations for surveillance of nonbreast cancers.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    广义脓疱性皮疹具有多种病因,并且在首次出现时可能具有挑战性。作者提供了对常见脓疱性皮疹的深入分析,包括全身性脓疱型银屑病(3GPP)和急性全身性发疹性脓疱病,专注于他们的病理生理学,触发器,临床表现,诊断挑战,和管理策略。本文还重点介绍了在基因研究和生物疗法方面的最新进展,以及个性化医学和预防策略的未来方向。
    Generalized pustular rashes have various etiologies and can be challenging to diagnose and manage at first presentation. The authors provide an in-depth analysis of common pustular skin eruptions including generalized pustular psoriasis (GPP) and acute generalized exanthematous pustulosis, focusing on their pathophysiology, triggers, clinical presentation, diagnostic challenges, and management strategies. The article also highlights recent advances in genetic research and biologic therapies for GPP and the future directions in personalized medicine and prevention strategies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    CRISPR系统是一种革命性的基因组编辑工具,有可能彻底改变癌症研究和治疗领域。精确靶向和编辑驱动肿瘤生长和扩散的特定基因突变的能力为开发更有效和个性化的癌症治疗开辟了新的可能性。在这次审查中,我们将讨论针对癌症治疗提出的基于CRISPR的不同策略,包括驱动肿瘤生长的失活基因,增强对癌细胞的免疫反应,修复导致癌症的基因突变,并将抗癌分子直接传递给肿瘤细胞。我们还将总结基于CRISPR的癌症治疗的临床前研究和临床试验的现状,强调最有希望的结果和仍然需要克服的挑战。安全性和递送也是基于CRISPR的癌症治疗成为可行的临床选择的重要挑战。我们将讨论需要克服的挑战和限制,比如脱靶效应,安全,并运送到肿瘤部位。最后,我们将概述基于CRISPR的癌症治疗领域当前的挑战和机遇,并讨论未来的研究和发展方向。CRISPR系统有可能改变癌症研究的格局,本次审查旨在概述该领域的现状以及实现这一潜力所需克服的挑战。
    The CRISPR system is a revolutionary genome editing tool that has the potential to revolutionize the field of cancer research and therapy. The ability to precisely target and edit specific genetic mutations that drive the growth and spread of tumors has opened up new possibilities for the development of more effective and personalized cancer treatments. In this review, we will discuss the different CRISPR-based strategies that have been proposed for cancer therapy, including inactivating genes that drive tumor growth, enhancing the immune response to cancer cells, repairing genetic mutations that cause cancer, and delivering cancer-killing molecules directly to tumor cells. We will also summarize the current state of preclinical studies and clinical trials of CRISPR-based cancer therapy, highlighting the most promising results and the challenges that still need to be overcome. Safety and delivery are also important challenges for CRISPR-based cancer therapy to become a viable clinical option. We will discuss the challenges and limitations that need to be overcome, such as off-target effects, safety, and delivery to the tumor site. Finally, we will provide an overview of the current challenges and opportunities in the field of CRISPR-based cancer therapy and discuss future directions for research and development. The CRISPR system has the potential to change the landscape of cancer research, and this review aims to provide an overview of the current state of the field and the challenges that need to be overcome to realize this potential.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    心脏肿瘤可与遗传综合征相关。据报道,横纹肌瘤与结节性硬化症有关,带有卡尼复合体的粘液瘤,心脏纤维瘤伴Gorlin综合征,副神经节瘤伴多发性内分泌肿瘤综合征。与散发性病例相比,与遗传综合征相关的心脏肿瘤的表现和预后有所不同。了解相关综合征的遗传特征和心外表现对诊断至关重要,预后,和心脏肿瘤的管理。此外,需要在良性和恶性心脏肿瘤中识别基因突变,以实现个性化管理和改善治疗结果.因此,这篇综述讨论了与心脏肿瘤相关的遗传异常,目前的基因筛查建议,以及这些基因突变对结果的影响。
    Cardiac tumours can occur in association with genetic syndromes. Rhabdomyomas have been reported in association with tuberous sclerosis, myxomas with Carney\'s complex, cardiac fibromas with Gorlin syndrome, and paragangliomas with multiple endocrine neoplasm syndrome. The presentation and prognosis of cardiac tumours associated with genetic syndromes differ compared with sporadic cases. Knowledge about the associated syndromes\' genetic features and extracardiac manifestations is essential for the diagnosis, prognosis, and management of cardiac neoplasms. Moreover, identifying genetic mutations in benign and malignant cardiac tumours is needed to personalise management and improve treatment outcomes. Thus, this review discusses the genetic abnormalities associated with cardiac tumours, the current genetic screening recommendations, and the effect of those genetic mutations on the outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    皮肤黑色素瘤(CM)是一个越来越重要的公共卫生问题。由于惊人的死亡率和不断上升的发病率,了解其病因和识别新出现的生物标志物对于改善诊断和治疗策略至关重要.这篇综述旨在全面概述CM的多因素病因,强调早期检测的重要性,讨论黑色素瘤发展和进展背后的分子机制,并阐明了潜在生物标志物在诊断和治疗中的作用。CM的发病机制涉及遗传易感性和环境暴露的复杂相互作用,紫外线辐射是主要的环境危险因素。新的生物标志物的出现,例如新的免疫组织化学标记,基因突变分析,microRNA,和外泌体蛋白质表达,有望改善早期检测,以及预后和个性化治疗策略。
    Cutaneous melanoma (CM) is an increasingly significant public health concern. Due to alarming mortality rates and escalating incidence, it is crucial to understand its etiology and identify emerging biomarkers for improved diagnosis and treatment strategies. This review aims to provide a comprehensive overview of the multifactorial etiology of CM, underscore the importance of early detection, discuss the molecular mechanisms behind melanoma development and progression, and shed light on the role of the potential biomarkers in diagnosis and treatment. The pathogenesis of CM involves a complex interplay of genetic predispositions and environmental exposures, ultraviolet radiation exposure being the predominant environmental risk factor. The emergence of new biomarkers, such as novel immunohistochemical markers, gene mutation analysis, microRNA, and exosome protein expressions, holds promise for improved early detection, and prognostic and personalized therapeutic strategies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    非典型溶血性尿毒综合征(aHUS)是一种血栓性微血管病,以微血管病性溶血性贫血为特征,血小板减少症,和急性肾衰竭.补体级联在aHUS中起着不可或缺的作用。补体级联突变,特别是在替代途径(AP)导致级联的不调节和连续激活。Eculizumab和ravulizumab是抑制补体级联的人源化单克隆抗体。这项系统分析回顾了两种抗体的证据,以比较它们的安全性和有效性。这篇综述还将评估生物标志物与干预措施相关的证据,基因突变在疾病预后中的作用,以及两种治疗方案的经济负担。在PubMed进行了深入搜索,科学直接,和科克伦图书馆遵循PRISMA2020指南。eculizumab和ravulizumab在安全性和有效性方面具有可比性,但ravulizumab是患者及其护理人员的首选,因为它造成较低的经济负担并且给药频率较低。可溶性补体5b-9(sC5b),尤其是在尿液中,有可能用作生物标志物来评估对治疗的反应。基因突变,尤其是补体因子I(CFI)的突变,膜辅因子蛋白(MCP),和补体因子H(CFH),与较高的复发风险相关,因此,在尝试停止这一部分患者的治疗时,应谨慎行事.一旦发现基因突变,就应开始使用单克隆抗体进行治疗。失明,双臂,为了有效地比较两种单克隆抗体,需要进行临床试验,优选使用更大的样本量.
    Atypical hemolytic uremic syndrome (aHUS) is a type of thrombotic microangiopathy and is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney failure. The complement cascade plays an integral role in aHUS. Mutations in the complement cascade, especially in the alternative pathway (AP) lead to an unregulated and continuous activation of the cascade. Eculizumab and ravulizumab are humanized monoclonal antibodies that inhibit the complement cascade. This systematic analysis reviews the evidence for both antibodies to compare them in terms of safety and efficacy. This review will also assess the evidence for biomarker associations with interventions, the role of genetic mutations in the prognosis of disease, and the financial burden of both treatment options. An in-depth search was conducted across PubMed, Science Direct, and Cochrane Library following the PRISMA 2020 guidelines. Both eculizumab and ravulizumab were comparable in safety and efficacy but ravulizumab was preferred by patients and their caregivers as it posed a lower financial burden and had less frequent dosing. Soluble complement 5b-9 (sC5b), especially in urine, has the potential to be used as a biomarker to assess response to treatment. Genetic mutations, especially mutations in complement factor I (CFI), membrane cofactor protein (MCP), and complement factor H (CFH), were associated with a higher risk of recurrence, and therefore care should be taken when attempting to discontinue treatment in this subset of patients. Treatment with a monoclonal antibody should be initiated as soon as a genetic mutation is identified. Blinded, double-arm, clinical trials preferably with larger sample sizes are needed to effectively compare both the monoclonal antibodies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    心律失常性心肌病(ACM)是一种心肌疾病,其特征是由于纤维脂肪心肌置换导致的心肌瘢痕形成的表型特征,通常与整体或局部心室功能障碍有关。在首次描述致心律失常性右心室心肌病(ARVC)之后的几年中,通常认为左心室(LV)正常或受累程度最低.近年来,然而,LV参与已得到认可。与扩张型心肌病相比,它通常表现为早期心律失常,而不是心力衰竭症状。它可以是右心室,双心室,或者左心室.潜在的病理生理学涉及桥粒或非桥粒突变。磷化氢(PLN)突变是其中之一,与更严重的心律失常和SCD有关。这些患者应考虑使用ICD植入进行一级预防,即使是射血分数大于35%的人.此外,如果这些患者进展到D期心力衰竭,他们需要评估晚期心力衰竭治疗。
    Arrhythmogenic cardiomyopathy (ACM) is a myocardium disease characterized by phenotypic features of myocardial scarring due to fibrofatty myocardial replacement often associated with global or regional ventricular dysfunction. For years after arrhythmogenic right ventricular cardiomyopathy (ARVC) was first described, the left ventricle (LV) was generally considered normal or minimally involved. In recent years, however, LV involvement has been recognized. It usually presents with early-on arrhythmias more than heart failure symptoms compared to dilated cardiomyopathy. It can be right ventricular, biventricular, or left ventricular. The underlying pathophysiology involves either desmosomal or non-desmosomal mutations. Phospholamban (PLN) mutation is one of those and is associated with more severe arrhythmias and SCD. Primary prevention with ICD implantation should be considered in these patients, even the ones with an ejection fraction greater than 35%. In addition, if such patients progress to Stage D heart failure, they need to be evaluated for advanced heart failure therapies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号