Proto-Oncogene Proteins c-kit

原癌基因蛋白质 c - kit
  • 文章类型: Journal Article
    本研究旨在探讨桃花可溶性膳食纤维(PBSDF)和多酚(PBP)组合对洛哌丁胺(Lop)诱导的小鼠便秘的改善作用。以及可能的作用机制。结果表明,PBSDF和PBP的联合使用可以协同加速胃肠转运速率和胃排空速率,缩短首次红粪排便时间,加快排便频率,调节胃肠神经递质和促炎细胞因子的异常分泌,下调AQP3和AQP8的表达。Westernblot和RT-qPCR分析证实PBSDF+PBP上调SCF/C-kit信号通路中SCF和C-kit蛋白和mRNA的表达,下调NF-κB信号通路中促炎介质的表达。16SrRNA测序表明,肠道菌群的多样性和特定菌株的相对丰度,包括Akkermansia,拟杆菌,Ruminococus,落叶松科_NK4A136_组,和Turicibacter,PBSDF+PBP干预后恢复。这些发现表明,一定剂量的PBSDF和PBP的组合对减轻Lop引起的便秘具有协同作用。改善便秘的协同机制可能与调节NF-κB和SCF/C-kit信号通路有关,并调节便秘相关全身类型的特定肠道菌株。本研究提供了一种通过膳食纤维和多酚相互作用治疗便秘的新策略。
    This study aimed to investigate the ameliorating effects of peach blossom soluble dietary fiber (PBSDF) and polyphenol (PBP) combinations on loperamide (Lop)-induced constipation in mice, together with the possible mechanism of action. The results demonstrated that the combined use of PBSDF and PBP could synergistically accelerate the gastrointestinal transit rate and gastric emptying rate, shorten first red fecal defecation time, accelerate the frequency of defecation, regulate the abnormal secretion of gastrointestinal neurotransmitters and pro-inflammatory cytokines, and down-regulate the expressions of AQP3 and AQP8. Western blotting and RT-qPCR analysis confirmed that PBSDF + PBP up-regulated the protein and mRNA expressions of SCF and C-kit in SCF/C-kit signaling pathway, and down-regulated pro-inflammatory mediator expressions in NF-κB signaling pathway. 16S rRNA sequencing showed that the diversity of gut microbiota and the relative abundance of specific strains, including Akkermansia, Bacteroides, Ruminococcus, Lachnospiraceae_NK4A136_group, and Turicibacter, rehabilitated after PBSDF + PBP intervention. These findings suggested that the combination of a certain dose of PBSDF and PBP had a synergistic effect on attenuating Lop-induced constipation, and the synergistic mechanism in improving constipation might associated with the regulating NF-κB and SCF/C-kit signaling pathway, and modulating the specific gut strains on constipation-related systemic types. The present study provided a novel strategy via dietary fiber and polyphenol interactions for the treatment of constipation.
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  • 文章类型: Journal Article
    造血干细胞(HSC)通常从骨髓(BM)动员到血液循环用于临床移植。然而,单个干细胞退出骨髓的确切机制尚不清楚。这项研究确定了可动员的造血干细胞池的细胞外在和分子决定因素。我们发现一组HSC在其细胞表面显示巨噬细胞相关标记。虽然功能齐全,与缺乏巨噬细胞标记的干细胞相反,这些HSC被选择性地保留,强制动员后退出BM。HSC上的巨噬细胞标记可以通过细胞生长直接转移获得,受受体酪氨酸蛋白激酶C-Kit(CD117)调节,来自小鼠和人类环境中的BM常驻巨噬细胞。我们的研究提供了以下概念的证据:成体干细胞利用细胞生长迅速建立和激活功能调节的分子机制。
    Hematopoietic stem cells (HSCs) are routinely mobilized from the bone marrow (BM) to the blood circulation for clinical transplantation. However, the precise mechanisms by which individual stem cells exit the marrow are not understood. This study identified cell-extrinsic and molecular determinants of a mobilizable pool of blood-forming stem cells. We found that a subset of HSCs displays macrophage-associated markers on their cell surface. Although fully functional, these HSCs are selectively niche-retained as opposed to stem cells lacking macrophage markers, which exit the BM upon forced mobilization. Macrophage markers on HSCs could be acquired through direct transfer by trogocytosis, regulated by receptor tyrosine-protein kinase C-Kit (CD117), from BM-resident macrophages in mouse and human settings. Our study provides proof of concept that adult stem cells utilize trogocytosis to rapidly establish and activate function-modulating molecular mechanisms.
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  • 文章类型: Journal Article
    背景:仅在TanaToraja中发现了具有不同程度白色斑点的沼泽型水牛,南苏拉威西岛,印度尼西亚,根据托拉扬的习俗,发现的水牛公牛的价值很高。白色斑点脱色是由黑素细胞的缺乏引起的。然而,导致这种表型的遗传变异尚未被完全表征。这项研究的目的是鉴定负责这种独特的毛色模式的基因组区域和变体。
    结果:全基因组关联研究(GWAS)和选择特征分析根据28只固体和39只斑点水牛的全基因组测序数据,将MITF确定为关键基因,同时通过候选基因方法还发现KIT参与了该表型的发展。替代候选突变包括,除了先前报道的无义突变c.649C>T(p。Arg217*)和MITF中的剪接供体突变c.11792T>A,无意义突变c.2028T>A(p。Tyr676*)在工具包中。所有这三个突变都位于仅在印度尼西亚沼泽水牛中高度保守的基因组区域,它们在很大程度上(95%)是白色斑点的表现。最后但并非最不重要的,ADAMTS20和TWIST2也可能有助于这种涂层颜色图案的多样化。
    结论:本研究中确定的替代突变影响,至少部分地和独立地,黑素细胞的发育。这种突变的存在和持续存在可以通过在TanaToraja的历史RambuSolo仪式中使用的斑点水牛的重大财务和社会价值来解释,印度尼西亚。因此,斑点水牛的传统育种支持几种从头自发突变。
    BACKGROUND: Swamp-type buffaloes with varying degrees of white spotting are found exclusively in Tana Toraja, South Sulawesi, Indonesia, where spotted buffalo bulls are highly valued in accordance with the Torajan customs. The white spotting depigmentation is caused by the absence of melanocytes. However, the genetic variants that cause this phenotype have not been fully characterized. The objective of this study was to identify the genomic regions and variants responsible for this unique coat-color pattern.
    RESULTS: Genome-wide association study (GWAS) and selection signature analysis identified MITF as a key gene based on the whole-genome sequencing data of 28 solid and 39 spotted buffaloes, while KIT was also found to be involved in the development of this phenotype by a candidate gene approach. Alternative candidate mutations included, in addition to the previously reported nonsense mutation c.649 C > T (p.Arg217*) and splice donor mutation c.1179 + 2T > A in MITF, a nonsense mutation c.2028T > A (p.Tyr676*) in KIT. All these three mutations were located in the genomic regions that were highly conserved exclusively in Indonesian swamp buffaloes and they accounted largely (95%) for the manifestation of white spotting. Last but not the least, ADAMTS20 and TWIST2 may also contribute to the diversification of this coat-color pattern.
    CONCLUSIONS: The alternative mutations identified in this study affect, at least partially and independently, the development of melanocytes. The presence and persistence of such mutations may be explained by significant financial and social value of spotted buffaloes used in historical Rambu Solo ceremony in Tana Toraja, Indonesia. Several de novo spontaneous mutations have therefore been favored by traditional breeding for the spotted buffaloes.
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  • 文章类型: Case Reports
    粘膜黑素瘤(MM)代表不常见的黑素瘤形式。原发性胃肠道(GIT)黑色素瘤甚至更罕见。一名70岁的男性访问了辽宁省肿瘤医院和研究所,中国,由于过去两个月的上腹部不适。他的内窥镜检查显示了一个突出的,胃食管交界处(GEJ)的6厘米溃疡肿瘤。病变内镜活检显示肿瘤细胞弥漫性分布。他接受了胃大部切除术伴淋巴结清扫术(LND)。术后组织病理学显示肿瘤细胞呈弥漫性分布,具有许多肿瘤浸润淋巴细胞(TIL)和色素颗粒。免疫组织化学(IHC)结果对于S-100和HMB-45均为阳性。分子分析显示KIT基因外显子11突变。尽管临床医生强调对患者及其家人进行全身化疗和免疫治疗的必要性,患者未接受任何辅助治疗,术后36个月死亡.在胃肠道恶性肿瘤的鉴别诊断中应考虑GEJ的原发性恶性黑色素瘤。尤其是在通过系统检查排除转移源之后。
    Mucosal melanoma (MM) represents an uncommon form of melanoma. Primary gastrointestinal tract (GIT) melanoma is even rarer. A 70-year-old male visited the Liaoning Cancer Hospital and Institute, China, due to upper abdominal discomfort for the past two months. His endoscopy revealed a prominent, 6-cm ulcerated neoplasm in the gastroesophageal junction (GEJ). Lesion endoscopic biopsy showed diffusely distributed tumour cells. He underwent subtotal gastrectomy with lymph node dissection (LND). Postoperative histopathology revealed a diffuse distribution of tumour cells with numerous tumourinfiltrating lymphocytes (TILs) and pigment granules. Immunohistochemical (IHC) results were positive for both S-100 and HMB-45. Molecular analysis showed KIT gene exon 11 mutations. Although the clinicians emphasised the necessity of systemic chemotherapy and immunotherapy with the patient and his family, the patient did not receive any adjuvant therapy and died 36 months after surgery. Primary malignant melanoma of GEJ should be considered in a differential diagnosis for gastrointestinal malignancies, especially after excluding the source of metastasis through a systemic examination.
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  • 文章类型: Journal Article
    背景:大多数胃肠道间质瘤(GIST)存在c-KIT或PDGFRA突变。酪氨酸激酶抑制剂(TKIs)的施用显著改善了患有GIST的患者的存活率。我们旨在评估台湾晚期或复发性GIST患者的临床结局。
    方法:纳入2010年至2020年确诊的患者。收集的数据包括基线特征,治疗模式,治疗结果,遗传畸变和生存状态。分析无进展生存期(PFS)和总生存期(OS)并用Kaplan-Meier法绘制。Cox回归分析影响生存的预后因素。
    结果:共纳入224例接受TKIs治疗的晚期或复发性GIST患者。所有患者均接受伊马替尼治疗。93例和42例患者接受舒尼替尼和瑞戈非尼治疗,分别。使用伊马替尼治疗的患者48个月PFS和OS分别为50.5%和79.5%,分别。在多变量Cox回归分析中,c-KIT外显子9和PDGFRA突变是PFS不良的预后因素,PDGFRA突变是伊马替尼治疗患者OS不良的预后因素。接受舒尼替尼治疗的患者的中位PFS为12.76个月(95%置信区间(CI),11.01-14.52)。具有c-KIT外显子9突变的患者比具有其他遗传畸变的患者具有更长的PFS。接受regorafenib治疗的患者的中位PFS为7.14个月(95%CI,3.39-10.89)。
    结论:我们展示了接受TKIs治疗的晚期GIST患者的真实临床结果,并确定了突变状态作为患者生存的独立预后因素。
    BACKGROUND: Most gastrointestinal stromal tumors (GISTs) harbor c-KIT or PDGFRA mutations. Administration of tyrosine kinase inhibitors (TKIs) has significantly improved the survival of patients with GISTs. We aimed to evaluate the clinical outcome of advanced or recurrent GIST patients in Taiwan.
    METHODS: Patients diagnosed between 2010 and 2020 were enrolled. The collected data included baseline characteristics, treatment pattern, treatment outcome, genetic aberrations and survival status. Progression-free survival (PFS) and overall survival (OS) were analyzed and plotted with the Kaplan-Meier method. Cox regression analysis was used to analyze the prognostic factors of survival.
    RESULTS: A total of 224 patients with advanced or recurrent GISTs treated with TKIs were enrolled. All patients received imatinib treatment. Ninety-three and 42 patients received sunitinib and regorafenib treatment, respectively. The 48-month PFS and OS rates for patients treated with imatinib were 50.5% and 79.5%, respectively. c-KIT exon 9 and PDGFRA mutations were prognostic factors for a poor PFS and PDGFRA mutation was a prognostic factor for a poor OS in patients treated with imatinib in multivariate Cox regression analysis. The median PFS of patients who received sunitinib treatment was 12.76 months (95% confidence interval (CI), 11.01-14.52). Patients with c-KIT exon 9 mutations had a longer PFS than those with other genetic aberrations. The median PFS of patients treated with regorafenib was 7.14 months (95% CI, 3.39-10.89).
    CONCLUSIONS: We present real-world clinical outcomes for advanced GIST patients treated with TKIs and identify mutational status as an independent prognostic factor for patient survival.
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  • 文章类型: English Abstract
    OBJECTIVE: To analyze the factors affecting overall survival (OS) of adult patients with core-binding factor acute myeloid leukemia (CBF-AML) and establish a prediction model.
    METHODS: A total of 216 newly diagnosed patients with CBF-AML in the First Affiliated Hospital of Zhengzhou University from May 2015 to July 2021 were retrospectively analyzed. The 216 CBF-AML patients were divided into the training and the validation cohort at 7∶3 ratio. The Cox regression model was used to analyze the clinical factors affecting OS. Stepwise regression was used to establish the optimal model and the nomogram. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the model performance.
    RESULTS: Age(≥55 years old), peripheral blood blast(≥80%), fusion gene (AML1-ETO), KIT mutations were identified as independent adverse factors for OS. The area under the ROC curve at 3-year was 0.772 and 0.722 in the training cohort and validation cohort, respectively. The predicted value of the calibration curve is in good agreement with the measured value. DCA shows that this model performs better than a single factor.
    CONCLUSIONS: This prediction model is simple and feasible, and can effectively predict the OS of CBF-AML, and provide a basis for treatment decision.
    UNASSIGNED: 核心结合因子相关成人急性髓系白血病患者总生存临床预测模型的建立.
    UNASSIGNED: 分析影响核心结合因子相关成人急性髓系白血病(CBF-AML)患者总生存(OS)的因素,并建立预测模型。.
    UNASSIGNED: 回顾性分析2015年5月至2021年7月在郑州大学第一附属医院新诊断的216例CBF-AML的临床资料。将患者按照7∶3随机分成训练集和验证集。采用Cox回归模型对影响OS的临床因素进行分析。采用逐步回归建立最优模型,画出列线图。使用受试者工作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)评估模型性能。.
    UNASSIGNED: 年龄≥55 岁、外周血原始幼稚≥80%、AML1-ETO、KIT突变被确定为OS的独立预后不良因素。训练集和验证集3年ROC下面积分别为0.772、0.722;校正曲线预测值与实测值具有较好一致性。DCA表明此模型性能优于单一因素。.
    UNASSIGNED: 该预测模型简便易行,可有效预测CBF-AML的OS,为治疗决策提供依据。.
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  • 文章类型: Journal Article
    背景:Piebaldism是一种罕见的常染色体显性疾病,其特征是先天性白前锁和色素沉着斑块,这通常是由KIT基因的有害变异引起的。
    方法:通过全外显子组测序在piebaldism病例系列中鉴定出4种KIT变异体。功能实验,包括体外小基因报告试验和酶联免疫吸附试验,进行以阐明变体的致病性。通过广泛的文献综述,总结了基因型与表型的相关性。
    结果:所有4例患者均有严重的piebalism,表现为典型的白色前锁和腹侧躯干和四肢的弥漫性色素脱失。鉴定了KIT基因酪氨酸激酶(TK)结构域的四种种系变体:两种新变体c.19901G>A(p。Pro627_Gly664delinsArg)和c.2716T>C(p。Cys906Arg),和两个已知的变体c.1879+1G>A(p。Gly592_Pro627delinsAla)和c.1747G>A(p。Glu583Lys)。两种剪接变体都导致TK1结构域中的外显子跳跃和帧内缺失。错义变体位于TK1和TK2结构域,分别损害PI3K/AKT和MAPK/ERK信号通路,KIT的下游。所有严重病例都与TK域的变异相关,引发疾病的主要显性负机制。
    结论:我们的数据扩展了KIT的突变谱,在严重的情况下,关键TK域中变体的显性负效应强调。我们还分享了受影响家庭的产前诊断和知情生殖选择的经验。
    BACKGROUND: Piebaldism is a rare autosomal dominant disorder characterized by congenital white forelock and depigmented patches, which is most commonly caused by deleterious variants in the KIT gene.
    METHODS: Four KIT variants were identified in a piebaldism case series by whole-exome sequencing. Functional experiments, including in vitro minigene reporter assay and enzyme-linked immunosorbent assay, were carried out to elucidate the pathogenicity of the variants. The genotype-phenotype correlation was summarized through extensive literature reviewing.
    RESULTS: All the four cases had severe piebaldism presented with typical white forelock and diffuse depigmentation on the ventral trunk and limbs. Four germline variants at the tyrosine kinase (TK) domains of the KIT gene were identified: two novel variants c.1990+1G>A (p.Pro627_Gly664delinsArg) and c.2716T>C (p.Cys906Arg), and two known variants c.1879+1G>A (p.Gly592_Pro627delinsAla) and c.1747G>A (p.Glu583Lys). Both splicing variants caused exon skipping and inframe deletions in the TK1 domain. The missense variants resided at the TK1 and TK2 domains respectively impairing PI3K/AKT and MAPK/ERK signaling pathways, the downstream of KIT. All severe cases were associated with variants in the TK domains, eliciting a major dominant-negative mechanism of the disease.
    CONCLUSIONS: Our data expand the mutation spectrum of KIT, emphasized by a dominant-negative effect of variants in the critical TK domains in severe cases. We also share the experience of prenatal diagnosis and informed reproductive choices for the affected families.
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  • 文章类型: Journal Article
    目的: 探讨原发性纵隔卵黄囊瘤中转移性胸腔积液的液基涂片及细胞蜡块的形态特征、免疫表型、诊断与鉴别诊断及临床特点。 方法: 收集3例术前胸腔积液,经术后组织病理确诊为原发性纵隔卵黄囊瘤的患者,回顾性分析患者的临床病理资料,复习胸腔积液细胞涂片及细胞蜡块的形态特征、免疫表型,分析容易误诊的原因,并复习相关文献。 结果: 3例患者均为男性,年龄分别为19、20和32岁,平均年龄24岁。胸腔积液细胞涂片镜下示:数量不等的肿瘤细胞呈球团状、乳头状排列;肿瘤细胞大,异型性明显;细胞核大而深染,核质比增高,核膜不规则,可见明显小核仁;核染色质粗糙;胞质内多少不等的黏液样空泡。免疫表型:肿瘤细胞甲胎蛋白、广谱细胞角蛋白、SALL4、CD117均阳性,胎盘碱性磷酸酶、Glypican-3均2例阳性,Ki-67阳性指数均>80%。 结论: 原发性纵隔卵黄囊瘤是一类临床罕见的恶性生殖细胞肿瘤,当患者术前发生胸腔积液时容易导致误诊,因此确诊需结合详细的临床及影像学资料、胸腔积液的细胞学形态特征,加做细胞蜡块及免疫标记,有助于提高诊断的准确性。.
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  • 文章类型: Journal Article
    头颅放疗是白血病和脑肿瘤的主要治疗方法。我们先前的研究发现,颅骨照射的远视效应可能导致小鼠精子发生障碍。然而,确切的机制尚未完全了解。在研究中,成年雄性C57BL/6小鼠接受20GyX射线颅骨照射(每天5Gy,连续4天),并在第1、2和4周处死。在头颅照射后4周,将睾丸串联质量标签(TMT)定量蛋白质组学与生物信息学分析相结合,以鉴定与精子发生相关的关键分子和信号通路。GO分析表明,精子发生与氧化应激和炎症密切相关。严重的氧化应激发生在睾丸,血清和大脑,而严重的炎症也发生在睾丸和血清中。此外,与下丘脑-垂体-性腺(HPG)轴相关的性激素被破坏。PI3K/Akt通路在睾丸中被激活,上游分子SCF/C-Kit显著升高。此外,精原干细胞(SSC)的增殖和分化能力发生改变。这些发现表明,颅骨照射可通过脑-血-睾丸级联氧化应激引起精子发生障碍,炎症和HPG轴的分泌功能障碍,SCF/C-kit通过激活PI3K/Akt途径驱动这一过程。
    Cranial radiotherapy is a major treatment for leukemia and brain tumors. Our previous study found abscopal effects of cranial irradiation could cause spermatogenesis disorder in mice. However, the exact mechanisms are not yet fully understood. In the study, adult male C57BL/6 mice were administrated with 20 Gy X-ray cranial irradiation (5 Gy per day for 4 days consecutively) and sacrificed at 1, 2 and 4 weeks. Tandem Mass Tag (TMT) quantitative proteomics of testis was combined with bioinformatics analysis to identify key molecules and signal pathways related to spermatogenesis at 4 weeks after cranial irradiation. GO analysis showed that spermatogenesis was closely related to oxidative stress and inflammation. Severe oxidative stress occurred in testis, serum and brain, while serious inflammation also occurred in testis and serum. Additionally, the sex hormones related to hypothalamic-pituitary-gonadal (HPG) axis were disrupted. PI3K/Akt pathway was activated in testis, which upstream molecule SCF/C-Kit was significantly elevated. Furthermore, the proliferation and differentiation ability of spermatogonial stem cells (SSCs) were altered. These findings suggest that cranial irradiation can cause spermatogenesis disorder through brain-blood-testicular cascade oxidative stress, inflammation and the secretory dysfunction of HPG axis, and SCF/C-kit drive this process through activating PI3K/Akt pathway.
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  • 文章类型: Journal Article
    RAS/RAF/MEK/ERK信号的异常激活对于KIT突变介导的胃肠道间质瘤(GIST)的肿瘤发生至关重要。在这项研究中,我们发现抑制RAF1抑制了GIST中野生型KIT和原发性KIT突变的激活,原发性KIT突变显示出更高的敏感性。这表明KIT和RAF1之间存在正反馈回路,其中RAF1促进KIT信号传导。我们进一步证明RAF1与KIT相关,RAF1的激酶活性对于其对KIT激活的贡献是必需的。因此,抑制RAF1抑制细胞存活,扩散,以及由野生型KIT和原发性KIT突变介导的体外细胞周期进程。体内抑制RAF1抑制了携带种系KIT/V558A突变的转基因小鼠模型中的GIST生长,显示与伊马替尼相似的治疗效率,GIST的一线靶向治疗药物,而联合使用伊马替尼和RAF1抑制剂进一步抑制了肿瘤的生长。获得KIT的耐药次级突变是GIST靶向治疗后治疗失败的主要原因。像野生型KIT和原发性KIT突变一样,抑制RAF1抑制了继发性KIT突变的激活,和细胞存活,扩散,体外细胞周期进程,和继发性KIT突变介导的体内肿瘤生长。然而,与原发性KIT突变相比,继发性KIT突变的激活对RAF1的依赖性较小.一起来看,我们的结果表明,RAF1促进KIT信号和KIT突变介导的GIST的肿瘤发生,提供进一步研究RAF1抑制剂单独或与KIT抑制剂联合治疗GIST的理由,特别是在对KIT抑制剂有抗性的情况下。
    The aberrant activation of RAS/RAF/MEK/ERK signaling is important for KIT mutation-mediated tumorigenesis of gastrointestinal stromal tumor (GIST). In this study, we found that inhibition of RAF1 suppresses the activation of both wild-type KIT and primary KIT mutations in GIST, with primary KIT mutations showing greater sensitivity. This suggests a positive feedback loop between KIT and RAF1, wherein RAF1 facilitates KIT signaling. We further demonstrated that RAF1 associates with KIT and the kinase activity of RAF1 is necessary for its contribution to KIT activation. Accordingly, inhibition of RAF1 suppressed cell survival, proliferation, and cell cycle progression in vitro mediated by both wild-type KIT and primary KIT mutations. Inhibition of RAF1 in vivo suppressed GIST growth in a transgenic mouse model carrying germline KIT/V558A mutation, showing a similar treatment efficiency as imatinib, the first-line targeted therapeutic drug of GIST, while the combination use of imatinib and RAF1 inhibitor further suppressed tumor growth. Acquisition of drug-resistant secondary mutation of KIT is a major cause of treatment failure of GIST following targeted therapy. Like wild-type KIT and primary KIT mutations, inhibition of RAF1 suppressed the activation of secondary KIT mutation, and the cell survival, proliferation, cell cycle progression in vitro, and tumor growth in vivo mediated by secondary KIT mutation. However, the activation of secondary KIT mutation is less dependent on RAF1 compared with that of primary KIT mutations. Taken together, our results revealed that RAF1 facilitates KIT signaling and KIT mutation-mediated tumorigenesis of GIST, providing a rationale for further investigation into the use of RAF1 inhibitors alone or in combination with KIT inhibitor in the treatment of GIST, particularly in cases resistant to KIT inhibitors.
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