somatic mutations

体细胞突变
  • 文章类型: Journal Article
    切除修复交叉互补组2(ERCC2)编码DNA解旋酶着色性干皮病D组,在转录和核苷酸切除修复中起作用。ERCC2中的点突变是约10%的膀胱癌(BLCA)的推定驱动因素,并且是顺铂治疗反应的潜在阳性生物标志物。然而,直接归因于ERCC2突变的预后意义及其在基因组不稳定中的致病作用仍然知之甚少.我们首次证明突变型ERCC2是BLCA预后的独立预测因子。然后,我们使用一组ERCC2野生型(n=343)和突变体(n=39)BLCA全基因组检查了其对体细胞突变景观的影响。在ERCC2突变体中,体细胞突变的全基因组分布显着改变,包括T[C>T]N富集,改变了复制时间相关性,和CTCF-粘附素结合位点突变热点。我们利用这些改变来开发用于预测致病性ERCC2突变的机器学习模型。这可能有助于告知BLCA患者的治疗。
    Excision repair cross-complementation group 2 (ERCC2) encodes the DNA helicase xeroderma pigmentosum group D, which functions in transcription and nucleotide excision repair. Point mutations in ERCC2 are putative drivers in around 10% of bladder cancers (BLCAs) and a potential positive biomarker for cisplatin therapy response. Nevertheless, the prognostic significance directly attributed to ERCC2 mutations and its pathogenic role in genome instability remain poorly understood. We first demonstrated that mutant ERCC2 is an independent predictor of prognosis in BLCA. We then examined its impact on the somatic mutational landscape using a cohort of ERCC2 wild-type (n = 343) and mutant (n = 39) BLCA whole genomes. The genome-wide distribution of somatic mutations is significantly altered in ERCC2 mutants, including T[C>T]N enrichment, altered replication time correlations, and CTCF-cohesin binding site mutation hotspots. We leverage these alterations to develop a machine learning model for predicting pathogenic ERCC2 mutations, which may be useful to inform treatment of patients with BLCA.
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  • 文章类型: Journal Article
    背景:植物分生组织是由不同的干细胞层组成的结构化器官,分化为新的植物组织。分生组织层中的突变可以传播到植物的大部分。然而,分生组织突变的特征仍不清楚,限制了我们对体细胞克隆表型变异的遗传基础的理解。
    结果:这里,我们分析了杏树体细胞突变的频率和分布。我们分别对整个树上采样的几种果实的表皮(从分生组织层1发育)和果肉(从分生组织层2发育)进行测序。我们发现大多数体细胞突变(>90%)是个体层特有的。有趣的是,层1显示比层2更高的突变负荷,这意味着层之间的突变动力学不同。体细胞突变的分布遵循树的分支。这表明体细胞突变通过腋生分生组织传播到发育中的分支。反过来,这导致了我们意想不到的观察,即远处分支的第1层的基因组比相同分支的第2层的基因组更相似。最后,使用单细胞RNA测序,我们证明,层特异性突变仅在相应层的细胞中转录,并且可以形成体细胞克隆表型变异的遗传基础。
    结论:这里,我们分析了分生组织起源的体细胞突变的频率和分布。我们对体细胞突变的层特异性的观察概述了它们是如何分布的,它们是如何传播的,以及它们如何影响克隆繁殖的作物。
    BACKGROUND: Plant meristems are structured organs consisting of distinct layers of stem cells, which differentiate into new plant tissue. Mutations in meristematic layers can propagate into large sectors of the plant. However, the characteristics of meristematic mutations remain unclear, limiting our understanding of the genetic basis of somaclonal phenotypic variation.
    RESULTS: Here, we analyse the frequency and distribution of somatic mutations in an apricot tree. We separately sequence the epidermis (developing from meristem layer 1) and the flesh (developing from meristem layer 2) of several fruits sampled across the entire tree. We find that most somatic mutations (> 90%) are specific to individual layers. Interestingly, layer 1 shows a higher mutation load than layer 2, implying different mutational dynamics between the layers. The distribution of somatic mutations follows the branching of the tree. This suggests that somatic mutations are propagated to developing branches through axillary meristems. In turn, this leads us to the unexpected observation that the genomes of layer 1 of distant branches are more similar to each other than to the genomes of layer 2 of the same branches. Finally, using single-cell RNA sequencing, we demonstrate that layer-specific mutations were only transcribed in the cells of the respective layers and can form the genetic basis of somaclonal phenotypic variation.
    CONCLUSIONS: Here, we analyse the frequency and distribution of somatic mutations with meristematic origin. Our observations on the layer specificity of somatic mutations outline how they are distributed, how they propagate, and how they can impact clonally propagated crops.
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  • 文章类型: Journal Article
    背景:已观察到体细胞突变可诱导产生醛固酮的腺瘤(APAs)。这些可能在怀孕期间加速。体细胞PRKACA突变在产生皮质醇的腺瘤(CPAs)中很常见。然而,他们在APA中的作用,特别是醛固酮和皮质醇产生腺瘤(A/CPAs),不是很了解。本研究旨在探讨PRKACA突变与妊娠期间A/CPA加速发育之间的关系。
    方法:一名原发性醛固酮增多症(PA)合并严重库欣综合征(CS)的患者在分娩后一年接受肾上腺肿瘤手术切除。病理检查显示,肾上腺皮质腺瘤的特征主要是肾小球带增生。体细胞突变分析显示存在体细胞PRKACA突变,它被各种计算数据库验证为有害突变。免疫组织化学结果显示细胞色素P450家族11亚家族B成员1(CYP11B1)染色呈阳性,细胞色素P450家族11亚家族B成员2(CYP11B2),和黄体生成素/绒毛膜促性腺激素受体(LHCGR)。我们的研究包括20例先前记录的醛固酮和皮质醇产生腺瘤(A/CPAs)病例的回顾,其中2例CYP11B1和CYP11B2同时呈阳性,与我们的发现一致.
    结论:PRKACA的体细胞突变可能与LHCGR的上调有关,协同驱动共同分泌肿瘤在怀孕期间加速生长,从而加剧疾病进展。
    BACKGROUND: Somatic mutations have been observed to induce aldosterone-producing adenomas (APAs). These may be accelerated during pregnancy. Somatic PRKACA mutations are common in cortisol-producing adenomas (CPAs). However, their role in APAs, particularly aldosterone- and cortisol-producing adenomas (A/CPAs), is not well understood. This study aims to investigate the association between PRKACA mutations and the accelerated development of A/CPAs during pregnancy.
    METHODS: A patient with primary aldosteronism (PA) associated with severe Cushing\'s syndrome (CS) underwent surgical resection of an adrenal tumor one year after delivery. Pathologic examination revealed an adrenocortical adenoma characterized primarily by zona glomerulosa hyperplasia. Somatic mutation analysis revealed the presence of the somatic PRKACA mutation, which was validated as a deleterious mutation by various computational databases. Immunohistochemical results showed positive staining for cytochrome P450 family 11 subfamily B member 1 (CYP11B1), cytochrome P450 family 11 subfamily B member 2 (CYP11B2), and luteinizing hormone/chorionic gonadotropin receptor (LHCGR). Our study included a review of 20 previously documented cases of aldosterone- and cortisol-producing adenomas (A/CPAs), two of which were concurrently positive for both CYP11B1 and CYP11B2, consistent with our findings.
    CONCLUSIONS: Somatic mutations in PRKACA may correlate with the upregulation of LHCGR, which synergistically drives the accelerated growth of co-secretion tumors during pregnancy, thereby exacerbating disease progression.
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  • 文章类型: Journal Article
    目的:骨转移(BoM)与非小细胞肺癌(NSCLC)患者的发病率增加和生存预后不良密切相关。鉴于其重大影响,本研究旨在系统比较有和无BoM的晚期NSCLC患者的生物学特征.方法:在本研究中,我们通过下一代测序(NGS)小组分析了42例无BoM的晚期NSCLC患者和67例BoM患者肿瘤组织DNA的基因组改变.采用电感耦合等离子体发射光谱法(ICP-MS)检测血清中18种重金属的浓度。结果:在67例BoM患者中的61例(91.05%)和42例无BoM患者中的37例(88.10%)中,共鉴定出18个突变基因的157个体细胞突变和跨越16个突变基因的105个体细胞突变。分别。在这些突变的基因中,NTRK1,FGFR1,ERBB4,NTRK3和FGFR2仅在BoM患者中脱颖而出,而BRAF,GNAS,而AKT1仅在没有BoM的情况下表现出来。此外,BoM患者的共现基因集和互斥基因集不同于无BoM患者.此外,BoM患者的血清Cu和Sr浓度明显高于无BoM患者。我们的目标之一是探索这些与BoM相关的重金属如何与其他重金属相互作用,Cu和Co之间呈显著正相关,在Cu和Cr之间,在Sr和Ba之间,BoM患者的Sr和Ni之间。鉴于分子特征对患者预后的显著影响,我们还观察到EGFR突变与Co,TP53突变与Cd呈显著正相关。结论:基因组改变,体细胞相互作用,关键信号通路,功能生物信息,血清重金属的积累在有和没有BoM的晚期NSCLC患者之间有显著差异,和某些重金属(例如,Cu,Sr)可能有潜力识别患有BoM的高风险患者。
    Purpose: Bone metastasis (BoM) has been closely associated with increased morbidity and poor survival outcomes in patients with non-small cell lung cancer (NSCLC). Given its significant implications, this study aimed to systematically compare the biological characteristics between advanced NSCLC patients with and without BoM. Methods: In this study, the genomic alterations from the tumor tissue DNA of 42 advanced NSCLC patients without BoM and 67 patients with BoM and were analyzed by a next-generation sequencing (NGS) panel. The serum concentrations of 18 heavy metals were detected by inductively coupled plasma emission spectrometry (ICP-MS). Results: A total of 157 somatic mutations across 18 mutated genes and 105 somatic mutations spanning 16 mutant genes were identified in 61 out of 67 (91.05%) patients with BoM and 37 of 42 (88.10%) patients without BoM, respectively. Among these mutated genes, NTRK1, FGFR1, ERBB4, NTRK3, and FGFR2 stood out exclusively in patients with BoM, whereas BRAF, GNAS, and AKT1 manifested solely in those without BoM. Moreover, both co-occurring sets of genes and mutually exclusive sets of genes in patients with BoM were different from those in patients without BoM. In addition, the serum concentrations of Cu and Sr in patients with BoM were significantly higher than in patients without BoM. One of our aims was to explore how these heavy metals associated with BoM interacted with other heavy metals, and significant positive correlations were observed between Cu and Co, between Cu and Cr, between Sr and Ba, and between Sr and Ni in patients with BoM. Given the significant impacts of molecular characteristics on patients\' prognosis, we also observed a noteworthy negative correlation between EGFR mutations and Co, alongside a significant positive correlation between TP53 mutations and Cd. Conclusions: The genomic alterations, somatic interactions, key signaling pathways, functional biological information, and accumulations of serum heavy metals were markedly different between advanced NSCLC patients with and without BoM, and certain heavy metals (e.g., Cu, Sr) might have potentials to identify high-risk patients with BoM.
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  • 文章类型: Journal Article
    The mutation rate is a pivotal biological characteristic, intricately governed by natural selection and historically garnering considerable attention. Recent advances in high-throughput sequencing and analytical methodologies have profoundly transformed our understanding in this domain, ushering in an unprecedented era of mutation rate research. This paper aims to provide a comprehensive overview of the key concepts and methodologies frequently employed in the study of mutation rates. It examines various types of mutations, explores the evolutionary dynamics and associated theories, and synthesizes both classical and contemporary hypotheses. Furthermore, this review comprehensively explores recent advances in understanding germline and somatic mutations in animals and offers an overview of experimental methodologies, mutational patterns, molecular mechanisms, and driving forces influencing variations in mutation rates across species and tissues. Finally, it proposes several potential research directions and pressing questions for future investigations.
    突变率是生命演化过程中的一个重要参数。它受到自然选的择精细调控,因此在演化生物学的研究历史上备受关注。近年来,随着高通量测序的发展和突变分析方法的进步,我们对突变率的理解有了显著地加深,突变的研究进入了一个前所未有的新时代。该文总结和讨论了突变研究中常见的演化生物学概念和经典的理论方法:我们首先详细介绍了突变的类型;之后,在此基础上探索前人提出的与演化动力学相关的理论模型;最后对经典假说与当代理论进行深入探讨和比较。此外,该文全面总结了动物生殖细胞和体细胞突变的最新进展:我们概述了这些研究过程中使用的实验方法、突变模式、突变的分子机制以及影响突变率变化的因素,并探讨了物种间和相同个体不同组织间突变率的差异。最终,我们概述了突变研究中未来潜在的研究方向和亟待解决的科学问题。.
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  • 文章类型: Journal Article
    目的:肺腺癌(LUAD)的发病率逐年升高,预后较差。这促使研究人员研究LUAD患者的生存率,以确保患者能够及时治愈或在适当治疗后生存。目前还没有完全有效的模型可以应用于临床实践。
    方法:我们引入了基于struc2vec的多组学数据集成(SBMOI),可以整合基因表达,体细胞突变和临床数据构建代表LUAD患者特征的突变基因载体。根据病人的特征,随机生存森林(RSF)模型用于预测LUAD患者的长期和短期生存。为了进一步证明SBMOI的优越性,我们同时将无标度基因共表达网络(FCN)替换为蛋白质-蛋白质相互作用(PPI)网络和显著共表达网络(SCN),以比较相同条件下预测LUAD患者生存率的准确性.
    结果:我们的结果表明,与SCN和PPI网络相比,基于FCN的SBMOI联合RSF模型在LUAD患者的长期和短期生存预测任务中具有更好的表现。1年的AUC,5年,验证数据集中的10年生存率分别为0.791,0.825和0.917.
    结论:这项研究为多组数据整合提供了一种强大的基于网络的方法。SBMOI联合RSF成功预测了LUAD患者的长期和短期生存。特别是对长期生存的高精度。此外,SBMOI算法有可能与其他机器学习模型相结合来完成聚类或分层任务,并应用于其他疾病。
    OBJECTIVE: The morbidity of lung adenocarcinoma (LUAD) has been increasing year by year and the prognosis is poor. This has prompted researchers to study the survival of LUAD patients to ensure that patients can be cured in time or survive after appropriate treatment. There is still no fully valid model that can be applied to clinical practice.
    METHODS: We introduced struc2vec-based multi-omics data integration (SBMOI), which could integrate gene expression, somatic mutations and clinical data to construct mutation gene vectors representing LUAD patient features. Based on the patient features, the random survival forest (RSF) model was used to predict the long- and short-term survival of LUAD patients. To further demonstrate the superiority of SBMOI, we simultaneously replaced scale-free gene co-expression network (FCN) with a protein-protein interaction (PPI) network and a significant co-expression network (SCN) to compare accuracy in predicting LUAD patient survival under the same conditions.
    RESULTS: Our results suggested that compared with SCN and PPI network, the FCN based SBMOI combined with RSF model had better performance in long- and short-term survival prediction tasks for LUAD patients. The AUC of 1-year, 5-year, and 10-year survival in the validation dataset were 0.791, 0.825, and 0.917, respectively.
    CONCLUSIONS: This study provided a powerful network-based method to multi-omics data integration. SBMOI combined with RSF successfully predicted long- and short-term survival of LUAD patients, especially with high accuracy on long-term survival. Besides, SBMOI algorithm has the potential to combine with other machine learning models to complete clustering or stratificational tasks, and being applied to other diseases.
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  • 文章类型: Journal Article
    背景:结直肠癌(CRC)是全球主要癌症。微生物剂已被认为有助于不同疾病的发病机理。但CRC与微生物群之间的潜在相关性仍不清楚。
    方法:我们解剖了41例CRC患者的匹配肿瘤和正常粘膜组织的粪便微生物组结构以及基因组和转录组概况。其中,通过外显子组测序技术研究了CRC相关细菌类群与其显著相关的体细胞突变基因之间的关系。CRC中差异表达的功能基因根据其与差异丰富的物种的相关性进行聚类。下面是带有DAVID的注释。免疫和基质细胞类型的组成由XCELL鉴定。
    结果:我们确定了一组与CRC相关的22种微生物肠道物种,并估计了KEGG本体类别的相对丰度。接下来,评估了CRC相关肠道微生物与临床表型之间的相互作用.4个显著突变的基因:TP53,APC,KRAS,指出了SMAD4,并鉴定了与癌症相关微生物的关联。其中,核梭杆菌与不同宿主代谢途径呈正相关。最后,我们发现核梭杆菌通过TNFSF9基因的表达改变了肿瘤的免疫环境。
    结论:总的来说,我们的多组学数据可以帮助识别新的生物标志物,为CRC检测和诊断的临床决策提供信息.
    Colorectal cancer (CRC) is the leading cancer worldwide. Microbial agents have been considered to contribute to the pathogenesis of different disease. But the underlying relevance between CRC and microbiota remain unclear.
    We dissected the fecal microbiome structure and genomic and transcriptomic profiles of matched tumor and normal mucosa tissues from 41 CRC patients. Of which, the relationship between CRC-associated bacterial taxa and their significantly correlated somatic mutated gene was investigated by exome sequencing technology. Differentially expressed functional genes in CRC were clustered according to their correlation with differentially abundant species, following by annotation with DAVID. The composition of immune and stromal cell types was identified by XCELL.
    We identified a set of 22 microbial gut species associated with CRC and estimate the relative abundance of KEGG ontology categories. Next, the interactions between CRC-related gut microbes and clinical phenotypes were evaluated. 4 significantly mutated gene: TP53, APC, KRAS, SMAD4 were pointed out and the associations with cancer related microbes were identified. Among them, Fusobacterium nucleatum positively corelated with different host metabolic pathways. Finally, we revealed that Fusobacterium nucleatum modified the tumor immune environment by TNFSF9 gene expression.
    Collectively, our multi-omics data could help identify novel biomarkers to inform clinical decision-making in the detection and diagnosis of CRC.
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  • 文章类型: Journal Article
    背景:香蕉的种植遇到了很大的障碍,特别是由于冷应激对其生长和生产力的不利影响。已获得关注的潜在补救措施是利用甲磺酸乙酯(EMS)诱导的诱变技术,这使得能够创造出一组基因不同的香蕉突变体。这种复杂的程序需要使用L-Hyp对突变体进行进一步的胁迫筛选,以鉴定表现出改善的耐寒性的那些。本研究对EMS诱变和L-Hyp的筛选条件进行了全面优化,从而鉴定出突变体cm784,该突变体表现出明显的抗寒性。随后的研究进一步阐明了cm784对低温胁迫的生理和转录组反应。
    结果:EMS诱变对香蕉幼苗有很大影响,导致芽和根性状的改变,其中大多数幼苗表现出延迟的分化和有限的伸长。值得注意的是,突变叶显示出改变的生物量组成,淀粉含量表现出最明显的变化。L-Hyp压力选择的应用有助于鉴定幼苗致死表型中的耐寒突变体。突变体cm784表现出增强的抗寒性,如提高生存率和减少冷害症状所证明的。生理分析表明,当遭受冷胁迫时,cm784中的抗氧化酶活性增强,脯氨酸产量增加。转录组分析揭示了在cm784中差异表达的946个基因,在与“碳水化合物运输和代谢”和“次级代谢产物生物合成”相关的类别中具有显着的富集,运输,和分解代谢。
    结论:目前的发现提供了对分子机制的见解,这些分子机制有助于在香蕉突变体中观察到增强的抗寒性。这些机制包括增强碳水化合物代谢和次级代谢产物生物合成,从而强调了用于减轻冷应力引起的有害影响的适应性策略。
    BACKGROUND: The cultivation of bananas encounters substantial obstacles, particularly due to the detrimental effects of cold stress on their growth and productivity. A potential remedy that has gained attention is the utilization of ethyl mesylate (EMS)-induced mutagenesis technology, which enables the creation of a genetically varied group of banana mutants. This complex procedure entails subjecting the mutants to further stress screening utilizing L-Hyp in order to identify those exhibiting improved resistance to cold. This study conducted a comprehensive optimization of the screening conditions for EMS mutagenesis and L-Hyp, resulting in the identification of the mutant cm784, which exhibited remarkable cold resistance. Subsequent investigations further elucidated the physiological and transcriptomic responses of cm784 to low-temperature stress.
    RESULTS: EMS mutagenesis had a substantial effect on banana seedlings, resulting in modifications in shoot and root traits, wherein a majority of seedlings exhibited delayed differentiation and limited elongation. Notably, mutant leaves displayed altered biomass composition, with starch content exhibiting the most pronounced variation. The application of L-Hyp pressure selection aided in the identification of cold-resistant mutants among seedling-lethal phenotypes. The mutant cm784 demonstrated enhanced cold resistance, as evidenced by improved survival rates and reduced symptoms of chilling injury. Physiological analyses demonstrated heightened activities of antioxidant enzymes and increased proline production in cm784 when subjected to cold stress. Transcriptome analysis unveiled 946 genes that were differentially expressed in cm784, with a notable enrichment in categories related to \'Carbohydrate transport and metabolism\' and \'Secondary metabolites biosynthesis, transport, and catabolism\'.
    CONCLUSIONS: The present findings provide insights into the molecular mechanisms that contribute to the heightened cold resistance observed in banana mutants. These mechanisms encompass enhanced carbohydrate metabolism and secondary metabolite biosynthesis, thereby emphasizing the adaptive strategies employed to mitigate the detrimental effects induced by cold stress.
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  • 文章类型: Journal Article
    背景:上皮性卵巢癌(EOC)严重依赖氧化磷酸化(OXPHOS)并表现出明显的线粒体代谢重编程。到目前为止,EOC组织中体细胞线粒体DNA(mtDNA)突变的进化模式及其在代谢重塑中的潜在作用尚未得到系统阐明。
    方法:基于来自私人和公共EOC队列(239和118名患者,分别),我们最全面地描述了mtDNA突变的EOC特异性进化模式,并研究了其生物学意义。
    结果:突变分析显示,与非癌性卵巢组织相比,EOC组织的线粒体基因组高度不稳定。此外,我们的数据表明,在EOC组织中mtDNA控制区(mtCTR)突变的延迟异质积累和mtCTR非高变段(非HVS)突变的几乎完全缺失,这与针对mtCTR突变的严格阴性选择一致。此外,我们观察到mtDNA编码区突变的双向和区域特异性进化模式,表现为针对复杂V(ATP6/ATP8)和tRNA环区突变的显着负选择,以及对复合物III(MT-CYB)突变的潜在正选择。同时,与非癌性卵巢组织相比,EOC组织显示出更高的线粒体生物发生。进一步的分析显示,mtDNA突变与线粒体生物发生和EOC患者的总体生存率之间存在显着关联。
    结论:我们的研究全面描述了EOC特异性mtDNA突变的进化模式,该模式与特定的线粒体代谢重塑吻合良好。为mtDNA突变在EOC肿瘤发生和发展中的功能作用提供了新的见解。
    Epithelial ovarian cancer (EOC) heavily relies on oxidative phosphorylation (OXPHOS) and exhibits distinct mitochondrial metabolic reprogramming. Up to now, the evolutionary pattern of somatic mitochondrial DNA (mtDNA) mutations in EOC tissues and their potential roles in metabolic remodelling have not been systematically elucidated.
    Based on a large somatic mtDNA mutation dataset from private and public EOC cohorts (239 and 118 patients, respectively), we most comprehensively characterised the EOC-specific evolutionary pattern of mtDNA mutations and investigated its biological implication.
    Mutational profiling revealed that the mitochondrial genome of EOC tissues was highly unstable compared with non-cancerous ovary tissues. Furthermore, our data indicated the delayed heteroplasmy accumulation of mtDNA control region (mtCTR) mutations and near-complete absence of mtCTR non-hypervariable segment (non-HVS) mutations in EOC tissues, which is consistent with stringent negative selection against mtCTR mutation. Additionally, we observed a bidirectional and region-specific evolutionary pattern of mtDNA coding region mutations, manifested as significant negative selection against mutations in complex V (ATP6/ATP8) and tRNA loop regions, and potential positive selection on mutations in complex III (MT-CYB). Meanwhile, EOC tissues showed higher mitochondrial biogenesis compared with non-cancerous ovary tissues. Further analysis revealed the significant association between mtDNA mutations and both mitochondrial biogenesis and overall survival of EOC patients.
    Our study presents a comprehensive delineation of EOC-specific evolutionary patterns of mtDNA mutations that aligned well with the specific mitochondrial metabolic remodelling, conferring novel insights into the functional roles of mtDNA mutations in EOC tumourigenesis and progression.
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  • 文章类型: Journal Article
    背景:小儿骨髓增生异常综合征(MDS)是一种罕见的疾病,发病机制尚未明确。我们的目的是探讨遗传因素在不同结局儿童MDS发病机制中的作用,并发现遗传特征与临床结局以及疾病特征之间的相关性。
    方法:我们对2015年至2021年在我们机构诊断为小儿MDS的26例患者的存档遗传数据进行了分析,检查了不同遗传特征与临床表现以及预后之间的关联。此外,我们介绍了三个具有不同遗传背景和结果的病例,以阐述遗传因素在具有不同预后的小儿MDS中的作用。
    结果:26例患者中有13例检测到基因变异,包括8例同时出现体细胞和种系突变(CSGM)的患者和5例单独出现体细胞突变的患者。我们的分析表明,高级MDS(4/8,50%与1/5,20%和4/11,36.4%),PD(3/8,37.5%与1/5、20%和1/119.1%),和TD(6/8,75%与2/5,40%和2/11,18.2%)在患有CSGM的患者中比单独存在体细胞突变或没有任何突变的患者更常见。在我们的研究中,我们还发现8例CSGM患者的临床结果明显不同,我们提出了其中的3个作为阐述的例子。具有未知意义的种系和体细胞突变的病例1的病程相对较慢,预后良好。具有复合杂合种系SBDS变体和体细胞突变如del20q的病例2具有稳定的病程和逆转的结果。具有种系GATA2变异体和包括-7的体细胞突变的病例3具有快速进展的病程和最差的预后。
    结论:我们的研究结果表明,儿童MDS的遗传背景与疾病特征和结局密切相关,CSGM可能导致疾病进展。应该强调的是,某些种系变异体和体细胞突变之间的相互作用,如SBDS和del20q,可能导致造血干细胞适应(改善造血)和逆转的临床结果,这可以促进靶向治疗的发展。
    Pediatric myelodysplastic syndromes (MDS) are rare disorders with an unrevealed pathogenesis. Our aim is to explore the role of genetic factors in the pathogenesis of MDS in children with different outcomes and to discover the correlation between genetic features and clinical outcomes as well as disease characteristics.
    We conducted an analysis of archived genetic data from 26 patients diagnosed with pediatric MDS at our institution between 2015 and 2021, examining the association between different genetic characteristics and clinical manifestations as well as prognosis. Additionally, We presented three cases with distinct genetic background and outcomes as examples to elaborate the role of genetic factors in pediatric MDS with different prognoses.
    Genetic variations were detected in 13 out of the 26 patients, including 8 patients with co-occurrence of somatic and germline mutations (CSGMs) and 5 patients with somatic mutations alone. Our analysis revealed that advanced MDS (4/8, 50% vs. 1/5, 20% and 4/11, 36.4%), PD (3/8, 37.5% vs. 1/5, 20% and 1/11 9.1%), and TD (6/8, 75% vs. 2/5, 40% and 2/11, 18.2%) were more common in patients with CSGMs than those with somatic mutations alone or without any mutations. We also found out in our study that 8 patients with CSGMs had evidently different clinical outcomes, and we presented 3 of them as examples for elaboration. Case 1 with germline and somatic mutations of unknown significance had a relatively slow disease course and a good prognosis. Case 2 with compound heterozygous germline SBDS variants and somatic mutations like del20q had a stable disease course and a reversed outcome. Case 3 with a germline GATA2 variant and somatic mutations including - 7 had a rapidly progressive disease course and a worst prognosis.
    Our findings indicate that genetic background of pediatric MDS is closely linked with disease characteristics as well as outcomes and that CSGMs may lead to disease progression. It should be emphasized that the interaction between certain germline variants and somatic mutations, such as SBDS and del20q, may result in hematopoietic stem cell adaptation (improved hematopoiesis) and reversed clinical outcomes, which can facilitate the development of targeted therapy.
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