Tandem Repeat Sequences

  • 文章类型: Journal Article
    串联重复(TRs)是重复数交替变化的基因组区域,通常是多等位基因的。它们的特征以及对水稻基因表达和数量性状的贡献在很大程度上是未知的。这里,我们基于231个基因组组装和水稻泛基因组图调查了水稻TR变异。我们鉴定了227,391个多等位基因TR基因座,包括在Nipponbare参考基因组中不存在的54,416个TR变异。只有1/3TR变异与附近的双等位基因变异体(SNP,IndelsandPAV).使用193个穗部和202个叶片转录组数据,我们揭示了485和511TR作为QTL独立于其他双等位基因变异附近的基因表达,分别。以株高和粒宽为例,我们确定并验证了TR对水稻农艺性状变异的贡献。这些发现将增强我们对多等位基因变体功能的理解,并促进水稻分子育种。
    Tandem repeats (TRs) are genomic regions that tandemly change in repeat number, which are often multiallelic. Their characteristics and contributions to gene expression and quantitative traits in rice are largely unknown. Here, we survey rice TR variations based on 231 genome assemblies and the rice pan-genome graph. We identify 227,391 multiallelic TR loci, including 54,416 TR variations that are absent from the Nipponbare reference genome. Only 1/3 TR variations show strong linkage with nearby bi-allelic variants (SNPs, Indels and PAVs). Using 193 panicle and 202 leaf transcriptomic data, we reveal 485 and 511 TRs act as QTLs independently of other bi-allelic variations to nearby gene expression, respectively. Using plant height and grain width as examples, we identify and validate TRs contributions to rice agronomic trait variations. These findings would enhance our understanding of the functions of multiallelic variants and facilitate rice molecular breeding.
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  • 文章类型: Journal Article
    胰岛素连接的多态性区域是胰岛素基因启动子中DNA的可变数量的串联重复区域,其调节胰岛素的转录。已知该区域形成替代的DNA结构,i-基序和G-四链体。个体具有不同的串联重复序列变体,尽管以前的工作研究了某些变体对G-四链体形成的影响,序列多样性之间的关系并不清楚,形成的DNA结构,以及对胰岛素基因表达的功能影响。在这里,我们显示胰岛素连接多态性区域的不同序列变体在体外形成不同的DNA结构。此外,细胞中的报告基因表明胰岛素表达可能会根据DNA结构的形成而变化。我们报告了分子内i-motif的晶体结构和动力学,这揭示了环区内形成额外的稳定相互作用的序列,这些相互作用对于稳定的i基序结构的形成至关重要。这项工作的结果揭示了稳定的i-motifDNA结构形成的细节,具有针对化合物靶向i-基序DNA的合理药物设计的潜力。
    The insulin-linked polymorphic region is a variable number of tandem repeats region of DNA in the promoter of the insulin gene that regulates transcription of insulin. This region is known to form the alternative DNA structures, i-motifs and G-quadruplexes. Individuals have different sequence variants of tandem repeats and although previous work investigated the effects of some variants on G-quadruplex formation, there is not a clear picture of the relationship between the sequence diversity, the DNA structures formed, and the functional effects on insulin gene expression. Here we show that different sequence variants of the insulin linked polymorphic region form different DNA structures in vitro. Additionally, reporter genes in cellulo indicate that insulin expression may change depending on which DNA structures form. We report the crystal structure and dynamics of an intramolecular i-motif, which reveal sequences within the loop regions forming additional stabilising interactions that are critical to formation of stable i-motif structures. The outcomes of this work reveal the detail in formation of stable i-motif DNA structures, with potential for rational based drug design for compounds to target i-motif DNA.
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  • 文章类型: Journal Article
    背景:分析基因组重复的常用方法是产生通过点图可视化的序列相似性矩阵。诸如StainedGlass之类的创新方法通过将点图绘制为序列同一性的热图,对这种经典的可视化进行了改进。使研究人员能够更好地可视化着丝粒和基因组其他异色区域内的多兆碱基串联重复序列阵列。然而,计算热图的相似性估计需要很高的计算开销,并且可能会降低准确性。
    结果:在这项工作中,我们介绍了ModDotPlot,交互式和无对齐的点图查看器。通过基于k聚体的遏制指数近似平均核苷酸同一性,ModDotPlot比StainedGlass更快地产生精确的绘图。我们通过使用分层修饰方案来实现这一点,该方案可以在笔记本电脑上5分钟内可视化拟南芥的完整128Mbp基因组。ModDotPlot与图形用户界面捆绑在一起,支持整个染色体的实时交互式导航。
    方法:ModDotPlot可在https://github.com/marbl/ModDotPlot获得。
    BACKGROUND: A common method for analyzing genomic repeats is to produce a sequence similarity matrix visualized via a dot plot. Innovative approaches such as StainedGlass have improved upon this classic visualization by rendering dot plots as a heatmap of sequence identity, enabling researchers to better visualize multi-megabase tandem repeat arrays within centromeres and other heterochromatic regions of the genome. However, computing the similarity estimates for heatmaps requires high computational overhead and can suffer from decreasing accuracy.
    RESULTS: In this work, we introduce ModDotPlot, an interactive and alignment-free dot plot viewer. By approximating average nucleotide identity via a k-mer-based containment index, ModDotPlot produces accurate plots orders of magnitude faster than StainedGlass. We accomplish this through the use of a hierarchical modimizer scheme that can visualize the full 128 Mb genome of Arabidopsis thaliana in under 5 min on a laptop. ModDotPlot is bundled with a graphical user interface supporting real-time interactive navigation of entire chromosomes.
    METHODS: ModDotPlot is available at https://github.com/marbl/ModDotPlot.
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  • 文章类型: Journal Article
    串联复制(TD)是人类基因组中常见且重要的结构变异类型。TDs已被证明在许多疾病中起着至关重要的作用,包括癌症.然而,由于读段的不均匀分布和下一代测序(NGS)数据的固有复杂性,很难准确检测TD.
    本文提出了一种称为DTDHM(基于混合方法的串联重复检测)的方法,它利用NGS数据来检测单个样品中的TD。DTDHM构建了一个集成读取深度(RD)的管道,拆分读取(SR),和配对端映射(PEM)信号。为解决正态和异常样本分布不均的问题,DTDHM使用K最近邻(KNN)算法进行多特征分类预测。然后,提取并分析合格的分裂读段和不一致读段,实现变异位点的准确定位。本文将DTDHM与其他三种方法在450个模拟数据集和五个真实数据集上进行了比较。
    在450个模拟数据样本中,DTDHM始终保持最高的F1得分。DTDHM的平均F1分数,SVIM,TARDIS,TIDDIT为80.0%,56.2%,43.4%,和67.1%,分别。DTDHM的F1评分变化范围小,其检测效果最稳定,是次优方法的1.2倍。DTDHM的大多数边界偏差在20bp左右波动,其边界偏差检测能力优于TARDIS和TIDDIT。在真实数据实验中,使用五个真实测序样品(NA19238、NA19239、NA19240、HG00266和NA12891)来测试DTDHM。结果表明,DTDHM在四种方法中具有最高的重叠密度得分(ODS)和F1得分。
    与其他三种方法相比,DTDHM在灵敏度方面取得了优异的结果,精度,F1分数,和边界偏差。这些结果表明,DTDHM可以用作从NGS数据中检测TD的可靠工具,特别是在低覆盖深度和肿瘤纯度样品的情况下。
    UNASSIGNED: Tandem duplication (TD) is a common and important type of structural variation in the human genome. TDs have been shown to play an essential role in many diseases, including cancer. However, it is difficult to accurately detect TDs due to the uneven distribution of reads and the inherent complexity of next-generation sequencing (NGS) data.
    UNASSIGNED: This article proposes a method called DTDHM (detection of tandem duplications based on hybrid methods), which utilizes NGS data to detect TDs in a single sample. DTDHM builds a pipeline that integrates read depth (RD), split read (SR), and paired-end mapping (PEM) signals. To solve the problem of uneven distribution of normal and abnormal samples, DTDHM uses the K-nearest neighbor (KNN) algorithm for multi-feature classification prediction. Then, the qualified split reads and discordant reads are extracted and analyzed to achieve accurate localization of variation sites. This article compares DTDHM with three other methods on 450 simulated datasets and five real datasets.
    UNASSIGNED: In 450 simulated data samples, DTDHM consistently maintained the highest F1-score. The average F1-score of DTDHM, SVIM, TARDIS, and TIDDIT were 80.0%, 56.2%, 43.4%, and 67.1%, respectively. The F1-score of DTDHM had a small variation range and its detection effect was the most stable and 1.2 times that of the suboptimal method. Most of the boundary biases of DTDHM fluctuated around 20 bp, and its boundary deviation detection ability was better than TARDIS and TIDDIT. In real data experiments, five real sequencing samples (NA19238, NA19239, NA19240, HG00266, and NA12891) were used to test DTDHM. The results showed that DTDHM had the highest overlap density score (ODS) and F1-score of the four methods.
    UNASSIGNED: Compared with the other three methods, DTDHM achieved excellent results in terms of sensitivity, precision, F1-score, and boundary bias. These results indicate that DTDHM can be used as a reliable tool for detecting TDs from NGS data, especially in the case of low coverage depth and tumor purity samples.
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  • 文章类型: Journal Article
    串联重复在整个人类基因组中频繁出现,重复长度的变化与多种性状有关。最近长读取测序技术的改进有可能极大地改善串联重复分析,尤其是长时间或复杂的重复。这里,我们介绍LongTR,从PacBio和OxfordNanoporeTechnologies提供的高保真长读数中准确地串联重复基因型。LongTR可在https://github.com/gymorek-lab/longtr和https://zenodo.org/doi/10.5281/zenodo.11403979上免费获得。
    Tandem repeats are frequent across the human genome, and variation in repeat length has been linked to a variety of traits. Recent improvements in long read sequencing technologies have the potential to greatly improve tandem repeat analysis, especially for long or complex repeats. Here, we introduce LongTR, which accurately genotypes tandem repeats from high-fidelity long reads available from both PacBio and Oxford Nanopore Technologies. LongTR is freely available at https://github.com/gymrek-lab/longtr and https://zenodo.org/doi/10.5281/zenodo.11403979 .
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  • 文章类型: Journal Article
    凝集素的多价在影响聚糖交联中起着关键作用,从而影响凝集素功能。这种多价可以通过低聚实现,串联重复的碳水化合物识别域的存在,或两者的组合。与依赖于多种因素的相同单体的低聚作用的凝集素不同,串联重复凝集素固有地具有多价性,独立于这个复杂的过程。重复结构域,虽然不相同,在预定的几何形状中显示略微不同的特性,增强特异性,亲和力,亲合力甚至寡聚化。尽管许多研究在最近发现的凝集素中认识到了这种结构特征,仍然需要一个统一的标准来定义串联重复凝集素。我们建议将它们定义为具有对应于碳水化合物识别域的链内串联重复序列的多价凝集素,独立于低聚。本系统综述研究了串联重复凝集素的折叠和种系多样性,并参考了相关文献。我们的研究将具有串联重复的碳水化合物识别域的所有凝集素分类为与特定生物学功能相关的9种不同的折叠类别。我们的发现从功能和结构特征方面对串联重复凝集素进行了全面的描述和分析。我们对系统发育和功能多样性的探索揭示了以前没有记载的串联重复凝集素。我们提出了研究方向,旨在增强我们对串联重复凝集素起源的理解,并促进医学和生物技术应用的发展。特别是在人造糖和新分子的设计中。
    Multivalency in lectins plays a pivotal role in influencing glycan cross-linking, thereby affecting lectin functionality. This multivalency can be achieved through oligomerization, the presence of tandemly repeated carbohydrate recognition domains, or a combination of both. Unlike lectins that rely on multiple factors for the oligomerization of identical monomers, tandem-repeat lectins inherently possess multivalency, independent of this complex process. The repeat domains, although not identical, display slightly distinct specificities within a predetermined geometry, enhancing specificity, affinity, avidity and even oligomerization. Despite the recognition of this structural characteristic in recently discovered lectins by numerous studies, a unified criterion to define tandem-repeat lectins is still necessary. We suggest defining them multivalent lectins with intrachain tandem repeats corresponding to carbohydrate recognition domains, independent of oligomerization. This systematic review examines the folding and phyletic diversity of tandem-repeat lectins and refers to relevant literature. Our study categorizes all lectins with tandemly repeated carbohydrate recognition domains into nine distinct folding classes associated with specific biological functions. Our findings provide a comprehensive description and analysis of tandem-repeat lectins in terms of their functions and structural features. Our exploration of phyletic and functional diversity has revealed previously undocumented tandem-repeat lectins. We propose research directions aimed at enhancing our understanding of the origins of tandem-repeat lectin and fostering the development of medical and biotechnological applications, notably in the design of artificial sugars and neolectins.
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  • 文章类型: Journal Article
    孟德尔遗传的例外通常突出了新的染色体行为。赋予植物色素沉着的玉米Pl1-Rhoades等位基因可以表现出偏离孟德尔预期的遗传模式,其行为被称为变位。然而,介导这种异常的染色体特征仍然未知。在这里,我们表明,在五个串联重复序列的远端下游集中反映RNA聚合酶IV功能的小RNA产生与Pl1-Rhoades转录单位的可减数分裂遗传抑制相一致。一个相关的pl1单倍型有三个,但不是一加二,重复单元还显示反式同源沉默典型的参数。4C互动,CHD3a依赖性小RNA谱,核酸酶敏感性,和聚腺苷酸化RNA水平突出了具有调节潜力的重复子区域。我们的比较和突变分析表明,Pl1-Rhoades的转录抑制与该子区域的24个核苷酸的RNA产生和胞嘧啶甲基化相关,表明特定的DNA依赖性RNA聚合酶复合物的作用。这些发现支持了一个工作模型,其中pl1参数化取决于跨染色体RNA指导的DNA甲基化,该甲基化在离散的顺式连接和拷贝数依赖性转录调控元件上运行。
    Exceptions to Mendelian inheritance often highlight novel chromosomal behaviors. The maize Pl1-Rhoades allele conferring plant pigmentation can display inheritance patterns deviating from Mendelian expectations in a behavior known as paramutation. However, the chromosome features mediating such exceptions remain unknown. Here we show that small RNA production reflecting RNA polymerase IV function within a distal downstream set of five tandem repeats is coincident with meiotically-heritable repression of the Pl1-Rhoades transcription unit. A related pl1 haplotype with three, but not one with two, repeat units also displays the trans-homolog silencing typifying paramutations. 4C interactions, CHD3a-dependent small RNA profiles, nuclease sensitivity, and polyadenylated RNA levels highlight a repeat subregion having regulatory potential. Our comparative and mutant analyses show that transcriptional repression of Pl1-Rhoades correlates with 24-nucleotide RNA production and cytosine methylation at this subregion indicating the action of a specific DNA-dependent RNA polymerase complex. These findings support a working model in which pl1 paramutation depends on trans-chromosomal RNA-directed DNA methylation operating at a discrete cis-linked and copy-number-dependent transcriptional regulatory element.
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  • 文章类型: Journal Article
    地中海夜蛾颗粒病毒(CnmeGV),属于肉芽胞杆状病毒,可以感染水稻害虫,水稻卷叶机.1979年,一个CnmeGV分离株,CnmeGV-EP,是从恩平县收集的,中国。2014年,我们收集了另一种CnmeGV分离株,CnmeGV-EPDH3在同一位置,并使用Illumina和ONT测序技术获得了完整的病毒基因组序列。通过结合这两种病毒分离物,我们更新了CnmeGV的基因组注释,并对其基因组特征进行了深入分析.CnmeGV基因组含有丰富的串联重复序列,并且同源区域中的重复单元(小时)表现出重叠和嵌套模式。EPDH3群体内的遗传变异显示了CnmeGV基因组的高稳定性,和串联重复序列是CnmeGV基因组复制中唯一的高遗传变异区域。在人群中发现了一些通过重组形成的缺陷病毒基因组。从Enping收集的两种病毒分离物的比较分析表明,由CnmeGV特异性基因编码的蛋白质相对于杆状病毒核心基因保守性较低。在基因组层面,两个病毒分离株之间存在大量的SNPs和InDels,特别是在兄弟基因和小时及其周围。此外,我们发现CnmeGV从其宿主获得了一段非ORF序列,它不提供任何新的蛋白质,而是作为整合到病毒基因组中的冗余遗传物质。此外,我们观察到宿主的转座子piggyBac已经插入了一些病毒基因。一起,dsDNA病毒可以从其宿主获得非编码遗传物质以扩大其基因组的大小。这些发现为dsDNA病毒的进化提供了新的见解。
    Cnaphalocrocis medinalis granulovirus (CnmeGV), belonging to Betabaculovirus cnamedinalis, can infect the rice pest, the rice leaf roller. In 1979, a CnmeGV isolate, CnmeGV-EP, was collected from Enping County, China. In 2014, we collected another CnmeGV isolate, CnmeGV-EPDH3, at the same location and obtained the complete virus genome sequence using Illumina and ONT sequencing technologies. By combining these two virus isolates, we updated the genome annotation of CnmeGV and conducted an in-depth analysis of its genome features. CnmeGV genome contains abundant tandem repeat sequences, and the repeating units in the homologous regions (hrs) exhibit overlapping and nested patterns. The genetic variations within EPDH3 population show the high stability of CnmeGV genome, and tandem repeats are the only region of high genetic variation in CnmeGV genome replication. Some defective viral genomes formed by recombination were found within the population. Comparison analysis of the two virus isolates collected from Enping showed that the proteins encoded by the CnmeGV-specific genes were less conserved relative to the baculovirus core genes. At the genomic level, there are a large number of SNPs and InDels between the two virus isolates, especially in and around the bro genes and hrs. Additionally, we discovered that CnmeGV acquired a segment of non-ORF sequence from its host, which does not provide any new proteins but rather serves as redundant genetic material integrated into the viral genome. Furthermore, we observed that the host\'s transposon piggyBac has inserted into some virus genes. Together, dsDNA viruses could acquire non-coding genetic material from their hosts to expand the size of their genomes. These findings provide new insights into the evolution of dsDNA viruses.
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  • 文章类型: Journal Article
    FLT3内部串联重复(ITD)在成人急性髓性白血病(AML)患者在异基因造血细胞移植(HCT)前的首次完全缓解(CR)中的持续存在与移植后复发和死亡增加相关。但检测到的可测量的残留病(MRD)水平与临床结局之间的关联尚不清楚.
    研究同种异体HCTMRD水平与首次CR成人AML移植后复发和死亡之间的关系。
    在这项队列研究中,对2013年3月至2019年2月移植的FLT3-ITDAML患者的首次CR血液进行DNA测序。临床随访至2022年5月。数据从2022年10月到2023年12月进行了分析。
    使用市售试剂盒对同种异体HCT第一CR血液中的FLT3-ITD进行集中DNA测序。
    主要结果是总生存率和累积复发率,与非复发相关的死亡率作为同种异体HCT后的竞争风险。卡普兰-迈耶估计(对数秩检验),Cox比例风险模型,和Fine-Gray模型用于估计终点。
    537名来自Pre-MEASURE研究的FLT3-ITDAML患者,296名(55.1%)为女性,中位年龄(IQR)为55.6岁(42.9-64.1岁)。使用MRD阳性的0.01%或更高的变异等位基因分数(VAF)阈值,结果与先前报告的结果密切相关.未应用VAF阈值(VAF大于0%),263个FLT3-ITD变体(中位数[范围]VAF,0.005%[0.0002%-44%]),和177例患者(33.0%)的阳性结果被确定。多变量分析显示残留FLT3-ITD是与复发和总生存率最相关的变量。具有剂量依赖性相关性。与接受使用美法仑或清髓性预处理的降低强度预处理的患者相比,在任何给定的MRD水平下,接受不使用美法仑或非清髓性预处理的患者复发和死亡的风险增加。
    这项研究提供了可推广和临床适用的证据,表明在同种异体HCT之前的AML首次CR中检测到成人血液中残留的FLT3-ITD与复发和死亡风险增加有关。特别是对于那些VAF为0.01%或更高的人。而移植调理强化,并非所有人都可以进行干预,可能有助于减轻这种风险,对于目前标准治疗服务不足的高危患者人群,有必要采取其他方法.
    UNASSIGNED: Persistence of FLT3 internal tandem duplication (ITD) in adults with acute myeloid leukemia (AML) in first complete remission (CR) prior to allogeneic hematopoietic cell transplant (HCT) is associated with increased relapse and death after transplant, but the association between the level of measurable residual disease (MRD) detected and clinical outcome is unknown.
    UNASSIGNED: To examine the association between pre-allogeneic HCT MRD level with relapse and death posttransplant in adults with AML in first CR.
    UNASSIGNED: In this cohort study, DNA sequencing was performed on first CR blood from patients with FLT3-ITD AML transplanted from March 2013 to February 2019. Clinical follow-up was through May 2022. Data were analyzed from October 2022 to December 2023.
    UNASSIGNED: Centralized DNA sequencing for FLT3-ITD in pre-allogeneic HCT first CR blood using a commercially available kit.
    UNASSIGNED: The primary outcomes were overall survival and cumulative incidence of relapse, with non-relapse-associated mortality as a competing risk post-allogeneic HCT. Kaplan-Meier estimations (log-rank tests), Cox proportional hazards models, and Fine-Gray models were used to estimate the end points.
    UNASSIGNED: Of 537 included patients with FLT3-ITD AML from the Pre-MEASURE study, 296 (55.1%) were female, and the median (IQR) age was 55.6 (42.9-64.1) years. Using the variant allele fraction (VAF) threshold of 0.01% or greater for MRD positivity, the results closely aligned with those previously reported. With no VAF threshold applied (VAF greater than 0%), 263 FLT3-ITD variants (median [range] VAF, 0.005% [0.0002%-44%]), and 177 patients (33.0%) with positive findings were identified. Multivariable analyses showed that residual FLT3-ITD was the variable most associated with relapse and overall survival, with a dose-dependent correlation. Patients receiving reduced-intensity conditioning without melphalan or nonmyeloablative conditioning had increased risk of relapse and death at any given level of MRD compared with those receiving reduced-intensity conditioning with melphalan or myeloablative conditioning.
    UNASSIGNED: This study provides generalizable and clinically applicable evidence that the detection of residual FLT3-ITD in the blood of adults in first CR from AML prior to allogeneic HCT is associated with an increased risk of relapse and death, particularly for those with a VAF of 0.01% or greater. While transplant conditioning intensification, an intervention not available to all, may help mitigate some of this risk, alternative approaches will be necessary for this high-risk population of patients who are underserved by the current standard of care.
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  • 文章类型: Journal Article
    FMS样受体酪氨酸激酶3(FLT3-ITD)的内部串联重复(ITD)突变是在大约30%的急性髓性白血病(AML)患者中观察到的最常见的突变。由于下游促进生长的信号通路如STAT5和PI3K/AKT的持续激活,其代表不良预后。因此,FLT3被认为是有吸引力的药物靶标;选择性小FLT3抑制剂(FLT3Is),如midostaurin和quizartinib,已获得临床批准。然而,单独使用FLT3I时,患者的缓解率和获得性耐药普遍较差。患者的各种因素可能导致这些不良反应,包括改变的表观遗传调节,主要导致基因表达模式异常。表观遗传修饰是造血干细胞(HSC)自我更新和分化所必需的;然而,已经在控制DNA甲基化的基因中鉴定出关键的驱动突变(如DNMT3A,TET2,IDH1/2)。当这些调节因子与FLT3-ITD突变共同发生时,它们引起白血病发病机制并影响疾病诊断和预后。因此,了解不同表观遗传改变在FLT3-ITDAML发病机制中的作用以及它们如何调节FLT3I的活性对于合理化组合治疗方法(包括FLT3Is和甲基化调节因子或通路调节剂)非常重要.来自正在进行的临床前和临床研究的数据将进一步精确地定义表观遗传疗法与FLT3Is一起的潜在用途,特别是在FLT3和DNA甲基化调节因子方面的特征患者突变状态之后。
    UNASSIGNED: The internal tandem duplication (ITD) mutation of the FMS-like receptor tyrosine kinase 3 (FLT3-ITD) is the most common mutation observed in approximately 30% of acute myeloid leukemia (AML) patients. It represents poor prognosis due to continuous activation of downstream growth-promoting signaling pathways such as STAT5 and PI3K/AKT. Hence, FLT3 is considered an attractive druggable target; selective small FLT3 inhibitors (FLT3Is), such as midostaurin and quizartinib, have been clinically approved. However, patients possess generally poor remission rates and acquired resistance when FLT3I used alone. Various factors in patients could cause these adverse effects including altered epigenetic regulation, causing mainly abnormal gene expression patterns. Epigenetic modifications are required for hematopoietic stem cell (HSC) self-renewal and differentiation; however, critical driver mutations have been identified in genes controlling DNA methylation (such as DNMT3A, TET2, IDH1/2). These regulators cause leukemia pathogenesis and affect disease diagnosis and prognosis when they co-occur with FLT3-ITD mutation. Therefore, understanding the role of different epigenetic alterations in FLT3-ITD AML pathogenesis and how they modulate FLT3I\'s activity is important to rationalize combinational treatment approaches including FLT3Is and modulators of methylation regulators or pathways. Data from ongoing pre-clinical and clinical studies will further precisely define the potential use of epigenetic therapy together with FLT3Is especially after characterized patients\' mutational status in terms of FLT3 and DNA methlome regulators.
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