genetic mutations

基因突变
  • 文章类型: Journal Article
    先天性心脏病(CHD)包括影响心脏和主要血管的各种结构和功能异常。流行病学研究表明,冠心病患病率在全球范围内有所增加,这可以归因于诊断技术的进步。广泛的研究已经确定了大量的CHD相关基因,提供对这种病理状态的生化途径和分子机制的见解。在这次审查中,我们讨论了各种体外和体内CHD模型的优势和挑战,包括灵长类动物,犬科动物,非洲爪蛙,兔子,小鸡,老鼠,果蝇,斑马鱼,和诱导多能干细胞(iPSC)。灵长类动物与人类密切相关,但罕见且昂贵。犬类模型成本高,但在结构上与人类相当。非洲爪蛙是有利的,因为它们产生了许多胚胎,易于进行基因改造,心脏相似性兔子模仿人类生理学,但对基因控制具有挑战性。小鸡价格低廉,操作简单;然而,心脏事件可能因人而异。小鼠在生理上不同,同时在进化上接近和资源充足。果蝇的基因与人类相似,但心脏结构不同。斑马鱼有几个优点,包括人类的高基因保守性和生理心脏相似性,但与哺乳动物抗体的交叉反应性有限,基因复制,和用于反向遗传方法的有限胚胎干细胞。iPSCs具有基因编辑的潜力,但在2D结构和基因组稳定性方面面临挑战。CRISPR-Cas9允许基因校正,但需要很高的技术技能和资源。这些模型提供了有关心脏发育的宝贵知识,疾病模拟,和遗传因素的验证。这篇综述强调了各种模型在生物学特征方面的不同特征,容易患上特定的心脏病,用于诱发特定条件的方法,以及这些物种与人类的可比性。因此,选择合适的模型是基于研究目标,最终导致对疾病病理和治疗的理解增强。
    Congenital heart disease (CHD) encompasses a diverse range of structural and functional anomalies that affect the heart and the major blood vessels. Epidemiological studies have documented a global increase in CHD prevalence, which can be attributed to advancements in diagnostic technologies. Extensive research has identified a plethora of CHD-related genes, providing insights into the biochemical pathways and molecular mechanisms underlying this pathological state. In this review, we discuss the advantages and challenges of various In vitro and in vivo CHD models, including primates, canines, Xenopus frogs, rabbits, chicks, mice, Drosophila, zebrafish, and induced pluripotent stem cells (iPSCs). Primates are closely related to humans but are rare and expensive. Canine models are costly but structurally comparable to humans. Xenopus frogs are advantageous because of their generation of many embryos, ease of genetic modification, and cardiac similarity. Rabbits mimic human physiology but are challenging to genetically control. Chicks are inexpensive and simple to handle; however, cardiac events can vary among humans. Mice differ physiologically, while being evolutionarily close and well-resourced. Drosophila has genes similar to those of humans but different heart structures. Zebrafish have several advantages, including high gene conservation in humans and physiological cardiac similarities but limitations in cross-reactivity with mammalian antibodies, gene duplication, and limited embryonic stem cells for reverse genetic methods. iPSCs have the potential for gene editing, but face challenges in terms of 2D structure and genomic stability. CRISPR-Cas9 allows for genetic correction but requires high technical skills and resources. These models have provided valuable knowledge regarding cardiac development, disease simulation, and the verification of genetic factors. This review highlights the distinct features of various models with respect to their biological characteristics, vulnerability to developing specific heart diseases, approaches employed to induce particular conditions, and the comparability of these species to humans. Therefore, the selection of appropriate models is based on research objectives, ultimately leading to an enhanced comprehension of disease pathology and therapy.
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  • 文章类型: Journal Article
    胰腺癌,随着发病率的惊人上升,预计到2040年将成为第二致命的实体瘤,这凸显了对改进诊断和治疗策略的迫切需要。尽管医学上取得了进步,胰腺癌的5年生存率保持在14%左右,转移时进一步下降。这篇综述探讨了早期检测生物标志物的前景,个性化治疗,和疾病监测。基于基因突变的胰腺癌分子分型,基因表达,蛋白质标记指导治疗决策,有可能改善结果。目前正在进行大量研究不同策略的临床试验。靶向治疗,其中反对CLAUDIN18.2和抑制Claudin18.1的人表现出了希望。下一代测序(NGS)已成为胰腺肿瘤全面基因组分析的强大工具,揭示了驱动癌症进展的独特遗传改变。这使肿瘤学家能够针对特定的分子异常定制治疗方法。然而,挑战依然存在,包括对生物标志物指导疗法的认识和吸收有限。继续研究胰腺癌的分子机制对于开发更有效的治疗方法和提高患者生存率至关重要。
    Pancreatic cancer, with its alarming rising incidence, is predicted to become the second deadliest type of solid tumor by 2040, highlighting the urgent need for improved diagnostic and treatment strategies. Despite medical advancements, the five-year survival rate for pancreatic cancer remains about 14%, dropping further when metastasized. This review explores the promise of biomarkers for early detection, personalized treatment, and disease monitoring. Molecular classification of pancreatic cancer into subtypes based on genetic mutations, gene expression, and protein markers guides treatment decisions, potentially improving outcomes. A plethora of clinical trials investigating different strategies are currently ongoing. Targeted therapies, among which those against CLAUDIN 18.2 and inhibitors of Claudin 18.1, have shown promise. Next-generation sequencing (NGS) has emerged as a powerful tool for the comprehensive genomic analysis of pancreatic tumors, revealing unique genetic alterations that drive cancer progression. This allows oncologists to tailor therapies to target specific molecular abnormalities. However, challenges remain, including limited awareness and uptake of biomarker-guided therapies. Continued research into the molecular mechanisms of pancreatic cancer is essential for developing more effective treatments and improving patient survival rates.
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  • 文章类型: Journal Article
    基因突变和结肠的慢性炎症有助于结直肠癌(CRC)的发展。使用炎症诱导的结肠肿瘤发生的小鼠模型,我们确定了基因突变如何改变结肠肿瘤细胞分化.由肠产毒性脆弱拟杆菌(ETBF)定植的多发性肠瘤形成(MinApcΔ716/)小鼠引起的炎症引发Apc杂合性丧失,导致结肠肿瘤形成。这里,我们报道了添加BRAFV600E突变(BRAFF-V600ELgr5tm1(Cre/ERT2)CleMinApcΔ716/+,BLM)或敲除Msh2(Msh2LoxP/LoxPVil1-creMinApcΔ716/+,Min模型中的MSH2KO)改变了结肠肿瘤分化。使用单细胞RNA测序,我们发现了BLM之间的差异,Min,和MSH2KO肿瘤在单细胞分辨率。BLM肿瘤显示分化的肿瘤上皮细胞谱系增加,肿瘤干细胞群减少。有趣的是,BLM肿瘤的肿瘤干细胞群具有复苏结肠干细胞特征,WNT信号传导低,RevCSC标记基因表达增加.相比之下,MSH2KO肿瘤的特征在于与Min肿瘤相比具有更高的WNT信号传导活性的肿瘤干细胞群增加。此外,整体BLM肿瘤有较高的转录因子表达驱动分化,如Cdx2,比Min肿瘤。利用RNA速度,我们确定了BLM肿瘤分化的其他潜在调节因子,如NDRG1.使用源自BLM肿瘤的类器官验证了CDX2和NDRG1作为BLM肿瘤细胞分化的推定调节剂的作用。我们的结果证明了在炎症诱导的结肠肿瘤发生中基因突变和细胞分化之间的关键联系。了解这些作用将加深我们对炎症相关结肠癌的理解。
    Genetic mutations and chronic inflammation of the colon contribute to the development of colorectal cancer (CRC). Using a murine model of inflammation-induced colon tumorigenesis, we determined how genetic mutations alter colon tumor cell differentiation. Inflammation induced by enterotoxigenic Bacteroides fragilis (ETBF) colonization of multiple intestinal neoplasia (MinApcΔ716/+) mice triggers loss of heterozygosity of Apc causing colon tumor formation. Here, we report that the addition of BRAFV600E mutation (BRAFF-V600ELgr5tm1(Cre/ERT2)CleMinApcΔ716/+, BLM) or knocking out Msh2 (Msh2LoxP/LoxPVil1-creMinApcΔ716/+, MSH2KO) in the Min model altered colon tumor differentiation. Using single-cell RNA sequencing, we uncovered the differences between BLM, Min, and MSH2KO tumors at a single-cell resolution. BLM tumors showed an increase in differentiated tumor epithelial cell lineages and a reduction in the tumor stem cell population. Interestingly, the tumor stem cell population of BLM tumors had revival colon stem cell characteristics with low WNT signaling and an increase in RevCSC marker gene expression. In contrast, MSH2KO tumors were characterized by an increased tumor stem cell population that had higher WNT signaling activity compared to Min tumors. Furthermore, overall BLM tumors had higher expression of transcription factors that drive differentiation, such as Cdx2, than Min tumors. Using RNA velocity, we identified additional potential regulators of BLM tumor differentiation such as NDRG1. The role of CDX2 and NDRG1 as putative regulators for BLM tumor cell differentiation was verified using organoids derived from BLM tumors. Our results demonstrate the critical connections between genetic mutations and cell differentiation in inflammation-induced colon tumorigenesis. Understanding such roles will deepen our understanding of inflammation-associated colon cancer.
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  • 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.
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  • 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.
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  • 文章类型: Journal Article
    非小细胞肺癌(NSCLC)是一个重要的全球健康问题,具有影响治疗反应的不同分子谱。然而,在摩洛哥,NSCLC的分子流行病学在很大程度上尚未被探索。本研究集中于NSCLC基因突变,特别是在腺癌中,摩洛哥患者有助于了解该人群中的非小细胞肺癌。分析94例诊断为肺腺癌的患者。处理福尔马林固定石蜡包埋的组织样品,使用标准化方案提取脱氧核糖核酸(DNA)/核糖核酸(RNA)。使用AmoyDxPan肺癌聚合酶链反应(PCR)面板试剂盒检测突变,并通过统计分析评估其频率。在22.34%的患者中检测到表皮生长因子受体(EGFR)突变,主要是外显子19缺失(66.66%)和外显子21L858R突变(23.80%)。间变性淋巴瘤激酶(ALK)基因融合者占3.19%,而KRAS基因突变率为1.06%。在其他测试基因中未发现突变。与男性(45.84%)相比,女性(54.16%)的突变率略高。该研究揭示了摩洛哥NSCLC患者的独特突变特征,EGFR突变的明显流行,尽管低于一些亚洲人口。EGFR突变在治疗反应中的意义与全球发现一致,强调了解区域分子变异对个性化治疗的重要性。尽管样本量和临床数据有限,这项研究揭示了摩洛哥非小细胞肺癌的遗传前景。观察到的突变率,特别是在EGFR中,强调了摩洛哥非小细胞肺癌患者靶向治疗的潜力,强调需要进一步研究以完善针对该人群的治疗策略。
    Non-small cell lung cancer (NSCLC) is a significant global health issue with diverse molecular profiles affecting treatment responses. Yet, NSCLC\'s molecular epidemiology in Morocco is largely unexplored. This study focuses on NSCLC genetic mutations, specifically in adenocarcinoma, among Moroccan patients to contribute to understanding NSCLC in this population. Ninety-four patients diagnosed with lung adenocarcinoma were analyzed. Formalin-fixed paraffin-embedded tissue samples were processed, and deoxyribonucleic acid (DNA)/ribonucleic acid (RNA) was extracted using standardized protocols. Mutations were detected using the AmoyDx Pan Lung Cancer Polymerase Chain Reaction (PCR) Panel kit, and their frequencies were assessed through statistical analysis. Epidermal Growth Factor Receptor (EGFR) mutations were detected in 22.34% of patients, predominantly exon 19 deletions (66.66%) and exon 21 L858R mutations (23.80%). Anaplastic lymphoma kinase (ALK) gene fusion was observed in 3.19% of patients, and KRAS mutations in 1.06%. No mutations were found in other tested genes. A slightly higher mutation rate was noted in females (54.16%) compared to males (45.84%). The study reveals a distinct mutation profile in Moroccan NSCLC patients, with a notable prevalence of EGFR mutations, albeit lower than in some Asian populations. The significance of EGFR mutations in treatment response aligns with global findings, highlighting the importance of understanding regional molecular variations for personalized therapy. Despite limitations in sample size and clinical data, this study sheds light on the genetic landscape of NSCLC in Morocco. The observed mutation rates, particularly in EGFR, underscore the potential for targeted therapies in Moroccan NSCLC patients, emphasizing the need for further research to refine treatment strategies tailored to this population.
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  • 文章类型: Journal Article
    遗传性血管性水肿(HAE)包括一组以复发性,遗传介导的血管性水肿与主要由于缓激肽引起的血管通透性增加有关。这种疾病带来了诊断挑战,导致诊断不足和治疗延迟。严重的表现包括喉和肠血管性水肿,导致显著的发病率和死亡率。如果没有确诊,由于喉血管性水肿引起的窒息,该疾病的估计死亡率为25%至40%。迫切需要提高对遗传性血管性水肿及其警告信号的认识。首字母缩写“H4AE”可能有助于记忆这些标志。本研究全面回顾了临床,实验室,和已记录的HAE亚型的病理生理学特征。该研究主张基于内生型改进HAE分类,建立在血管性水肿病理生理学知识的基础上。提出的HAE的内型分类提供了一个清晰和适用的框架,鼓励疾病理解和分类方面的进步。
    Hereditary angioedema (HAE) encompasses a group of diseases characterized by recurrent, genetically mediated angioedema associated with increased vascular permeability primarily due to bradykinin. The disease poses diagnostic challenges, leading to underdiagnosis and delayed therapy. Severe manifestations include laryngeal and intestinal angioedema, contributing to significant morbidity and mortality. If left undiagnosed, the estimated mortality rate of the disease ranges from 25% to 40% due to asphyxiation caused by laryngeal angioedema. There is a pressing need to enhance awareness of hereditary angioedema and its warning signs. The acronym \"H4AE\" may facilitate the memorization of these signs. This study comprehensively reviews clinical, laboratory, and physiopathological features of documented HAE subtypes. The study advocates for an improved HAE classification based on endotypes, building on the knowledge of angioedema pathophysiology. The proposed endotype classification of HAE offers a clear and applicable framework, encouraging advancements in disease understanding and classification.
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  • 文章类型: Journal Article
    胎儿小头畸形是一个小头,大脑皮层体积有各种损失。受影响的病例可能患有严重的大脑发育受损严重程度,从轻度到重度智力低下。它可以是孤立的发现,也可以是其他异常,这取决于包括基因突变在内的异质性原因。染色体异常,先天性传染病,产妇饮酒,怀孕期间代谢紊乱。它往往是一个终身和不可治愈的条件。因此,早期发现胎儿小头畸形和确定潜在原因对于临床工作人员为父母提供适当的遗传咨询和准确的管理很重要。
    Fetal microcephaly is a small head with various losses of cerebral cortical volume. The affected cases may suffer from a wide range in severity of impaired cerebral development from slight to severe mental retardation. It can be an isolated finding or with other anomalies depending on the heterogeneous causes including genetic mutations, chromosomal abnormalities, congenital infectious diseases, maternal alcohol consumption, and metabolic disorders during pregnancy. It is often a lifelong and incurable condition. Thus, early detection of fetal microcephaly and identification of the underlying causes are important for clinical staff to provide appropriate genetic counseling to the parents and accurate management.
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  • 文章类型: Journal Article
    作为支架蛋白,钙/钙调蛋白依赖性丝氨酸蛋白激酶(CASK)已在整个身体的各种组织中进行了广泛的研究。Cask基因普遍存在于多种组织中,比如神经元,胰岛,心,肾脏和精子,并且主要位于基底膜附近的细胞质中。CASK通过其结构域与多种蛋白质结合以发挥其生物活性。
    这里,我们讨论了CASK在全身多个组织中的作用。不同CASK结构域在调节神经元发育中的作用,强调了神经递质的释放和突触小泡的分泌;分析了CASK对胰岛β细胞功能的调节机制;讨论了肾脏和精子发育;并比较了CASK在不同肿瘤中的作用。最后,我们阐明了Cask基因在体内的重要性,以及Cask基因的缺失或突变如何产生不良后果。
    CASK是一种保守基因,在各种组织中具有相似的作用。Cask基因在神经系统中的功能主要参与神经系统的发育和神经递质的释放。在内分泌系统中,据报道,CASK参与了胰岛素囊泡的运输过程。CASK还参与心肌细胞离子通道的调节,肾脏和精子发育,和肿瘤增殖。CASK是全身不可缺少的基因,CASK突变可导致胎儿畸形或出生时死亡。在这次审查中,我们总结了CASK在各种系统中的生物学功能和病理机制,从而为进一步深入研究CASK函数提供了依据。
    UNASSIGNED: As a scaffold protein, calcium/calmodulin-dependent serine protein kinase (CASK) has been extensively studied in a variety of tissues throughout the body. The Cask gene is ubiquitous in several tissues, such as the neurons, islets, heart, kidneys and sperm, and is mostly localised in the cytoplasm adjacent to the basement membrane. CASK binds to a variety of proteins through its domains to exerting its biological activity.
    UNASSIGNED: Here, we discuss the role of CASK in multiple tissues throughout the body. The role of different CASK domains in regulating neuronal development, neurotransmitter release and synaptic vesicle secretion was emphasised; the regulatory mechanism of CASK on the function of pancreatic islet β cells was analysed; the role of CASK in cardiac physiology, kidney and sperm development was discussed; and the role of CASK in different tumours was compared. Finally, we clarify the importance of the Cask gene in the body, and how deletion or mutation of the Cask gene can have adverse consequences.
    UNASSIGNED: CASK is a conserved gene with similar roles in various tissues. The function of the Cask gene in the nervous system is mainly involved in the development of the nervous system and the release of neurotransmitters. In the endocrine system, an involvement of CASK has been reported in the process of insulin vesicle transport. CASK is also involved in cardiomyocyte ion channel regulation, kidney and sperm development, and tumour proliferation. CASK is an indispensable gene for the whole body, and CASK mutations can cause foetal malformations or death at birth. In this review, we summarise the biological functions and pathological mechanisms of CASK in various systems, thereby providing a basis for further in-depth studies of CASK functions.
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  • 文章类型: Journal Article
    背景:甲状腺癌中的microRNA(miRNA)库开始被阐明。在分化型甲状腺癌(DTC)中,甲状腺乳头状癌(PTC)是最常见的。miRNA表达的评估可能有助于改善手术前诊断,以便为患者获得个性化和更有效的治疗。
    目的:本研究旨在评估(1)一系列DTC中的miRNA,以及它们与所选择的基因突变的存在的关联,以提高诊断和预测DTC/PTC的生物学行为。(2)超声引导下细针穿刺细胞学(US-FNAC)中分子检测技术的可靠性,用于更精确的术前诊断。
    方法:本系列包括从106例接受手术的患者中获得的176个样本(98个细胞学样本和78个组织学样本),包括13个良性病变(对照)和93个DTC(病例)。评估miR-146b的microRNA表达,miR-221,miR-222和miR-15a通过定量逆转录酶聚合酶链反应(qRT-PCR)。结果用2-ΔΔCT法分析,使用miR16作为内源性对照。关于PTC诊断,通过接受者工作特征曲线(AUC)下面积来评估miRNA表达的辨别能力。在PTC中,miRNA表达的关联,临床病理特征,和基因突变(BRAF,RAS,和TERTp)进行评估。
    结论:与良性病变相比,所有分析的miRNA在DTC/PTC中呈现过表达的趋势,细胞学和组织学样本。在细胞学中,miRNA在恶性肿瘤中的表达水平高于良性肿瘤。在组织学上,关于PTC诊断的判别能力如下:miR-146b(AUC0.94,95%CI0.87-1),miR-221(AUC0.79,95%CI0.68-0.9),miR-222(AUC0.76,95%CI0.63-0.89),和miR-15a(AUC0.85,95%CI0.74-0.97)。miR-146b显示89%的灵敏度(se)和87%的特异性(sp);miR-221se=68.4,sp=90;miR-222se=73,sp=70;和mi-R15ase=72,sp=80。MicroRNAs与PTCs预后最差的临床病理特征相关(p<0.05),特别是对于miR-222。我们的数据揭示了miR-146b较高表达水平之间的显著关联,miR-221和miR-222在存在BRAF突变(p<0.001)和miR-146b(p=0.016)和miR-221(p=0.010)的情况下具有RAS突变,提示这些突变与miRNAs表达的相互作用。尽管这项研究的样本量相对较小,miRNA在细胞学中的过表达可能有助于更精确的术前诊断。miRNA在PTC诊断中表现出良好的辨别能力。miRNA表达谱和遗传改变之间的关联对于FNAC中DTC/PTC的准确诊断可以是有利的。
    The repertoire of microRNAs (miRNAs) in thyroid carcinomas starts to be elucidated. Among differentiated thyroid carcinomas (DTCs), papillary thyroid carcinoma (PTC) is the most frequent. The assessment of miRNAs expression may contribute to refine the pre-surgical diagnosis in order to obtain a personalized and more effective treatment for patients.
    This study aims to evaluate (1) the miRNAs in a series of DTCs, and their association with the presence of selected genetic mutations in order to improve diagnosis and predict the biologic behavior of DTC/PTC. (2) The reliability of molecular tests in Ultrasound-guided Fine Needle Aspiration Cytology (US-FNAC) for a more precise preoperative diagnosis.
    This series includes 176 samples (98 cytology and 78 histology samples) obtained from 106 patients submitted to surgery, including 13 benign lesions (controls) and 93 DTCs (cases). The microRNA expression was assessed for miR-146b, miR-221, miR-222, and miR-15a through quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). The results were analyzed by the 2-ΔΔCT method, using miR16 as an endogenous control. Regarding PTC diagnosis, the discriminative ability of miRNAs expression was assessed by the area under the Receiver Operating Characteristic Curve (AUC). In PTCs, the association of miRNAs expression, clinicopathological features, and genetic mutations (BRAF, RAS, and TERTp) was evaluated.
    All the analyzed miRNAs presented a tendency to be overexpressed in DTCs/PTCs when compared with benign lesions, both in cytology and histology samples. In cytology, miRNAs expression levels were higher in malignant tumors than in benign tumors. In histology, the discriminative abilities regarding PTC diagnosis were as follows: miR-146b (AUC 0.94, 95% CI 0.87-1), miR-221 (AUC 0.79, 95% CI 0.68-0.9), miR-222 (AUC 0.76, 95% CI 0.63-0.89), and miR-15a (AUC 0.85, 95% CI 0.74-0.97). miR-146b showed 89% sensitivity (se) and 87% specificity (sp); miR-221 se = 68.4, sp = 90; miR-222 se = 73, sp = 70; and mi-R15a se = 72, sp = 80. MicroRNAs were associated with worst-prognosis clinicopathological characteristics in PTCs (p < 0.05), particularly for miR-222. Our data reveal a significant association between higher expression levels of miR-146b, miR-221, and miR-222 in the presence of the BRAF mutation (p < 0.001) and miR-146b (p = 0.016) and miR-221 (p = 0.010) with the RAS mutation, suggesting an interplay of these mutations with miRNAs expression. Despite this study having a relatively small sample size, overexpression of miRNAs in cytology may contribute to a more precise preoperative diagnosis. The miRNAs presented a good discriminative ability in PTC diagnosis. The association between the miRNAs expression profile and genetic alterations can be advantageous for an accurate diagnosis of DTCs/PTCs in FNAC.
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