Nature Genetics：科学家发现与两种血液病恶化有关的基因变异

日本研究人员最新发现，骨髓增生异常综合征和幼年型粒－单核细胞白血病这两种血液疾病的恶化都与基因SETBP1发生变异有关。这一发现有助于提早制定治疗方案，比如在发现基因出现变异的阶段就进行骨髓移植。这一研究成果的论文刊登在近期出版的《自然—遗传学》杂志网络版上。

骨髓增生异常综合征是造血干细胞增殖分化异常所导致的一种血液疾病，患者会出现贫血、免疫力低下等症状。随着病情恶化，可能向死亡率较高的急性骨髓性白血病转化。而幼年型粒－单核细胞白血病是一种罕见的克隆性造血干细胞增生异常性疾病，多发生在幼年期。

日本京都大学、名古屋大学和东京大学等机构的研究人员，对上述两种疾病患者的基因进行分析后发现，在骨髓增生异常综合征恶化，并转化为急性骨髓性白血病后，约17%的患者体内控制细胞增殖的SETBP1基因出现变异。

研究小组认为，造血干细胞中的SETBP1基因出现变异是令骨髓增生异常综合征发展成白血病的导火索。

而幼年型粒－单核细胞白血病患者体内的SETBP1基因出现变异，会导致患者生存率降低。研究小组推测，这一基因可能与造血干细胞的增殖有关。

研究小组带头人、京都大学教授小川诚司指出：“如果定期进行血液检查，监视基因变异的时机，就能提早制定治疗方案，比如进行化疗或骨髓移植等。”

原文链接：

---

Somatic SETBP1 mutations in myeloid malignancies

Here we report whole-exome sequencing of individuals with various myeloid malignancies and identify recurrent somatic mutations in SETBP1, consistent with a recent report on atypical chronic myeloid leukemia (aCML)1. Closely positioned somatic SETBP1 mutations encoding changes in Asp868, Ser869, Gly870, Ile871 and Asp880, which match germline mutations in Schinzel-Giedion syndrome (SGS)2, were detected in 17% of secondary acute myeloid leukemias (sAML) and 15% of chronic myelomonocytic leukemia (CMML) cases. These results from deep sequencing demonstrate a higher mutational detection rate than reported with conventional sequencing methodology3, 4, 5. Mutant cases were associated with advanced age and monosomy 7/deletion 7q (–7/del(7q)) constituting poor prognostic factors. Analysis of serially collected samples indicated that SETBP1 mutations were acquired during leukemic evolution. Transduction with mutant Setbp1 led to the immortalization of mouse myeloid progenitors that showed enhanced proliferative capacity compared to cells transduced with wild-type Setbp1. Somatic mutations of SETBP1 seem to cause gain of function, are associated with myeloid leukemic transformation and convey poor prognosis in myelodysplastic syndromes (MDS) and CMML.

来源：新华社