Cell:染色体碎裂带来医学奇迹

2015-02-16 佚名 生物360

这里要讲述的故事可以说是一个科学奇闻,抑或是一个医学奇迹。从前有个女孩从小患有严重的遗传学免疫疾病,但她居然在三十多岁的时候自己痊愈了。科学家们发现,她的痊愈是因为造血干细胞中发生了DNA破碎,去除了一个有害的基因。这个故事的主角生活在美国俄亥俄州的辛辛那提,她小时候总是反复遭遇细菌感染。医生发现,她体内负责抵御入侵细菌的白细胞水平异常低。1964年,《新英格兰医学》上的两份报告描述了这个女孩的病



这里要讲述的故事可以说是一个科学奇闻,抑或是一个医学奇迹。从前有个女孩从小患有严重的遗传学免疫疾病,但她居然在三十多岁的时候自己痊愈了。科学家们发现,她的痊愈是因为造血干细胞中发生了DNA破碎,去除了一个有害的基因。

这个故事的主角生活在美国俄亥俄州的辛辛那提,她小时候总是反复遭遇细菌感染。医生发现,她体内负责抵御入侵细菌的白细胞水平异常低。1964年,《新英格兰医学》上的两份报告描述了这个女孩的病情,将其作为WHIM综合症的首个病例。这种疾病非常罕见,全世界大约只有六十名患者。这些患者能够长大成人,但是他们会因为频繁感染而出现肺部瘢痕、听觉损失和其他健康问题。而且WHIM综合症患者对可能致癌的人乳头瘤病毒高度敏感。

2003年,研究者们将CXCR4基因与WHIM关联起来。这个基因编码一种细胞表面蛋白,免疫细胞通过该蛋白来识别趋化因子。WHIM患者带有一个有缺陷的CXCR4拷贝,使得这个受体过度活化,在应该关闭的时候关不上。结果是白细胞“卡”在骨髓里无法进入血流,美国国家过敏症和传染病研究所的免疫学家Philip Murphy说。

Murphy及其同事一直在NIH临床中心研究WHIM患者,以便更好的理解这种疾病和开发抑制CXCR4的药物。两年前,一个女子带着自己的两个女儿来做检查。这名59岁的女子就是上文所述的第一位WHIM患者。她的两个二十岁的女儿遗传了这种疾病,表现出典型的WHIM症状,血细胞中也存在着CXCR4突变。然而,这位母亲自己在三十多岁以后就没有出现过严重的感染。“这让我们非常非常感兴趣,”Murphy说。

NIH开始对这位母亲进行研究,他们发现,尽管其他细胞还带有CXCR4突变,但这位女性的白细胞中已经没有CXCR4突变了。研究人员检测了这些表面上正常的白细胞,结果发现2号染色体的一个拷贝比另一个拷贝短15%。全基因组测序显示,较短的染色体拷贝曾经被打碎,缺失的那一块包含CXCR4和163个正常基因。

研究人员认为,这一现象是染色体碎裂(chromothripsis)造成的。染色体碎裂是指,一个染色体在复制过程被打碎,然后这些碎片以另一种顺序重组。染色体碎裂事件是人们四年前在一个白血病患者中发现的,偶尔也出现在其他癌症中。发生染色体碎裂的细胞一般会死亡,如果细胞存活下来就会引发癌症。

这项研究中的染色体碎裂发生在造血干细胞中,可以源源不断地为这名女性提供正常白细胞。研究人员发现,与正常CXCR4和WHIM版CXCR4相比,缺乏一个CXCR4拷贝的干细胞能够更好的移植给小鼠。正因如此,这位女性的白细胞现在全都表现正常。Murphy等人将这些研究结果发表在二月五日的Cell杂志上。

Murphy指出,这位女性身上发生的奇迹说明,染色体碎裂可以治愈疾病。以后可以在自己痊愈的罕见病患者中检测这一事件。

这一发现“非常有趣,”西奈山伊坎医学院的临床遗传学家George Diaz评论道,CXCR4突变引发WHIM就是他鉴定的。Diaz由此想到了“柏林病人”的故事,这个HIV阳性患者得了白血病,但在接受骨髓移植之后,体内就没有可检出的HIV病毒了。这是因为他的骨髓供体缺乏一种趋化因子受体,HIV需要这一受体才能进入细胞。毫无疑问,现在这项染色体破碎研究也有着重要的临床意义。

原始出处:

McDermott DH1, Gao JL1, Liu Q1, Siwicki M1, Martens C2, Jacobs P1, Velez D1, Yim E1, Bryke CR3, Hsu N3, Dai Z4, Marquesen MM5, Stregevsky E6, Kwatemaa N5, Theobald N5, Long Priel DA7, Pittaluga S8, Raffeld MA8, Calvo KR9, Maric I9, Desmond R10, Holmes KL6, Kuhns DB7, Balabanian K11, Bachelerie F11, Porcella SF2, Malech HL5, Murphy PM12.Chromothriptic cure of WHIM syndrome.Cell. 2015 Feb 12;160(4):686-99. doi: 10.1016/j.cell.2015.01.014. Epub 2015 Feb 5.

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    2015-12-09 维他命
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    2015-02-21 orthoW

    非常好的文章,学习

    0

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    2015-02-20 orthoW

    很不错学习了

    0

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    2015-02-19 orthoW

    ?学习了

    0

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