在B细胞淋巴瘤中,CARD11的功能增强调节了BCL2A1的表达,并促进了针对性治疗组合的耐药性
Salomé Decombis1, Celine Bellanger1, Yannick Le Bris2
1Hematology Department, Nantes Université, INSERM, CNRS, Université d'Angers, CRCI2NA, Nantes, France.
Blood
|August 10, 2023
概括
针对B细胞淋巴瘤的向疗法可以通过CARD11突变导致耐药性,导致NF-κB1激活. 与BCL2抑制相结合的MALT1抑制克服了这种抵抗,为攻击性B细胞淋巴瘤提供了新的治疗策略.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 免疫学 免疫学 免疫学
背景情况:
- 结合CD20,BCL2和布鲁顿氨酸激酶抑制剂 (OASI) 的向疗法在B细胞淋巴瘤 (BCL) 和地幔细胞淋巴瘤 (MCL) 中显示出有效性.
- 对这些向疗法的获得性耐药性仍然是BCL治疗中的重大临床挑战.
研究的目的:
- 调查基因组和转录基因组机制,这些机制是MCL中OASIs组合疗法耐药性的基础.
- 确定新的治疗策略,以克服侵略性BCL的抵抗.
主要方法:
- 长度基因组和单细胞RNA测序分析的MCL患者接受OASIs治疗.
- 功能性研究评估CARD11突变和MALT1抑制的影响.
- 开发和验证一个16基因抗药特征.
主要成果:
- 耐药的MCL亚克隆表现出BCR独立的NF-κB1基因过度表达,由CARD11突变驱动.
- CARD11功能增益突变导致BCL2A1过度表达,从而产生对venetoclax和OASIs的耐药性.
- 一个16基因的耐药性特征预测了MCL患者的治疗结果,表明一种共同的耐药性机制.
- MALT1蛋白酶抑制降低了与耐药性相关的基因表达,并且与BCL2抑制相结合,诱导了协同作用的细胞死亡.
结论:
- 通过NF-κB1通路激活和BCL2A1上调调节,CARD11突变驱动对向BCL疗法的耐药性.
- 抑制MALT1是一种有前途的治疗策略,特别是与BCL2抑制剂结合使用,以克服侵袭性BCL的耐药性.
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