在患有急性淋巴细胞白血病的儿科患者中,新型基因组变异影响了甲特雷克萨特延迟清除
Jung Yoon Choi1,2, Hoshik Kwon3, Hyery Kim4
1Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Frontiers in pharmacology
|November 29, 2024
概括
这项研究确定了包括 ENG 和 PKD1L2 在内的遗传变异,与儿科白血病患者高剂量甲状腺素清除延迟相关. 这些发现可能有助于减少MTX的毒性.
科学领域:
- 药物基因组学 药物基因组学
- 儿科瘤学 儿科瘤学
- 毒理学 毒理学 毒理学
背景情况:
- 高剂量的甲状腺素 (HD-MTX) 对于治疗儿科急性淋巴细胞白血病 (ALL) 是至关重要的.
- 晚期清除HD-MTX可以导致严重的毒性,包括毒性,粘膜炎,肝毒性和神经毒性.
- 识别影响MTX清除的遗传因素对于个性化治疗策略至关重要.
研究的目的:
- 在患有ALL的儿科患者中识别与延迟高剂量甲状腺素清除相关的遗传变异.
- 调查MTX水平与毒性结果之间的相关性.
- 为修改治疗方法和减少不良反应提供基础.
主要方法:
- 来自51名韩国儿科ALL患者的生殖基因DNA的全外体序列测序.
- 分析了341个HD-MTX输液数据点,包括MTX水平和毒性标记.
- 血清MTX峰值水平与毒性结果之间的相关性分析,并确定影响MTX清除的变异.
主要成果:
- 在24小时MTX水平和随后的肌素水平之间观察到强烈的相关性.
- 与延迟的MTX清除相关的候选变体包括rs2229866 (CNTN2),rs200687372 (MTMR9),rs777260512 (POLI),rs16954698 (PKD1L2),rs117765468 (NSMCE1) 和rs1800956 (ENG).这些变体是最常见的.
- 变种NG rs1800956与延迟的MTX清除有显著的关联,PKD1L2 rs16954698在外部数据集中得到复制.
结论:
- 这是第一个分析儿科ALL患者延迟MTX清除的全外体测序研究.
- ENG rs1800956和PKD1L2 rs16954698是可能影响MTX清除的具有影响力的变体.
- 这些发现为HD-MTX诱导的毒性提供了见解,并可能有助于通过治疗调整来最大限度地减少不良事件.
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