在骨髓增殖性新生瘤中,JAK2抑制调解了RAS途径突变的克隆选择
Nabih Maslah1,2, Nina Kaci3, Blandine Roux3
1Université Paris Cité, APHP, Hôpital Saint-Louis, Laboratoire de Biologie Cellulaire, Paris, France.
Nature communications
|July 7, 2025
概括
像ruxolitinib这样的Janus 激酶 (JAK) 抑制剂可以意外地促进骨髓纤维化患者RAS突变的生长. 这一发现表明,在用于骨髓增殖性瘤 (MPN) 的JAK抑制剂治疗之前,需要对RAS突变进行查.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子生物学分子生物学
背景情况:
- 雅努斯激酶 (JAK) 抑制剂,包括鲁克索利提尼布,已被用于治疗骨髓增殖性瘤 (MPN) 一十年.
- 了解JAK抑制剂对MPN克隆进化的长期影响对于优化患者的治疗结果至关重要.
研究的目的:
- 研究ruxolitinib治疗对髓纤维化 (MF) 的克隆演变的影响.
- 为了确定RAS途径突变与JAK抑制剂治疗期间患者存活率之间的关系.
主要方法:
- 骨髓纤维化患者队列的纵向分子评估.
- 单细胞DNA测序和RAS突变的CD34+细胞的体外治疗.
- 在体外和体外竞争测试以评估细胞适应性.
主要成果:
- 卢克索利提尼布治疗与MPN患者RAS途径突变的克隆增长有关.
- 鲁克索利提尼布在JAK/STAT野生类型和超活化环境中都诱导了RAS克隆选择.
- RAS突变与减少无转化和整体存活率相关,特别是在接受鲁克索利提尼布治疗的患者中.
- 经RAS突变的细胞在 ruxolitinib 或 JAK2 淘汰下表现出增加的适应性,这表明对目标有影响.
结论:
- 治疗JAK抑制剂可以导致RAS突变的选择和生长,这可能会影响患者的生存.
- 与JAK2下调相关的MAPK通路激活,增强了RAS突变的致癌潜力.
- 在考虑使用JAK抑制剂治疗的MPN患者中,应对先前存在的RAS突变进行查.
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