在多发性骨髓瘤患者中,蛋白质酶抑制剂相关心脏毒性的表观基因组广泛关联研究
Raed Awadh Alshammari1,2, Samuel M Rubinstein3, Eric Farber-Eger4
1Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL 32610-0486, USA.
Cancers
|February 13, 2026
概括
这项研究在多发性骨髓瘤患者中发现了与心血管不良事件 (CVAE) 相关的明显的DNA甲基化变化,这些患者接受了卡菲尔佐米布或博特佐米布治疗,这表明表观遗传因素有助于这些副作用.
科学领域:
- 基因组学和表观遗传学
- 在瘤学瘤学.
- 心脏病学 心脏病学
背景情况:
- 蛋白质酶抑制剂,如卡菲尔佐米布 (CFZ) 和博特佐米布 (BTZ) 是复发性/耐药性多发性骨髓瘤 (MM) 的第一线治疗方法.
- 这些疗法与显著的心血管不良事件 (CVAE) 有关.
- 了解CVAE的分子基础对于患者的安全至关重要.
研究的目的:
- 在接受CFZ或BTZ治疗的MM患者中,确定与CVAE相关的差异甲基化位置 (DMP) 和区域 (DMR).
- 探索与治疗相关的CVAEs相关的丰富生物途径.
- 在蛋白质酶抑制剂治疗中调查潜在的CVAE表观遗传贡献者.
主要方法:
- 在PROTECT研究中分析了79名MM患者的基线生殖线DNA甲基化概况.
- 全表观基因组关联研究 (EWAS) 针对CFZ和BTZ治疗组分别进行.
- 进行了元分析,以确定两种药物治疗中与CVAE相关的常见表观遗传信号.
主要成果:
- 四个重要的DMP与CFZ相关的CVAE相关,包括接近ENSG00000224400,TBX3和WDR86.4的CVAE.
- 对于CFZ-CVAE,在FAM166B地区确定了一个重要的DMR.
- 在接受BTZ治疗的患者中 (DNAJC18,USP18,WDR86/WDR86-AS1) 发现了暗示性DMP和DMR,但元分析显示没有显著的常见DMP.
- 途径分析涉及过氧体,MAPK,Rap1,粘附结,脂酶D,自和CVAEs中的阿尔多激素信号传递.
结论:
- 在接受CFZ治疗的患者中,与CVAE相关的显著表观遗传特征 (DMPs和DMRs),在较小程度上,BTZ.
- 丰富的途径表明CVAEs的基础是各种各样的生物机制.
- 这些发现强调了表观遗传学在CVAE发展中的作用,并强调了需要进行更大规模的验证研究的需要.
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