Mori Ako, Wada Hiroshi, Nishimura Yasuo, Okamoto Takahiro, Takemoto Yoshinobu, Kakishita Eizo
Second Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Int J Hematol. 2002 Feb;75(2):161-5. doi: 10.1007/BF02982021.
Loss of the inhibition of apoptosis is important in leukemogenesis and may influence the prognosis. Survivin is an inhibitor of apoptosis that shows selective expression during fetal development and in human malignancies. Survivin expression was examined in human leukemias using the reverse transcriptase-polymerase chain reaction. Survivin gene expression was detected in 17 of 31 patients with acute myelocytic leukemia and 11 of 16 patients with acute lymphocytic leukemia but was not identified in normal bone marrow cells. Survivin expression was lower in patients with M3 acute myelocytic leukemia than in patients with other types of acute leukemia. Survivin was not detected in the chronic phase of chronic myelocytic leukemia but was observed in 5 of 7 patients with chronic myelocytic leukemia in blastic crisis. These findings suggest a relationship between survivin gene expression and hematopoietic cell differentiation. In fact, survivin gene expression was down-regulated during the differentiation of HL-60 cells after treatment with dimethyl sulfoxide or all-trans-retinoic acid. Moreover, the disease-free survival rates of patients with survivin expression were lower than in patients without survivin expression. Accordingly, survivin may have a role in leukemogenesis as well as in other malignancies. Detecting survivin may also provide prognostic information.
凋亡抑制的丧失在白血病发生过程中很重要，并且可能影响预后。生存素是一种凋亡抑制剂，在胎儿发育和人类恶性肿瘤中呈选择性表达。使用逆转录聚合酶链反应检测人类白血病中的生存素表达。在31例急性髓细胞白血病患者中的17例以及16例急性淋巴细胞白血病患者中的11例中检测到生存素基因表达，但在正常骨髓细胞中未检测到。M3型急性髓细胞白血病患者的生存素表达低于其他类型急性白血病患者。在慢性髓细胞白血病的慢性期未检测到生存素，但在7例慢性髓细胞白血病急变期患者中的5例中观察到生存素。这些发现提示生存素基因表达与造血细胞分化之间存在关联。事实上，在用二甲基亚砜或全反式维甲酸处理后，HL-60细胞分化过程中生存素基因表达下调。此外，有生存素表达的患者的无病生存率低于无生存素表达的患者。因此，生存素可能在白血病发生以及其他恶性肿瘤中起作用。检测生存素也可能提供预后信息。
