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[嗜酸性粒细胞增多综合征中JAK/STAT信号通路的激活及患者对伊马替尼的治疗反应]

[The activation of JAK/STAT signal pathway in hypereosinophilic syndrome and the patients therapeutic response to imatinib].

作者信息

Li Bin, Zhang Guang-Sen, Dai Chong-Wen, Pei Min-Fei

机构信息

Division of Hematology, Institute of Molecular Hematology, the Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 Feb 23;85(7):448-52.

Abstract

OBJECTIVE

To determine whether JAK/STAT pathway is involved in proliferation of hypereosinophilic syndrome (HES) cells, and reveal the pathogenesis of HES; observe the dynamic change of the clinical phenotype and hematological response, the expression of janaus kinase/signal transducer and activator of transcription (JAK/STAT) protein or FIP1L1-PDGFRA mRNA in one HES patient treated with low-dose imatinib.

METHODS

The granulocytes of peripheral blood of 4 HES patients, including 3 FIP1L1-PDGFRA positive cases and 1 negative case, were collected. The expression of JAK2, STAT3, and phosphorylated STAT (P-STAT5) proteins were detected by western blotting. One FIP1L1-PDGFRA fusion gene positive patient was administered with low-dose imatinib. Retrospective reverse transcription polymerase chain reaction (RT-PCR) analysis of FIP1L1-PDGFRA was performed and the expressions of JAK2, STAT3 and P-STAT5 were detected by western blotting before treatment and 10, 30, and 60 days after the beginning of treatment.

RESULTS

Upregulation of JAK2, STAT3, and P-STAT5 proteins was shown in 3 FIP1L1-PDGFRA fusion gene positive HES patients, while all of these proteins were not expressed in one case of FIP1L1-PDGFRA negative HES. Continuous hematological remission was observed in one FIP1L1-PDGFRA fusion gene positive HES patient after low-dose imatinib treatment. The amount of FIP1L1-PDGFRA transcripts in peripheral blood granulocytes was significantly decreased in 30 days after therapy and turned negative 60 days after therapy. JAK2, STAT3, STAT5, and P-STAT5 expressions were all down-regulated time-dependently and were all negative 60 days after.

CONCLUSION

There is excessive activation of JAK/STAT signal pathway in HES patient, which may contribute to the malignant proliferation of eosinophils. Low-dose imatinib, that induces complete hematological and molecular genetic remission, exerts significant effects on FIP1L1-PDGFRA positive HES.

摘要

目的

探讨JAK/STAT信号通路是否参与嗜酸性粒细胞增多综合征(HES)细胞的增殖,以揭示HES的发病机制;观察1例接受低剂量伊马替尼治疗的HES患者临床表型和血液学反应的动态变化,以及janus激酶/信号转导及转录激活因子(JAK/STAT)蛋白或FIP1L1-PDGFRA mRNA的表达情况。

方法

收集4例HES患者外周血粒细胞,其中3例FIP1L1-PDGFRA阳性,1例阴性。采用蛋白质印迹法检测JAK2、STAT3及磷酸化STAT(P-STAT5)蛋白的表达。对1例FIP1L1-PDGFRA融合基因阳性患者给予低剂量伊马替尼治疗。治疗前及治疗开始后10、30和60天,采用回顾性逆转录聚合酶链反应(RT-PCR)分析FIP1L1-PDGFRA,并采用蛋白质印迹法检测JAK2、STAT3和P-STAT5的表达。

结果

3例FIP1L1-PDGFRA融合基因阳性的HES患者JAK2、STAT3及P-STAT5蛋白表达上调,而1例FIP1L1-PDGFRA阴性的HES患者这些蛋白均未表达。1例FIP1L1-PDGFRA融合基因阳性的HES患者经低剂量伊马替尼治疗后持续血液学缓解。治疗30天后外周血粒细胞中FIP1L1-PDGFRA转录本数量显著减少,治疗60天后转阴。JAK2、STAT3、STAT5及P-STAT5的表达均随时间依赖性下调,60天后均为阴性。

结论

HES患者存在JAK/STAT信号通路的过度激活,这可能导致嗜酸性粒细胞的恶性增殖。低剂量伊马替尼可诱导完全血液学和分子遗传学缓解,对FIP1L1-PDGFRA阳性的HES有显著疗效。

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