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[真性红细胞增多症中蛋白激酶JAK2的突变:病理生理学与治疗的新视角]

[Mutation of protein kinase JAK2 in polycythemia vera: new perspectives in physiopathology and therapy].

作者信息

Marie I, Hervé F

机构信息

Département de médecine interne, CHU de Rouen-Boisguillaume, 76031 Rouen cedex, France.

出版信息

Rev Med Interne. 2006 Jun;27(6):473-7. doi: 10.1016/j.revmed.2006.02.011. Epub 2006 Mar 30.

Abstract

INTRODUCTION

The pathogenic mechanisms of polyvythemia vera (PV) still remain unknown, although there is evidence that genetic parameters may play a role in the pathogenesis of the disease.

EXEGESIS

In 2005, many international research groups have identified an acquired mutation in the Janus kinase (JAK2) gene of chromosome 9; the mutation is defined by a valine-to-phenylalanine substitution at amino acid position 617 (V617F) in the JAK2's pseudokinase domain. JAK2 V617F mutation has been found in as high as 65 to 97% of patients with PV. Both in vitro and in vivo functional studies have further indicated that JAK2 V617F mutation leads to dysregulation of kinase activity, explaining, in part, clinical and biochemical features of PV.

CONCLUSION

These data suggest that JAK2 V617F mutation may be a novel diagnostic marker of PV. Moreover, JAK2 V617F mutation finding may permit promising therapeutic approaches in patients with PV, particularly tyrosine kinase inhibitors; preliminary series have, in fact, underscored the potential efficacy of imatinib mesylate in PV.

摘要

引言

真性红细胞增多症(PV)的发病机制仍不清楚,尽管有证据表明遗传因素可能在该疾病的发病过程中起作用。

解释

2005年,许多国际研究小组在9号染色体的Janus激酶(JAK2)基因中发现了一种获得性突变;该突变是由JAK2假激酶结构域中第617位氨基酸(V617F)的缬氨酸到苯丙氨酸取代所定义的。在高达65%至97%的PV患者中发现了JAK2 V617F突变。体外和体内功能研究进一步表明,JAK2 V617F突变导致激酶活性失调,部分解释了PV的临床和生化特征。

结论

这些数据表明JAK2 V617F突变可能是PV的一种新型诊断标志物。此外,发现JAK2 V617F突变可能为PV患者带来有前景的治疗方法,特别是酪氨酸激酶抑制剂;事实上,初步研究已经强调了甲磺酸伊马替尼在PV中的潜在疗效。

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