McDermott David H, Gao Ji-Liang, Murphy Philip M
Laboratory of Molecular Immunology; National Institute of Allergy and Infectious Diseases; National Institutes of Health ; Bethesda, MD USA.
Rare Dis. 2015 Aug 11;3(1):e1073430. doi: 10.1080/21675511.2015.1073430. eCollection 2015.
We recently reported a 59 year old female, designated WHIM-09, who was born with the rare immunodeficiency disease WHIM syndrome but underwent spontaneous phenotypic reversion as an adult. The causative WHIM mutation CXCR4 (R334X) was absent in her myeloid and erythroid lineage, but present in her lymphoid lineage and in epithelial cells, defining her as a somatic genetic mosaic. Genomic and hematologic analysis revealed chromothripsis (chromosome shattering) on one copy of chromosome 2, which deleted 164 genes including CXCR4 (R334X) in a single haematopoietic stem cell (HSC) (Fig. 1). Experiments in mice indicated that deleting one copy of Cxcr4 is sufficient to confer a selective advantage for engraftment of transplanted HSCs, suggesting a mechanism for clinical cure in WHIM-09. Genome editing may allow autologous transplantation of HSCs lacking one copy of CXCR4 without bone marrow conditioning as a general cure strategy in WHIM syndrome, safely recapitulating the outcome in patient WHIM-09. Figure 1.Chromothripsis (chromosomal shattering) resulted in clinical cure of a patient with a rare immunodeficiency (WHIM syndrome) by deleting the mutant copy of CXCR4.
我们最近报道了一名59岁的女性,代号为WHIM-09,她出生时患有罕见的免疫缺陷疾病WHIM综合征,但成年后经历了自发的表型逆转。致病的WHIM突变CXCR4(R334X)在她的髓系和红系谱系中不存在,但在她的淋巴系谱系和上皮细胞中存在,这将她定义为体细胞遗传嵌合体。基因组和血液学分析显示,2号染色体的一个拷贝上发生了染色体碎裂,在单个造血干细胞(HSC)中删除了164个基因,包括CXCR4(R334X)(图1)。在小鼠身上进行的实验表明,删除一个拷贝的Cxcr4足以赋予移植的造血干细胞植入的选择性优势,这提示了WHIM-09临床治愈的一种机制。基因组编辑可能允许对缺乏一个拷贝CXCR4的造血干细胞进行自体移植,而无需进行骨髓预处理,作为WHIM综合征的一种通用治愈策略,安全地重现患者WHIM-09的治疗结果。图1.染色体碎裂通过删除CXCR4的突变拷贝导致一名患有罕见免疫缺陷(WHIM综合征)的患者临床治愈。