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CLPB 的杂合变体是严重先天性中性粒细胞减少症的一个原因。

Heterozygous variants of CLPB are a cause of severe congenital neutropenia.

机构信息

Division of Hematology-Oncology, Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO.

Department of Biochemistry and Biophysics, Pharmacology Graduate Group, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

出版信息

Blood. 2022 Feb 3;139(5):779-791. doi: 10.1182/blood.2021010762.

Abstract

Severe congenital neutropenia is an inborn disorder of granulopoiesis. Approximately one third of cases do not have a known genetic cause. Exome sequencing of 104 persons with congenital neutropenia identified heterozygous missense variants of CLPB (caseinolytic peptidase B) in 5 severe congenital neutropenia cases, with 5 more cases identified through additional sequencing efforts or clinical sequencing. CLPB encodes an adenosine triphosphatase that is implicated in protein folding and mitochondrial function. Prior studies showed that biallelic mutations of CLPB are associated with a syndrome of 3-methylglutaconic aciduria, cataracts, neurologic disease, and variable neutropenia. However, 3-methylglutaconic aciduria was not observed and, other than neutropenia, these clinical features were uncommon in our series. Moreover, the CLPB variants are distinct, consisting of heterozygous variants that cluster near the adenosine triphosphate-binding pocket. Both genetic loss of CLPB and expression of CLPB variants result in impaired granulocytic differentiation of human hematopoietic progenitor cells and increased apoptosis. These CLPB variants associate with wild-type CLPB and inhibit its adenosine triphosphatase and disaggregase activity in a dominant-negative fashion. Finally, expression of CLPB variants is associated with impaired mitochondrial function but does not render cells more sensitive to endoplasmic reticulum stress. Together, these data show that heterozygous CLPB variants are a new and relatively common cause of congenital neutropenia and should be considered in the evaluation of patients with congenital neutropenia.

摘要

严重先天性中性粒细胞减少症是一种先天性粒细胞生成障碍。大约三分之一的病例没有已知的遗传原因。对 104 名先天性中性粒细胞减少症患者的外显子组测序发现,5 例严重先天性中性粒细胞减少症患者存在 CLPB(组织蛋白酶 B)的杂合错义变异,通过额外的测序或临床测序发现了另外 5 例。CLPB 编码一种三磷酸腺苷酶,该酶与蛋白质折叠和线粒体功能有关。先前的研究表明,CLPB 的双等位基因突变与 3-甲基戊烯二酸尿症、白内障、神经疾病和可变中性粒细胞减少症有关。然而,在我们的研究中没有观察到 3-甲基戊烯二酸尿症,除了中性粒细胞减少症之外,这些临床特征并不常见。此外,CLPB 变体是独特的,由杂合变体组成,这些变体聚集在三磷酸腺苷结合口袋附近。CLPB 的遗传缺失和变体的表达都会导致人造血祖细胞的粒细胞分化受损和凋亡增加。这些 CLPB 变体与野生型 CLPB 相关联,并以显性负性方式抑制其三磷酸腺苷酶和解聚酶活性。最后,CLPB 变体的表达与线粒体功能受损有关,但不会使细胞对内质网应激更敏感。总之,这些数据表明,杂合 CLPB 变体是先天性中性粒细胞减少症的一个新的、相对常见的原因,在评估先天性中性粒细胞减少症患者时应考虑到这一点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4679/8814677/b61794a9f54c/bloodBLD2021010762absf1.jpg

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