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大型病例对照研究表明,KIR 基因型与急性髓系白血病发病风险无关。

Large case-control study indicates no association of KIR genotype and risk of developing acute myeloid leukemia.

机构信息

Department of Internal Medicine I, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Clinical Trials Unit, DKMS gGmbH, Dresden, Germany.

出版信息

Blood Adv. 2023 Jul 11;7(13):2994-3004. doi: 10.1182/bloodadvances.2022008514.

Abstract

Immunogenetic association studies may give rise to new hypotheses on the immune surveillance of cancer. We hypothesized that certain combinations of killer immunoglobulin-like receptor (KIR) and HLA genotypes may enhance natural killer (NK) cell immunity against nascent acute myeloid leukemia (AML) and, thereby, lead to a skewed genotype distribution among patients. For this purpose, we analyzed KIR and HLA genotypes of 1767 German patients with AML and compared the results with that of the data of 51 890 German volunteers who had registered with German bone marrow donor file (DKMS). Patient samples were retrieved from the Collaborative Biobank and the biorepository of the Study Alliance Leukemia. All samples were genotyped with high-resolution amplicon-based next-generation sequencing. Because of the large number of controls, this study was very sensitive to detect the impact of KIR genotype. Knowledge on KIRs and their cognate HLA ligands allowed for testing of several hypotheses of NK cell-mediated endogenous leukemia surveillance. We did not find significant differences between the 2 cohorts in regard to the presence or absence of single KIR genes. When grouped based on telomeric or centromeric gene content, the major haplotypes A/A, A/B, and B/B were equally distributed among patients and control subjects. Using information on KIRs and their HLA ligands, we further tested receptor-ligand models and summation models without revealing markedly significant differences between patients and controls, albeit we observed a trend pointing at a minor protective effect of a low number of inhibitory KIR/KIR-ligand pairs. The results suggest that the KIR/KIR-ligand genotype has no effect on the susceptibility for the development of de novo AML.

摘要

免疫遗传关联研究可能会产生关于癌症免疫监测的新假设。我们假设某些杀伤免疫球蛋白样受体(KIR)和 HLA 基因型的组合可能增强自然杀伤(NK)细胞对新生急性髓系白血病(AML)的免疫,从而导致患者中存在偏倚的基因型分布。为此,我们分析了 1767 名德国 AML 患者的 KIR 和 HLA 基因型,并将结果与 51890 名已在德国骨髓捐赠者档案(DKMS)注册的德国志愿者的数据进行了比较。患者样本取自协作生物库和研究联盟白血病生物库。所有样本均采用基于高分辨率扩增子的下一代测序进行基因分型。由于对照数量众多,这项研究非常敏感,可以检测到 KIR 基因型的影响。对 KIR 及其同源 HLA 配体的了解允许测试 NK 细胞介导的内源性白血病监测的几个假设。我们没有发现两组之间在单个 KIR 基因的存在或缺失方面存在显著差异。当根据端粒或着丝粒基因含量进行分组时,主要单倍型 A/A、A/B 和 B/B 在患者和对照受试者中均匀分布。利用 KIR 及其 HLA 配体的信息,我们进一步测试了受体-配体模型和总和模型,但没有发现患者和对照组之间存在明显显著差异,尽管我们观察到一个趋势表明,抑制性 KIR/KIR 配体对数量较少的配体对具有较小的保护作用。结果表明,KIR/KIR 配体基因型对新发 AML 的易感性没有影响。

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