Shannon K M, O'Connell P, Martin G A, Paderanga D, Olson K, Dinndorf P, McCormick F
Department of Pediatrics, University of California, San Francisco 94143-0724.
N Engl J Med. 1994 Mar 3;330(9):597-601. doi: 10.1056/NEJM199403033300903.
Children with type 1 neurofibromatosis (NF-1) are at increased risk for malignant myeloid disorders. Analysis of the NF-1 gene (NF1) suggests that the function of its product, neurofibromin, is reduced in affected persons and that NF1 belongs to the tumor-suppressor class of recessive cancer genes. This model is consistent with evidence that neurofibromin accelerates the intrinsic guanosine triphosphate-hydrolyzing activity of the Ras family of regulatory proteins. Loss of constitutional heterozygosity has not been reported in the benign tumors associated with NF-1, however, and has only been detected in a few malignant neural-crest tumors and in some tumor-derived cell lines.
We studied DNA extracted from the bone marrow of 11 children with NF-1 in whom malignant myeloid disorders developed and from parental leukocytes. We used a series of polymorphic markers within and near NF1 to determine whether leukemogenesis was associated with structural alterations of the gene.
Bone marrow samples from five patients showed loss of heterozygosity. In each case, the NF1 allele was inherited from a parent with NF-1 and the normal allele was deleted.
These data provide evidence of NF1 may function as a tumor-suppressor allele in malignant myeloid diseases in children with NF-1 and that neurofibromin is a regulator of ras in early myelopoiesis.
1型神经纤维瘤病(NF-1)患儿发生恶性髓系疾病的风险增加。对NF-1基因(NF1)的分析表明,其产物神经纤维瘤蛋白在患者体内的功能降低,且NF1属于隐性癌基因中的肿瘤抑制基因类别。该模型与神经纤维瘤蛋白加速调节蛋白Ras家族的内在鸟苷三磷酸水解活性的证据一致。然而,尚未在与NF-1相关的良性肿瘤中报道结构杂合性缺失,仅在少数恶性神经嵴肿瘤和一些肿瘤衍生细胞系中检测到。
我们研究了从11例发生恶性髓系疾病的NF-1患儿的骨髓以及其父母白细胞中提取的DNA。我们使用了一系列位于NF1基因内部及附近的多态性标记,以确定白血病发生是否与该基因的结构改变有关。
5例患者的骨髓样本显示杂合性缺失。在每种情况下,NF1等位基因均从患有NF-1的父母一方遗传而来,而正常等位基因缺失。
这些数据提供了证据,表明NF1在患有NF-1的儿童的恶性髓系疾病中可能作为肿瘤抑制等位基因发挥作用,并且神经纤维瘤蛋白在早期骨髓生成中是ras的调节因子。