Wake N, Arima T, Matsuda T
Department of Reproductive Physiology and Endocrinology, Medical Institute of Bioregulation, Kyushu University, Beppu, Oita, Japan.
Int J Gynaecol Obstet. 1998 Apr;60 Suppl 1:S1-8.
Complete hydatidiform mole is an abnormal pregnancy characterized by grossly swollen villi in the absence of a fetus (Kajii and Ohama 1997, Wake et al., 1978, Jacobs et al., 1980). It is well known that this abnormal pregnancy product is androgenetic in origin. The entire genome of the molar conceptus is paternally derived. The majority of moles result from fertilization of an empty egg by haploid sperm. The paternally derived haploid set then duplicated without cytokinesis and restores diploidy. Invariably, this class of moles has a 46, XX karyotype and is completely homozygous for genetic markers. Fertilization of an empty egg by two sperms is responsible for the remaining case. These moles show a mixture of homozygous and heterozygous patterns of paternally derived genetic markers. Although complete mole is usually a benign process, 10 to 20 percent of cases leads to either invasive mole or choriocarcinoma. This propensity to malignancy has to associate with the genetic features shown in the mole, that imply the formation of homozygosity and the selective inheritance of paternal genome. It has been described in various human malignancies that both genetic features associate with the inactivation of tumor suppressor genes. Homozygosity would lead to the inactivation of tumor suppressor gene in the mole by a signal event occurred on sperm DNAs. In turn, paternal transmission would result in the silencing of particular tumor suppressor genes. Thus, tumor suppressor genes inactivated either by homozygosity formation or by paternal transmission would be involved in the pathogenesis of choriocarcinoma. Both the maternal and paternal genomes are necessary for normal embryonic development in mammals. Parental-origin-specific functional differences between two alleles, known as genomic imprinting, seem to be exploited for a regulatory mechanism crucial for the proper development of both embryonic and extraembryonic tissues. The list of imprinted genes identified is growing rapidly lately in mouse and man (DeChiara TM et al., 1991, Barlow et al., 1991, Bartolomei MS et al., 1991, Leff SE et al., 1992, Hatada I et al., 1993, Giddings SJ et al., 1994, Hayashizaki Y et al., 1994, Villar AJ et al., 1994, Guillemot F et al., 1995). Among these, IGF2 and H19 tightly linked on human chromosome 11 are of special interest because of their reciprocal imprinting and possible association with certain malignancy and congenital abnormalities. The IGF2 gene expressed from the paternally derived allele (Ohlsson et al., 1993, Giannoukalis et al., 1993), whereas the H19 gene is expressed from the maternally derived allele (Rachmilewitz et al., 1992, Zhang et al 1993, Ferguson-Smith et al., 1993).
完全性葡萄胎是一种异常妊娠,其特征是绒毛显著肿胀且无胎儿(Kajii和Ohama,1997年;Wake等人,1978年;Jacobs等人,1980年)。众所周知,这种异常妊娠产物起源于孤雄生殖。葡萄胎妊娠产物的整个基因组都来自父方。大多数葡萄胎是由单倍体精子使空卵受精所致。随后,父方来源的单倍体基因组在没有胞质分裂的情况下进行复制并恢复为二倍体。这类葡萄胎无一例外具有46,XX核型,并且在遗传标记上完全纯合。其余病例是由两个精子使空卵受精引起的。这些葡萄胎显示出父方来源遗传标记的纯合和杂合模式的混合。尽管完全性葡萄胎通常是一个良性过程,但10%至20%的病例会发展为侵蚀性葡萄胎或绒毛膜癌。这种恶变倾向必定与葡萄胎中显示的遗传特征相关,这些特征意味着纯合性的形成以及父方基因组的选择性遗传。在各种人类恶性肿瘤中都有描述,这两种遗传特征都与肿瘤抑制基因的失活有关。纯合性会通过精子DNA上发生的信号事件导致葡萄胎中肿瘤抑制基因失活。反过来,父方传递会导致特定肿瘤抑制基因沉默。因此,通过纯合性形成或父方传递而失活的肿瘤抑制基因可能参与绒毛膜癌的发病机制。在哺乳动物中,母方和父方基因组对于正常胚胎发育都是必需的。两个等位基因之间父母来源特异性的功能差异,即基因组印记,似乎被用于一种对胚胎和胚外组织正常发育至关重要的调节机制。最近,在小鼠和人类中鉴定出的印记基因列表迅速增加(DeChiara TM等人,1991年;Barlow等人,1991年;Bartolomei MS等人,1991年;Leff SE等人,1992年;Hatada I等人,1993年;Giddings SJ等人,1994年;Hayashizaki Y等人,1994年;Villar AJ等人,1994年;Guillemot F等人,1995年)。其中,人类11号染色体上紧密连锁的IGF2和H19因其相互印记以及可能与某些恶性肿瘤和先天性异常相关而特别受关注。IGF2基因由父方来源的等位基因表达(Ohlsson等人,1993年;Giannoukalis等人,1993年),而H19基因由母方来源的等位基因表达(Rachmilewitz等人,1992年;Zhang等人,1993年;Ferguson-Smith等人,1993年)。