Differences in Disease Severity but Similar Telomere Lengths in Genetic Subgroups of Patients with Telomerase and Shelterin Mutations 英文参考文献.docVIP
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Differences in Disease Severity but Similar Telomere Lengths in Genetic Subgroups of Patients with Telomerase and Shelterin Mutations 英文参考文献
DifferencesinDiseaseSeveritybutSimilarTelomere
LengthsinGeneticSubgroupsofPatientswith
TelomeraseandShelterinMutations
TomJ.Vulliamy1*,MichaelJ.Kirwan1,RichardBeswick1,UpalHossain1,CharlotteBaqai2 ,Anna
Ratcliffe1,JudithMarsh3,AmandaWalne1,InderjeetDokal1
1Centre for Paediatrics, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom, 2Department of
Haematology,ImperialCollege,HammersmithHospital,London,UnitedKingdom,3DepartmentofHaematologicalMedicine,King’sCollegeHospital,London,United
Kingdom
Abstract
The bone marrow failure syndrome dyskeratosis congenita (DC) has been considered to be a disorder of telomere
maintenanceinwhichdiseasefeaturesariseduetoacceleratedshorteningoftelomeres.Byscreeningcorecomponentsof
thetelomeraseandshelterincomplexesinpatientswithDCandrelatedbonemarrowfailuresyndromeswehaveidentified
24novelmutations:11intheRNAcomponentoftelomerase(TERC),8inthereversetranscriptasecomponent(TERT),4in
dyskerin(DKC1)and1inTRF1-interactingnuclearfactor2(TINF2).Thishaspromptedustoreviewthesegeneticsubtypesin
terms of telomere length, telomerase activity and clinical presentation among 194 genetically characterised index cases
recruitedontotheregistryinLondon.WhilethosewithDKC1andTINF2mutationspresentatayoungerageandhavemore
diseasefeaturesthanthosewithTERCorTERTmutations,thereisnodifferenceintelomerelengthbetweenthesegroups.
ThereisnodifferenceintheageofonsetandnumbersofdiseasefeaturesseeninthosewithTERCandTERTmutations
despitethefactthatthelattershowhigherlevelsoftelomeraseactivityinvitro.Theincidenceofaplasticanaemiaisgreater
inpatientswithTERCorTINF2mutationscomparedtopatientswithDKC1mutations,andcancerincidenceishighestin
patientswithTERCmutations.Thesedataarethefirsttoproviderobustcomparisonsbetweendifferentgeneticsubtypesof
telomeraseandshelterinmutations(the‘‘telomereopathies’’)andclearlydemonstratethatdiseaseseverityisnotexplained
bytelomerelengthalone.
Citation:VulliamyTJ,KirwanMJ,BeswickR,
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