一VHL 家系致病基因突变的检测与分析*

目的:研究中枢神经系统血管母细胞瘤(VHL)基因突变的主要类型和发生情况,探讨VHL疾病发生的原因、临床特点等。方法:以基因组DNA为模板,PCR扩增VHL基因3个外显子及5’UTR区域,结合DNA直接测序的方法,对一个有多个小脑血管母细胞瘤患者的家系进行VHL基因突变检测。结果:发现该家系VHL基因5’UTR区、外显子1和外显子2正常,外显子3存在c.499C>G的改变,为一个错意突变,氨基酸改变为Arg-Gln(p.R167Q),该突变是导致这个家系的患者发病的直接原因。结论:VHL疾病的突变主要集中在VHL蛋白的α、β结构域,位于α结构域的p.R167Q突变为该VHL家系致病的主要原因。     

Elongin的转录延伸调控及其与VHL肿瘤抑制蛋白的关系

一种新的转录延伸因子Elongin能催化哺乳动物细胞中RNA pclⅡ的转录延伸速度。El-ogin复合体是由分子量分别为110、18、和15KD的A、B、C三种亚基组成的异源三聚体。VHL蛋白对Elongin的转录延伸作用有负调控作用,VHL蛋白由VHL基因(Von Hippel-Lindau tumor suppressor gene)所编码。VHL基因的突变会引起VHL型肿瘤,一种遗传性癌症综合征。VHL蛋白能与Elongin的B,C亚基紧密结合,从而抑制Elongin复合体的转录延伸活力,这可能是VHL型肿瘤抑制的基础。这些发现表明,VHL蛋白在Elongin的转录调控中起着一定的作用。     

VHL综合征遗传学研究

VHL综合征(von Hippel-Lindau syndrome,VHL;MIM 193300)是一种常染色体显性遗传的多系统肿瘤综合征,最常见临床表现是视网膜或中枢神经系统(central nervous system,CNS)血管母细胞瘤.CNS血管母细胞瘤和肾细胞癌(renal cell carcinoma,RCC)的并发症是VHL患者最主要的死因.VHL综合征主要因VHL基因(the vonHipple-Lindau gene,VHL)突变所致,细胞周期素D1基因(the cyclin D1 gene,CCND1)突变和蛋白异常也可能参与其发生.目前已建立了多个VHL基因缺陷动物模型.在此就VHL综合征的遗传学研究进展作一概述.     

肾癌中VHL基因的研究进展

抑癌基因VHL(von Hippel-Lindau)的突变可导致VHL综合征。其所编码的蛋白产物——肿瘤抑制蛋白VHL(von Hippel-Lindau tumor suppressor protein,p VHL)可与多种底物特别是低氧诱导因子(hipoxia inducible factor,HIF)相互作用。p VHL在有氧状态下主要通过参与组成泛素连接酶复合体作用于HIF,从而介导其泛素化降解。VHL突变所致的HIF活化,导致肿瘤血管生成、肿瘤细胞增多,与肾细胞癌的发生、发展密切相关,可作为肾细胞癌潜在治疗靶点之一。     

VHL基因的研究进展及其在肾癌基因治疗中的应用

VHL基因是抑癌基因,定位于染色体3p25-26,其产物pVHL与Wnt-β-catenin信号通路、缺氧诱导因子、氧化磷酸化的调控有关。VHL基因的失活会导致VHL蛋白不能正常合成,这与散发性肾透明细胞癌的发生、发展有着密切的关系。VHL基因的失活机制主要包括基因突变,杂合性缺失和甲基化。通过对VHL基因失活机制的研究有助于筛选用于肾透明细胞癌早期诊断与预后的新分子标志物。目前利用VHL基因开展了肾癌基因治疗的试验探索。     

Von Hippel—Lindau（VHL）基因

Von Hippel-Lindau(VHL)病虽然发病率较低,但受影响的个体容易产生多种肿瘤,如眼部肿瘤,肾和脑肿瘤等,最近已发现了VHL基因,将其定位在染色体3p25区,很可能是一个新的肿瘤抑制基因,这将对VHL病或肿瘤的诊断和治疗都有重要意义。     

低氧诱导因子在肾透明细胞癌中作用的研究进展

VHL基因具有调节转录、稳定细胞生长相关基因和调节细胞周期的功能,其突变、缺失、重排和超甲基化与肾细胞癌(RCC)的发生密切相关。VHL基因产物VHL肿瘤抑制蛋白(p VHL)是泛素连接酶的成分,具有调节低氧诱导因子(HIF)稳定性的作用。HIF家族主要包含三种HIFα因子(HIF1α、HIF2α、HIF3α)和两种HIFβ因子(HIF1β、HIF2β)。HIF1α位于14q染色体上,在肾透明细胞癌中该染色体经常缺失,且这种14q的缺失常伴有预后不良。HIF2α的表达异常促进了p VHL缺陷型肾透明细胞癌中的发生。目前,抑制HIF2α及其下游的血管内皮生长因子(VEGF)的药物都处于临床试验的不同阶段,已有四种VEGF抑制剂获准用于肾透明细胞癌的治疗。选择抑制HIF或具有HIF靶基因抑制选择性的药物进行研究,可能为肾透明细胞癌的治疗提供新的方法。本文就HIF在VHL蛋白缺陷型肾透明细胞癌中作用的研究进展进行了综述。     

DNA肿瘤病毒蛋白与p53蛋白的相互作用

大多数人类肿瘤发生p53基因突变,突变性p53蛋白功能失活、半衰期延长,并在肿瘤细胞中大量累积,一般认为,p53基因突变是肿瘤发生的主要因素之一。但是,近年也发现一些人类肿瘤细胞存在p53蛋白累积而无基因突变。这种现象与DNA肿瘤病毒密切相关,业已证明：SV－40T抗原、腺病毒E1B55－kD、E4orf6蛋白、HBVX蛋白、HPVE6蛋白、HCMVIE84蛋白、EBVBZLF1和EBNA5蛋白均与p53蛋白结合而使其功能失活。这表明：p53基因突变并非是p53蛋白功能失活的唯一原因。p53蛋白与病毒蛋白或细胞蛋白相互作用可能是其功能失活的另一主要原因？本文就近年国外有关病毒蛋白与p53蛋白相互作用的研究加以概述;试图引起人们的注意。     

BRCA1蛋白参与DNA双链损伤应答

BRCA1是乳腺癌易感基因,负责维持细胞基因组的稳定性,防止调控细胞增殖和肿瘤生长的基因突变的积累。BRCA1基因蛋白产物结构复杂,功能多样,是细胞内重要的多功能蛋白,参与执行多种生理代谢过程。本主要探讨了BRCA1蛋白应答DNA双链损伤过程中所伴随的一系列信号传导的历程,阐述了连续的生理生化反应中BRCA1蛋白所发挥的作用。     

非肌肉肌球蛋白重链ⅡA（NMHCⅡA）生理病理功能研究进展

非肌肉肌球蛋白重链ⅡA（NMHCⅡA）是Ⅱ型非肌肉肌球蛋白的主要亚型,近年来NMHCⅡA基因及蛋白功能的研究日益增多,引起国内外学者的广泛重视。已证实NMHCⅡA基因突变导致多种遗传性疾病,临床多见巨大血小板减少,并逐渐发展为伴有听力障碍、白内障和肾功能损伤;NMHCⅡA参与胞质分裂、细胞吞噬、细胞运动、血栓形成、炎症、肿瘤转移、视网膜变性、听力、肾脏功能调节等病理生理过程。MYH9不同位点的基因突变,NMHCⅡA蛋白构象的变化,表达量的改变,在细胞内分布的变化,磷酸化的强弱以及其结合蛋白的改变都可能成为影响肿瘤、心血官疾病发生发展的重要机制之一。本文就近年来NMHCⅡA主要生理病理功能做一综述。     

Von Hippel-Lindau disease

Germline mutations in the VHL tumour suppressor gene may cause a variety of phenotypes including von Hippel-Lindau (VHL) disease, familial phaeochromocytoma and inherited polycythaemia. VHL disease is a multisystem familial cancer syndrome and is the commonest cause of familial renal cell carcinoma (RCC). VHL disease provides a paradigm for illustrating how studies of a rare familial cancer syndrome can produce advances in clinical medicin and important insights into basic biological processes. Thus the identification of the VHL gene has improved the diagnosis and clinical management of VHL disease and provided insights into the pathogenesis of sporadic clear cell RCC. Functional investigations of the VHL gene product have provided novel information on how cells sense oxygen and the role of hypoxia-response pathways in human tumourigenesis. Such information offers prospects of novel therapeutic interventions for VHL disease and common cancers including RCC.     

Molecular genetic investigations of the mechanism of tumourigenesis in von Hippel-Lindau disease: analysis of allele loss in VHL tumours

Von Hippel-Lindau (VHL) disease is a dominantly inherited familial cancer syndrome characterised by the development of retinal and central nervous system haemangioblastomas, renal cell carcinoma (RCC), phaeochromocytoma and pancreatic tumours. The VHL disease gene maps to chromosome 3p25-p26. To investigate the mechanism of tumourigenesis in VHL disease, we analysed 24 paired blood/tumour DNA samples from 20 VHL patients for allele loss on chromosome 3p and in the region of tumour suppressor genes on chromosomes 5, 11, 13, 17 and 22. Nine out of 24 tumours showed loss of heterozygosity (LOH) at at least one locus on chromosome 3p and in each case the LOH included the region to which the VHL gene has been mapped. Chromosome 3p allele loss was found in four tumour types (RCC, haemangioblastoma, phaeochromocytoma and pancreatic tumour) suggesting a common mechanism of tumourigenesis in all types of tumour in VHL disease. The smallest region of overlap was between D3S1038 and D3S18, a region that corresponds to the target region for the VHL gene from genetic linkage studies. The parental origin of the chromosome 3p25-p26 allele loss could be determined in seven tumours from seven familial cases; in each tumour, the allele lost had been inherited from the unaffected parent. Our results suggest that the VHL disease gene functions as a recessive tumour suppressor gene and that inactivation of both alleles of the VHL gene is the critical event in the pathogenesis of VHL neoplasms. Four VHL tumours showed LOH on other chromosomes (5q21, 13q, 17q) indicating that homozygous VHL gene mutations may be required but may not be sufficient for tumourigenesis in VHL disease.     

Von Hippel-Lindau disease (VHL): a need for a murine model with retinal hemangioblastoma

Von Hippel-Lindau (VHL) disease is a highly penetrant autosomal dominant systemic malignancy that gives rise to cystic and highly vascularized tumors in a constellation of organs. Patients with VHL disease commonly present with hemangioblastomas in the central nervous system and the eye while other manifestations include pheochromocytoma, clear cell renal cell carcinoma, endolymphatic sac tumors of the middle ear, pancreatic cystadenomas, epididymal and broad ligament cystadenomas. Animal models inactivating the VHL gene product in various organ tissues have been constructed over the past 15 years to parse its HIF-associated mechanisms and its link to tumorigenesis. These models, despite advancing our understanding the molecular role of VHL, are by and large unable to recapitulate the more common features of human VHL disease. Up to date, no model exists that develop retinal hemangioblastomas, the most common clinical manifestation. The purpose of this review is: (1) to discuss the need for an ocular VHL model, (2) to review the animal models that recapitulate clinical VHL disease and (3) to propose potential mechanisms of tumorigenesis for the development of ocular VHL.     

Genotype-phenotype correlations in families with deletions in the von Hippel-Lindau (VHL) gene

Von Hippel-Lindau (VHL) disease is a hereditary tumor syndrome characterized by predisposition for bilateral and multi-centric hemangioblastoma in the retina and central nervous system, pheochromocytoma, renal cell carcinoma, and cysts in the kidney, pancreas, and epididymis. We describe five families for which direct sequencing of the coding region of the VHL gene had failed to identify the family-specific mutation. Further molecular analysis revealed deletions involving the VHL gene in each of these families. In four families, partial deletions of one or more exons were detected by Southern blot analysis. In the fifth family, FISH analysis demonstrated the deletion of the entire VHL gene. Our results show that (quantitative) Southern blot analysis is a sensitive method for detecting germline deletions of the VHL gene and should be implemented in routine DNA diagnosis for VHL disease. Our data support the previously established observation that families with a germline deletion have a low risk for pheochromocytoma. Further unraveling of genotype-phenotype correlations in VHL disease has revealed that families with a full or partial deletion of the VHL gene exhibit a phenotype with a preponderance of central nervous system hemangioblastoma.     

猪VHL基因克隆及敲低克隆胚胎的构建

通过在细胞和胚胎水平对猪Von Hippel-Lindau(VHL)基因进行了基因敲低研究,以便为建立VHL疾病模型猪奠定基础.研究首先通过 3'RACE和5'RACE克隆得到猪VHL基因cDNA全长序列(2 725 bp),Real-time PCR结果表明VHL基因广泛表达于猪的各种组织器官,其中在肾上腺、肝脏、胰腺、心脏和睾丸等组织器官高量表达.进一步在猪iPS细胞中对5条干扰片段进行筛选,获得2条高效的干扰片段,干扰效率分别达到72％(P=0.0012)和64％ (P＜ 0.01).以稳定干扰VHL基因的猪胎儿成纤维细胞为核供体,构建克隆胚胎,结果表明,克隆胚胎的发育能力与对照组相比没有明显差异,而且在克隆囊胚中VHL基因的干扰效率达到71％ (P＜ 0.01).综上所述,文中获得了猪VHL基因全长序列并获得该基因稳定敲低的猪细胞和胚胎,从而为VHL疾病模型猪的构建奠定了良好的基础.     

Formation of the VHL-elongin BC tumor suppressor complex is mediated by the chaperonin TRiC

von Hippel-Lindau (VHL) disease is caused by loss of function of the VHL tumor suppressor protein. Here, we demonstrate that the folding and assembly of VHL into a complex with its partner proteins, elongin B and elongin C (herein, elongin BC), is directly mediated by the chaperonin TRiC/CCT. Association of VHL with TRiC is required for formation of the VHL-elongin BC complex. A 55-amino acid domain of VHL is both necessary and sufficient for binding to TRiC. Importantly, mutation or deletion of this domain is associated with VHL disease. We identified two mutations that disrupt the normal interaction with TRiC and impair VHL folding. Our results define a novel role for TRiC in mediating oligomerization and suggest that inactivating mutations can impair polypeptide function by interfering with chaperone-mediated folding.     

Mosaicism in von Hippel-Lindau disease: lessons from kindreds with germline mutations identified in offspring with mosaic parents

von Hippel-Lindau disease (VHL [MIM 193300]) is a heritable autosomal dominant multiple-neoplastic disorder with high penetrance. It is characterized by brain and spinal-cord hemangioblastomas, retinal angiomas, clear-cell renal carcinoma, neuroendocrine tumors and cysts of the pancreas, pheochromocytomas, endolymphatic-sac tumors, and papillary cystadenomas of the epididymis and broad ligament. Although most index cases have a positive family history of VHL, some do not and may represent de novo cases. Cases without a family history of VHL may or may not have a germline mutation in their VHL tumor-suppressor gene. We present two cases of VHL mosaicism. In each of two families, standard testing methods (Southern blot analysis and direct sequencing) identified the germline mutation in the VHL gene of the offspring, but not in their clinically affected parent. Additional methods of analysis of the affected parents' blood detected the VHL-gene mutation in a portion of their peripheral blood lymphocytes. In one case, detection of the deleted allele was by FISH, and, in the second case, the 3-bp deletion was detected by conformational sensitive gel electrophoresis and DNA sequencing of cloned genomic DNA. Mosaicism in VHL is important to search for and recognize when an individual without a family history of VHL has VHL. Patients diagnosed without family histories of the disease have been reported in as many as 23% of kindreds with VHL. Identification of individuals potentially mosaic for VHL will affect counseling of families, and these individuals should themselves be included in clinical screening programs for occult disease.     

Systemic VHL gene functions and the VHL disease

The von Hippel-Lindau tumor suppressor gene (VHL) is best known as an E3 ubiquitin ligase that negatively regulates the hypoxia inducible factor (HIF). VHL mutations are the genetic defects underlying several human diseases including polycythemia, familial VHL tumor syndrome and sporadic renal cell carcinoma. VHL mutations can lead to cell-autonomous phenotypes in the tumor cells. However, non-tumor cell-autonomous functions of VHL have also been noted. VHL tumor-derived cytokines can promote inflammation and induce mobilization of endothelial progenitor cells. Up-regulation of HIF caused by VHL loss-of-function mutants, including heterozygotes, has been shown to increase the activities of hematopoietic stem cells, endothelial cells and myeloid cells. As such, systemic functions of VHL likely play important roles in the development of VHL disease.     

Mutations in the VHL tumor suppressor gene and associated lesions in families with von Hippel-Lindau disease from central Europe

von Hippel-Lindau (VHL) disease is a dominantly inherited familial cancer syndrome predisposing to retinal, cerebellar and spinal hemangioblastoma, renal cell carcinoma (RCC), pheochromocytoma and pancreatic tumors. Clinically two types of the disease can be distinguished: VHL type 1 (without pheochromocytoma) and VHL type 2 (with pheochromocytoma). We report VHL germline mutations and trends in phenotypic variation in families from central Europe. We identified 28 mutations in 53/65 (81.5%) families with 18 (64%) mutations being unique to this population. Whereas types and distribution of mutations as well as a strong correlation of missense mutations with the VHL 2 phenotype were similar to those identified in other populations, these families have provided new insights into the molecular basis for variability in the VHL 2 phenotype. Seven different missense mutations in exons 1 and 3 varied in their biological consequences from a minimal VHL 2 phenotype with pheochromocytoma only to a full VHL 2 phenotype with RCC and pancreatic lesion. These findings contribute to a better understanding of the fundamental mechanisms of VHL disease and its phenotypic variability. Further, we have provided rapid VHL screening for the families in central Europe, which has resulted in improved diagnosis and clinical management. Received: 10 November 1995 / Revised: 1 March 1996