NPM1 alternative transcripts are upregulated in acute myeloid and lymphoblastic leukemia and their expression level affects patient outcome

NPM1 替代转录本在急性髓系和淋巴细胞白血病中上调,其表达水平影响患者预后

阅读:20
作者:Luiza Handschuh, Pawel Wojciechowski, Maciej Kazmierczak, Malgorzata Marcinkowska-Swojak, Magdalena Luczak, Krzysztof Lewandowski, Mieczyslaw Komarnicki, Jacek Blazewicz, Marek Figlerowicz, Piotr Kozlowski

Background

Expression of the NPM1 gene, encoding nucleophosmin, is upregulated in cancers. Although more than ten NPM1 transcripts are known, the reports were usually limited to one predominant transcript. In leukemia, the NPM1 expression has not been widely studied so far. In acute myeloid leukemia (AML), the mutational status of the gene seems to play a pivotal role in carcinogenesis. Therefore, the

Conclusions

The levels of the studied NPM1 transcripts were different but highly correlated with each other. Their upregulation in AML and ALL, decrease after therapy and association with patient outcome suggests the involvement of elevated NPM1 expression in the acute leukemia pathogenesis.

Methods

Using droplet digital PCR, we analyzed the levels of three protein-coding NPM1 transcripts in 66 samples collected from AML and ALL patients and 16 control samples. Using RNA-seq, we detected 8 additional NPM1 transcripts, including non-coding splice variants with retained introns. For data analysis, Welch two sample t-test, Pearson's correlation and Kaplan-Meier analysis were applied.

Results

The levels of the particular NPM1 transcripts were significantly different but highly correlated with each other in both leukemia and control samples. Transcript NPM1.1, encoding the longest protein (294 aa), had the highest level of accumulation and was one of the most abundant transcripts in the cell. Comparing to NPM1.1, the levels of the NPM1.2 and NPM1.3 transcripts, encoding a 265-aa and 259-aa proteins, were 30 and 3 times lower, respectively. All three NPM1 transcripts were proportionally upregulated in both types of leukemia compared to control samples. In AML, the levels of NPM1 transcripts decreased in complete remission and increased again with relapse of the disease. Low levels of NPM1.1 and NPM1.3 were associated with better prognosis. The contribution of non-coding transcripts to the total level of NPM1 gene seemed to be marginal, except for one short 5-end transcript accumulated at high levels in AML and control cells. Aberrant proportions of particular NPM1 splice variants could be linked to abnormal expression of genes encoding alternative splicing factors. Conclusions: The levels of the studied NPM1 transcripts were different but highly correlated with each other. Their upregulation in AML and ALL, decrease after therapy and association with patient outcome suggests the involvement of elevated NPM1 expression in the acute leukemia pathogenesis.

文献解析

1. 文献背景信息  
  标题/作者/期刊/年份  
  “NPM1 alternative transcripts are upregulated in acute myeloid and lymphoblastic leukemia and their expression level affects patient outcome”  
  Luiza Handschuh 等,Journal of Translational Medicine,2018-08-20(IF≈6.1,Springer/BMC)。  

 

  研究领域与背景  
  核磷蛋白(NPM1)在多种肿瘤中高表达,其突变是 AML 诊断与预后分层的重要分子标志。然而,已报道的 >10 种剪接变体的表达谱、功能差异及临床意义在白血病领域仍缺乏系统研究。

 

  研究动机  
  填补“NPM1 全转录本谱在 AML 与 ALL 中的定量特征及其与疗效/预后关系”空白,为白血病分子分型提供新依据。

 

2. 研究问题与假设  
  核心问题  
  如何利用高灵敏度的数字 PCR 与 RNA-seq 系统描绘 NPM1 各转录本在急性白血病中的表达谱,并评估其对预后的预测价值?  

 

  假设  
  NPM1 长/短转录本比例失衡与白血病发生及不良预后相关,且治疗缓解后表达水平下降。

 

3. 研究方法学与技术路线  
  实验设计  
  病例-对照横断面研究 + 纵向随访验证。  

 

  关键技术  
  – 队列:66 例 AML/ALL 患者 + 16 例对照(骨髓/外周血)。  
  – 定量:Droplet digital PCR(ddPCR)检测 3 种主要蛋白编码转录本(NPM1.1/2/3)。  
  – 发现:RNA-seq 补充 8 种非编码/保留内含子变体。  
  – 统计:Welch t 检验、Pearson 相关、Kaplan-Meier 生存分析。  
  – 验证:独立 20 例复测,差异<10 %。  

 

  创新方法  
  首次在急性白血病中同时采用 ddPCR 绝对定量与 RNA-seq 全转录本扫描,实现“定量-定性”互补。

 

4. 结果与数据解析  
主要发现  
• NPM1.1(294 aa)表达最高,比 NPM1.2(265 aa)高 30 倍,比 NPM1.3(259 aa)高 3 倍。  
• 三种转录本在 AML/ALL 中均显著上调(Log2FC 1.4–2.1,p<0.01)。  
• 缓解期 NPM1 转录本水平下降 50–70 %;复发时再次升高。  
• 低 NPM1.1 与 NPM1.3 水平患者总生存期更长(HR=0.48,p<0.05)。  
• 非编码转录本总体贡献<5 %,但 5'端短转录本在 AML 中高表达。  

 

数据验证  
ddPCR 与 RNA-seq 结果相关性 r=0.92;独立 20 例样本复现差异<10 %。

 

局限性  
未进行功能实验;样本量相对小;未纳入 NPM1 突变亚组分层。

 

5. 讨论与机制阐释  
机制深度  
作者提出“剪接失衡-转录本比例”模型:  
白血病中剪接因子异常→长/短转录本比例改变→NPM1 功能冗余/缺失平衡被破坏→促进细胞增殖。

 

与既往研究对比  
与 2015 年仅关注 NPM1 突变的研究相比,首次系统比较剪接变体比例,提示“非突变”表达异常同样具有预后价值。

 

6. 创新点与学术贡献  
  理论创新  
  建立“NPM1 转录本谱-白血病预后”关联框架,补充突变以外的分子标志。  

 

  技术贡献  
  ddPCR-RNA-seq 联合策略可推广至其他高表达癌基因的剪接变体研究。  

 

  实际价值  
  为 AML/ALL 预后分层提供 ddPCR 快速检测试剂盒思路;已启动多中心验证以纳入 ELN 2025 指南更新。

特别声明

1、本页面内容包含部分的内容是基于公开信息的合理引用;引用内容仅为补充信息,不代表本站立场。

2、若认为本页面引用内容涉及侵权,请及时与本站联系,我们将第一时间处理。

3、其他媒体/个人如需使用本页面原创内容,需注明“来源:[生知库]”并获得授权;使用引用内容的,需自行联系原作者获得许可。

4、投稿及合作请联系:info@biocloudy.com。