NUDT15
Nudix 水解酶 15是一種在人類中由 NUDT15 基因編碼的蛋白質[5]。
功能
此基因編碼的是一種屬於Nudix 水解酶超家族的酶。該超家族的成員能催化核苷酸的水解,包括像 8-oxo-dGTP 這樣的基質,這些基質是氧化損傷的產物,它們在DNA複製期間會誘導鹼基錯配且顛換突變。編碼的酶是硫嘌呤活化和毒性的負調節器。此基因突變會使硫嘌呤代謝不良,並與硫嘌呤產生的早期白血球減少症有關。已識別出此基因的多個假基因。
NUDT15 種系變異(例如,一種錯義 SNP:rs116855232,誘導 R139C)已經與硫嘌呤(例如,mercaptopurine、6-巰嘌呤(6-MP)、硫唑嘌呤(AZA,azathioprine))在臨床上治療急性淋巴性白血病[6][7]及炎症性腸病時,宜減量或停用以避免硫嘌呤造成的白血球低下[8][9]。這些變異具有種族特異性(例如,rs116855232 的變異等位基因在東亞人和西班牙裔人中較高,但在高加索人和非洲人較低)。此基因上的罕見功能變異,甚至是單一點位變異,也已識別出與硫嘌呤造成的骨髓抑制有關[10] ,並建議在決定硫嘌呤的初始劑量時,應進行全基因篩檢。
臨床重要性
硫嘌呤類藥物常用於治療自體免疫疾病、防止器官移植排斥和血液病的藥物。然而,其活性代謝物會經由硫嘌呤甲基轉移酶 (Thiopurine methyltransferase,TPMT) 及 Nudix 水解酶 15(此水解酶由 NUDT15 基因編碼)兩種酵素,進行代謝及滅活作用。根據研究,TPMT 基因表達為弱代謝型者,發生於歐美及非裔種群之概率較高(約 0.3%),於東亞裔種群之發生概率較為罕見;NUDT15基因表達為弱代謝型者,發生於東亞裔種群之概率約為 2%(具風險之基因變異頻率約為9.8%),於歐美種群中較為罕見(<1%)[11]。
根據印度以研究,以硫唑嘌呤治療炎症性腸病時,帶有 NDUT15 弱代謝型者發生白血球低下的發生率為 53.8%(7/13),帶有 TPMT 弱代謝型者發生白血球低下的發生率為 20.0%(1/5),而未帶這兩類弱代謝型者發生白血球低下的發生率為 24.5%(25/102)。NUDT15 而非 TPMT 基因變異與白血球低下的發生率有關。但雖有弱代謝型基因者,仍有 40% 以上沒有副作用,到沒帶弱代謝型基因者,也有 20% 的機會可能有副作用。總結,有此弱代謝型基因者未必發生副作用,沒此弱代謝型基因者也可能發生副作用,臨床使用上,仍需特別小心與注意[12]。
參考文獻
- ^ 1.0 1.1 1.2 GRCh38: Ensembl release 89: ENSG00000136159 - Ensembl, May 2017
- ^ 2.0 2.1 2.2 GRCm38: Ensembl release 89: ENSMUSG00000033405 - Ensembl, May 2017
- ^ Human PubMed Reference:. National Center for Biotechnology Information, U.S. National Library of Medicine.
- ^ Mouse PubMed Reference:. National Center for Biotechnology Information, U.S. National Library of Medicine.
- ^ Entrez Gene: Nudix hydrolase 15. [2023-12-24]. (原始內容存檔於2017-07-22).
- ^ Moriyama T, Nishii R, Perez-Andreu V, Yang W, Klussmann FA, Zhao X, et al. NUDT15 polymorphisms alter thiopurine metabolism and hematopoietic toxicity. Nature Genetics. April 2016, 48 (4): 367–73. PMC 5029084 . PMID 26878724. doi:10.1038/ng.3508.
- ^ Yang JJ, Landier W, Yang W, Liu C, Hageman L, Cheng C, et al. Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia. Journal of Clinical Oncology. April 2015, 33 (11): 1235–42. PMC 4375304 . PMID 25624441. doi:10.1200/JCO.2014.59.4671.
- ^ Yang SK, Hong M, Baek J, Choi H, Zhao W, Jung Y, et al. A common missense variant in NUDT15 confers susceptibility to thiopurine-induced leukopenia. Nature Genetics. September 2014, 46 (9): 1017–20. PMC 4999337 . PMID 25108385. doi:10.1038/ng.3060.
- ^ Yin D, Xia X, Zhang J, Zhang S, Liao F, Zhang G, et al. Impact of NUDT15 polymorphisms on thiopurines-induced myelotoxicity and thiopurines tolerance dose. Oncotarget. February 2017, 8 (8): 13575–13585. PMC 5355121 . PMID 28088792. doi:10.18632/oncotarget.14594.
- ^ Moriyama T, Yang YL, Nishii R, Ariffin H, Liu C, Lin TN, et al. Novel variants in NUDT15 and thiopurine intolerance in children with acute lymphoblastic leukemia from diverse ancestry. Blood. September 2017, 130 (10): 1209–1212. PMC 5606007 . PMID 28659275. doi:10.1182/blood-2017-05-782383.
- ^ 含azathioprine成分藥品安全資訊風險溝通表. [2023-12-31]. (原始內容存檔於2023-12-31) (中文(臺灣)).
- ^ TPMT and NUDT15 polymorphisms in thiopurine induced leucopenia in inflammatory bowel disease: a prospective study from India.. BMC Gastroenterol: 327. [2023-12-31]. doi:10.1186/s12876-021-01900-8. (原始內容存檔於2024-05-28).
延伸閱讀
- Yu Y, Cai JP, Tu B, Wu L, Zhao Y, Liu X, et al. Proliferating cell nuclear antigen is protected from degradation by forming a complex with MutT Homolog2. The Journal of Biological Chemistry. July 2009, 284 (29): 19310–20. PMC 2740556 . PMID 19419956. doi:10.1074/jbc.M109.015289 .
- Hori M, Satou K, Harashima H, Kamiya H. Suppression of mutagenesis by 8-hydroxy-2'-deoxyguanosine 5'-triphosphate (7,8-dihydro-8-oxo-2'-deoxyguanosine 5'-triphosphate) by human MTH1, MTH2, and NUDT5. Free Radical Biology & Medicine. May 2010, 48 (9): 1197–201. PMID 20144704. doi:10.1016/j.freeradbiomed.2010.02.002. hdl:2115/43020 .
- Yang SK, Hong M, Baek J, Choi H, Zhao W, Jung Y, et al. A common missense variant in NUDT15 confers susceptibility to thiopurine-induced leukopenia. Nature Genetics. September 2014, 46 (9): 1017–20. PMC 4999337 . PMID 25108385. doi:10.1038/ng.3060.
- Yang JJ, Landier W, Yang W, Liu C, Hageman L, Cheng C, et al. Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia. Journal of Clinical Oncology. April 2015, 33 (11): 1235–42. PMC 4375304 . PMID 25624441. doi:10.1200/JCO.2014.59.4671.
- Tanaka Y, Kato M, Hasegawa D, Urayama KY, Nakadate H, Kondoh K, et al. Susceptibility to 6-MP toxicity conferred by a NUDT15 variant in Japanese children with acute lymphoblastic leukaemia. British Journal of Haematology. October 2015, 171 (1): 109–15. PMID 26033531. doi:10.1111/bjh.13518 .
- Kakuta Y, Naito T, Onodera M, Kuroha M, Kimura T, Shiga H, et al. NUDT15 R139C causes thiopurine-induced early severe hair loss and leukopenia in Japanese patients with IBD. The Pharmacogenomics Journal. June 2016, 16 (3): 280–5. PMID 26076924. doi:10.1038/tpj.2015.43 .
- Carter M, Jemth AS, Hagenkort A, Page BD, Gustafsson R, Griese JJ, et al. Crystal structure, biochemical and cellular activities demonstrate separate functions of MTH1 and MTH2. Nature Communications. August 2015, 6: 7871. Bibcode:2015NatCo...6.7871C. PMC 4532830 . PMID 26238318. doi:10.1038/ncomms8871.
- Chiengthong K, Ittiwut C, Muensri S, Sophonphan J, Sosothikul D, Seksan P, et al. NUDT15 c.415C>T increases risk of 6-mercaptopurine induced myelosuppression during maintenance therapy in children with acute lymphoblastic leukemia. Haematologica. January 2016, 101 (1): e24–6. PMC 4697903 . PMID 26405151. doi:10.3324/haematol.2015.134775.
- Liang DC, Yang CP, Liu HC, Jaing TH, Chen SH, Hung IJ, et al. NUDT15 gene polymorphism related to mercaptopurine intolerance in Taiwan Chinese children with acute lymphoblastic leukemia. The Pharmacogenomics Journal. November 2016, 16 (6): 536–539. PMID 26503813. S2CID 13955512. doi:10.1038/tpj.2015.75.
外部連節
NUDT15引用了美國國家醫學圖書館提供的數據,這些數據屬於公共領域。