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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bloodjour</journal-id><journal-title-group><journal-title xml:lang="ru">Гематология и трансфузиология</journal-title><trans-title-group xml:lang="en"><trans-title>Russian journal of hematology and transfusiology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0234-5730</issn><issn pub-type="epub">2411-3042</issn><publisher><publisher-name>ООО Издательский дом «Практика»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25837/HAT.2018.61..2..004</article-id><article-id custom-type="elpub" pub-id-type="custom">bloodjour-95</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ПОИСК НОВЫХ МАРКЕРОВ ЭФФЕКТИВНОСТИ ТЕРАПИИ ИНГИБИТОРАМИ ТИРОЗИНКИНАЗ ПРИ ХРОНИЧЕСКОМ МИЕЛОИДНОМ ЛЕЙКОЗЕ МЕТОДОМ ПОЛНОЭКЗОМНОГО СЕКВЕНИРОВАНИЯ</article-title><trans-title-group xml:lang="en"><trans-title>SEARCH OF NEW PROGNOSTIC MARKERS OF EFFICACY OF THERAPY WITH TYROSINE KINASE INHIBITORS IN CHRONIC MYELOID LEUKEMIA PATIENTS USING EXOME SEQUENCING</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6440-0500</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Адильгереева</surname><given-names>Э. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Adilgereeva</surname><given-names>E. P.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4962-6947</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лавров</surname><given-names>A. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Lavrov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"/><bio xml:lang="en"/><email xlink:type="simple">avlavrov@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1558-3048</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Смирнихина</surname><given-names>С. A.</given-names></name><name name-style="western" xml:lang="en"><surname>Smirnikhina</surname><given-names>S. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6423-1789</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Челышева</surname><given-names>E. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Chelysheva</surname><given-names>E. Y.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5393-0816</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шухов</surname><given-names>О. A.</given-names></name><name name-style="western" xml:lang="en"><surname>Shukhov</surname><given-names>O. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9881-6221</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цаур</surname><given-names>Г. A.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsaur</surname><given-names>G. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0096-4542</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кочергин-Никитский</surname><given-names>К. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Kochergin-Nikitsky</surname><given-names>K. S.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5236-9297</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Якушина</surname><given-names>В. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakushina</surname><given-names>V. D.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7924-4945</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Морданов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mordanov</surname><given-names>S. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9947-2371</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Туркина</surname><given-names>A. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Turkina</surname><given-names>A. G.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3133-8018</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куцев</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kutsev</surname><given-names>S. I.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-6"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Медико-генетический научный центр», Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FederalState Budgetary Institution «Research Centre for Medical Genetics», Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБНУ «Медико-генетический научный центр»; ФГБОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FederalState Budgetary Institution «Research Centre for Medical Genetics», Moscow; Department of Molecular and Cellular Genetics, State Budgetary Educational Institution of Higher Professional Education “Russian National Research Medical University named after N. I. Pirogov” of Ministry of Health of the Russian Federation, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр гематологии» Минздрава России, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific and Advisory Department of Chemotherapy of Myeloproliferative Disorders, Federal State-Funded Institution National Research Center for Hematology of the Ministry of Healthcare of the Russian Federation, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ГБУЗ СО «Областная детская клиническая больница № 1» Министерства здравоохранения Свердловской области, г. Екатеринбург; ГАУЗ СО «Институт медицинских клеточных технологий», г. Екатеринбург; ФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России, г. Екатеринбург</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Regional Children Hospital 1; Research Institute of Medical Cell Technologies; Urals State Medical University, Ekaterinburg</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава России, г. Ростов-на-Дону</institution><country>Россия</country></aff><aff xml:lang="en"><institution>The Rostov State Medical University of Ministry of Healthcare of the Russian Federation, Rostov</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГБНУ «Медико-генетический научный центр»; ФГБОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России, Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>FederalState Budgetary Institution «Research Centre for Medical Genetics», Moscow; Department of Molecular and Cellular Genetics, State Budgetary Educational Institution of Higher Professional Education “Russian National Research Medical University named after N. I. Pirogov” of Ministry of Health of the Russian Federation, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>21</day><month>04</month><year>2019</year></pub-date><volume>63</volume><issue>2</issue><fpage>134</fpage><lpage>143</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Адильгереева Э.П., Лавров A.В., Смирнихина С.A., Челышева E.Ю., Шухов О.A., Цаур Г.A., Кочергин-Никитский К.С., Якушина В.Д., Морданов С.В., Туркина A.Г., Куцев С.И., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Адильгереева Э.П., Лавров A.В., Смирнихина С.A., Челышева E.Ю., Шухов О.A., Цаур Г.A., Кочергин-Никитский К.С., Якушина В.Д., Морданов С.В., Туркина A.Г., Куцев С.И.</copyright-holder><copyright-holder xml:lang="en">Adilgereeva E.P., Lavrov A.V., Smirnikhina S.A., Chelysheva E.Y., Shukhov O.A., Tsaur G.A., Kochergin-Nikitsky K.S., Yakushina V.D., Mordanov S.V., Turkina A.G., Kutsev S.I.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.htjournal.ru/jour/article/view/95">https://www.htjournal.ru/jour/article/view/95</self-uri><abstract><p>Введение. Хронический миелоидный лейкоз (ХМЛ) — частое миелопролиферативное заболевание, характеризующееся патогенной активностью химерной тирозинкиназы BCR/ABL, которая стимулирует неконтролируемую пролиферацию клеток и нестабильность ДНК. Первичная резистентность или неоптимальный ответ на терапию ингибиторами тирозинкиназ (ИТК) регистрируется примерно у 20% пациентов с ХМЛ. Цель работы: обнаружение экзомных вариантов, связанных с неоптимальным ответом больных ХМЛ на таргетную терапию ИТК. Материалы и методы. В исследование были включены восемь пациентов с Ph+ ХМЛ в хронической фазе. Через 6 мес наблюдения пациенты были разделены на две группы: четыре человека с оптимальным ответом на терапию ИТК и четыре человека с неоптимальным ответом. В группу валидации вошли 62 пациента (32 — с оптимальным и 30 — с неоптимальным ответом на терапию). Экзомное секвенирование проводили на платформе Ion Torrent PGM. Выравнивание проводили на геном человека (GRCh37). Секвенирование по Сэнгеру проводили на приборе ABI PRISM 3500xl. Статистическую обработку результатов проводили с помощью программ MS Office Excel, SPSS21. Результаты и заключение. По результатам экзомного секвенирования выделено семь вариантов, ассоциированных с ответом на терапию: ANKRD35-rs11579366, DNAH9-rs1990236, MAGEC1-rs176037, TOX3- rs10653661, THSD1-rs3803264, MORN2-rs3099950, PTCRA-rs9471966. Валидация этих вариантов на дополнительной выборке больных (n = 62) и поиск ассоциаций различных сочетаний генотипов и гаплотипов с ответом на терапию не позволил однозначно выделить варианты, ассоциированные с неоптимальным ответом на терапию ИТК. Кроме того, были исследованы варианты в 9000 генах, в результате чего удалось обнаружить 75 генов, достоверно различающихся по количеству вариантов между группами. Анализ обогащения показал, что выявленные гены участвуют в регуляции клеточной адгезии, межклеточных контактов, антигенной активации Т-лимфоцитов, опосредованном ингибировании áИФН сигнального пути, отвечающего за антипролиферативный эффект. Также была выявлена связь многих из этих генов с развитием различных злокачественных новообразований (рак почки, легкого и молочной железы). Многофакторная природа ответа на терапию, безусловно, осложняет поиск прогностических факторов.</p></abstract><trans-abstract xml:lang="en"><p>Background. Chronic myeloid leukemia (CML) is a common myeloproliferative disease characterized by pathologic activity of the fusion gene BCR/ABL, which encodes a tyrosine kinase that stimulates uncontrolled cell proliferation and DNA instability. Up to 20% of CML patients demonstrate primary resistance or non-optimal response to targeted tyrosine-kinase inhibitors (TKI) therapy. Objective. To find new potential genetic markers of TKI resistance by whole exome sequencing. Materials and methods. The study included eight patients with Ph+ CML in the chronic phase (CF). After 6 months of follow-up period patients were divided into two groups: four with an optimal response to TKI therapy and four with a non optimal response. The validation group included 62 patients (32 with optimal and 30 with non-optimal response to therapy). Exome sequencing was performed using the Ion Torrent PGM platform. Alignment was performed on the human genome (GRCh37). Sanger sequencing was conducted on an ABI PRISM 3500xl . Statistical processing of the results was carried out using MS Office Excel and SPSS21. Results and conclusion. Exome sequencing revealed seven single-nucleotide variants (SNVs) associated with therapy outcomes: ANKRD35-rs11579366, DNAH9- rs1990236, MAGEC1-rs176037, TOX3-rs10653661, THSD1-rs3803264, MORN2-rs3099950, and PTCRArs9471966. Validation of these variants in 62 patients did not confirm prognostic role of any of the individual SNVs or their combinations. An additional analysis of the number of SNVs in 9000 genes revealed 75 genes with significant differences in the number of SNVs. Enrichment analysis showed that these genes are involved in cell adhesion, cell contacts, T-cell antigen activation, and inhibition of IFNα-mediated antiproliferative signaling. Many of these genes are also associated with a variety of cancers (renal, lung and breast cancer). Possible multifactorial nature of the efficacy of therapy complicates the search of new prognostic markers.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронический миелоидный лейкоз</kwd><kwd>ингибиторы тирозинкиназ</kwd><kwd>экзомное секвенирование</kwd><kwd>резистентность к ингибиторам тирозинкиназ</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic myeloid leukemia</kwd><kwd>thyrosine kinase inhibitors</kwd><kwd>exome sequencing</kwd><kwd>TKI resistance</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена при поддержке Министерства образования и науки РФ (соглашение № 8113 от 28.08.2012).</funding-statement><funding-statement xml:lang="en">This work was partly supported by the Russian Ministry of Education and Science (grant #8113 from 28.08.2012).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Куликов С. 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