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Inactivation of protein-phosphatase 2A causing hyperphosphorylation of autoantigenic paraprotein targets in MGUS/MM is due to an exchange of its regulatory subunits.
[waldenström macroglobulinemia]
Hyperphosphorylated
paratarg-
7
(
pP-
7
)
carrier
state
is
the
strongest
molecularly
defined
risk
factor
for
monoclonal
gammopathy
of
undetermined
significance
(
MGUS
)
,
multiple
myeloma
(
MM
)
and
Waldenstrom
's
macroglobulinemia
(
WM
)
.
pP-
7
is
inherited
as
autosomal-dominant
trait
and
depending
on
the
ethnic
background
is
found
in
over
one
-
third
of
MGUS
/
MM
patients
.
P-
7
,
which
is
the
antigenic
paraprotein
target
in
these
patients
,
is
hyperphosphorylated
at
serine
17
.
P-
7
hyperphosphorylation
can
be
induced
in
wild-
type
P-
7
(
wtP-
7
)
carriers
by
PKC
ζ
and
reverted
by
protein-phosphatase
2
A
(
PP
2
A
)
.
Here
we
show
that
dephosphorylation
of
pP-
7
is
defective
in
pP-
7
carriers
due
to
inactivation
of
the
PP
2
A
by
substitution
of
the
regulatory
B
55
δ
subunit
with
B
56
γ
3
.
In
lymphoblastoid
cell
lines
from
pP-
7
carriers
,
transfection
of
recombinant
B
55
δ
or
treatment
with
ceramide
led
to
a
partial
reconstitution
of
PP
2
A
activity
and
dephosphorylation
of
pP-
7
to
wtP
7
.
Similar
results
were
observed
with
other
previously
reported
autoantigenic
paraproteins
targets
.
In
conclusion
,
the
mechanisms
responsible
for
the
defective
dephosphorylation
and
maintaining
the
hyperphosphorylated
state
of
P-
7
and
other
autoantigenic
paraprotein
targets
have
been
elucidated
,
facilitating
the
identification
of
the
genetic
basis
underlying
this
phenomenon
which
is
obviously
common
in
the
pathogenesis
of
MGUS
/
MM
/
WM
and
not
restricted
to
pP-
7
cases
.
Diseases
Validation
Diseases presenting
"molecularly defined risk factor"
symptom
waldenström macroglobulinemia
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