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Blood, 1 September 2008, Vol. 112, No. 5, pp. 1582-1592. Prepublished online as a Blood First Edition Paper on June 5, 2008; DOI 10.1182/blood-2008-02-140012.
PLENARY PAPER Abnormalities of the large ribosomal subunit protein, Rpl35a, in Diamond-Blackfan anemia1 Division of Pediatric Oncology, Department of Oncology, Kimmel Comprehensive Cancer Center, 2 Division of Hematology, Department of Medicine, 3 Division of Oncology Biostatistics, Department of Oncology, Kimmel Comprehensive Cancer Center, 4 Division of Pediatric Hematology, Department of Pediatrics, and 5 Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; 6 Cancer Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD; 7 Cold Spring Harbor Laboratory, NY; 8 Division of Genetics and Program in Genomics, Children's Hospital Boston, MA; 9 Harvard Medical School, Boston, MA; 10 Department of Cellular and Molecular Medicine, St George's University of London, London, United Kingdom; 11 Department of Paediatric Haematology/Oncology, University Medical School, Warsaw, Poland; 12 Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA; 13 Division of Pediatric Hematology, Children's Hospital Boston, MA; 14 Division of Hematology/Oncology and Stem Cell Transplantation, Schneider Children's Hospital, New Hyde Park, NY; Feinstein Institute for Medical Research, Manhasset, NY; and 15 Department of Biochemistry and Molecular Biology, University of Louisville, KY Diamond-Blackfan anemia (DBA) is an inherited bone marrow failure syndrome characterized by anemia, congenital abnormalities, and cancer predisposition. Small ribosomal subunit genes RPS19, RPS24, and RPS17 are mutated in approximately one-third of patients. We used a candidate gene strategy combining high-resolution genomic mapping and gene expression microarray in the analysis of 2 DBA patients with chromosome 3q deletions to identify RPL35A as a potential DBA gene. Sequence analysis of a cohort of DBA probands confirmed involvement RPL35A in DBA. shRNA inhibition shows that Rpl35a is essential for maturation of 28S and 5.8S rRNAs, 60S subunit biogenesis, normal proliferation, and cell survival. Analysis of pre-rRNA processing in primary DBA lymphoblastoid cell lines demonstrated similar alterations of large ribosomal subunit rRNA in both RPL35A-mutated and some RPL35A wild-type patients, suggesting additional large ribosomal subunit gene defects are likely present in some cases of DBA. These data demonstrate that alterations of large ribosomal subunit proteins cause DBA and support the hypothesis that DBA is primarily the result of altered ribosomal function. The results also establish that haploinsufficiency of large ribosomal subunit proteins contributes to bone marrow failure and potentially cancer predisposition.
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