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PITX2：修订间差异

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==功能==
==功能==
PITX2蛋白屬於RIEG/PITX同源框蛋白家族，有一個屬於{{link-en|Bicoid|Bicoid}}蛋白家族的[[同源結構域]]。從功能上說，PITX2是一種[[轉錄因子]]<ref name=tabin>{{cite journal | vauthors = Logan M, Pagán-Westphal SM, Smith DM, Paganessi L, Tabin CJ | title = The transcription factor Pitx2 mediates situs-specific morphogenesis in response to left-right asymmetric signals | journal = Cell | volume = 94 | issue = 3 | pages = 307–17 | date = Aug 1998 | pmid = 9708733 | doi = 10.1016/S0092-8674(00)81474-9 | authorlink5 = Clifford Tabin }}</ref>，主要調控{{link-en|賴氨酰羥化酶|lysyl hydroxylase|前膠原賴氨酰羥化酶（procollagen lysyl hydroxylase）基因的表達。賴氨酰羥化酶參與眼、牙，以及腹部器官的發育過程。PITX2的轉錄調節火星受到催乳素的調節。 已發現人體內的PITX2有三種轉錄變體<ref name="entrez">{{cite web | title = Entrez Gene: PITX2 paired-like homeodomain transcription factor 2| url = http://www.ncbi.nlm.nih.gov/sites/entrez?Db=gene&Cmd=ShowDetailView&TermToSearch=5308| accessdate = }}</ref>。
PITX2蛋白屬於RIEG/PITX同源框蛋白家族，有一個屬於{{link-en|Bicoid|Bicoid}}蛋白家族的[[同源結構域]]。從功能上說，PITX2是一種[[轉錄因子]]<ref name=tabin>{{cite journal | vauthors = Logan M, Pagán-Westphal SM, Smith DM, Paganessi L, Tabin CJ | title = The transcription factor Pitx2 mediates situs-specific morphogenesis in response to left-right asymmetric signals | journal = Cell | volume = 94 | issue = 3 | pages = 307–17 | date = Aug 1998 | pmid = 9708733 | doi = 10.1016/S0092-8674(00)81474-9 }}</ref>，主要調控{{link-en|賴氨酰羥化酶|lysyl hydroxylase|前膠原賴氨酰羥化酶}}（procollagen lysyl hydroxylase）基因的表達。賴氨酰羥化酶參與眼、牙，以及腹部器官的發育過程。PITX2的轉錄調節活性受到[[催乳素]]的調節。 已發現人體內的PITX2有三種轉錄變體<ref name="entrez">{{cite web | title = Entrez Gene: PITX2 paired-like homeodomain transcription factor 2| url = http://www.ncbi.nlm.nih.gov/sites/entrez?Db=gene&Cmd=ShowDetailView&TermToSearch=5308| accessdate = }}</ref>。


PITX2在發育中與左—右軸的建立及左右不對稱性的形成有關，比如左[[側中胚層]]、心臟、肺、脾的不對稱發育及早起胃腸道的彎折。已證明在非人脊椎動物中，PITX2的同源基因亦有這樣的功能。敲除小鼠的Pitx2基因後，會導致身體左側器官形態發育異常。PITX2本身的表達受到ASE增強子和{{link-en|NODAL|NODAL}}蛋白的調控。目前的研究證據顯示NODAL蛋白主要調控頭部的PITX2基因表達，而ASE主要調控控制不對稱發展的PITX2基因的發展，如肝、脾的不對稱發展。在眼部發育中，PITX2能抑制眼外肌的自噬，並能控制其生長<ref name="pmid10021341">{{cite journal | vauthors = Campione M, Steinbeisser H, Schweickert A, Deissler K, van Bebber F, Lowe LA, Nowotschin S, Viebahn C, Haffter P, Kuehn MR, Blum M | title = The homeobox gene Pitx2: mediator of asymmetric left-right signaling in vertebrate heart and gut looping | journal = Development | volume = 126 | issue = 6 | pages = 1225–34 | date = Mar 1999 | pmid = 10021341 | doi = }}</ref><ref name="pmid16835440">{{cite journal | vauthors = Shiratori H, Yashiro K, Shen MM, Hamada H | title = Conserved regulation and role of Pitx2 in situs-specific morphogenesis of visceral organs | journal = Development | volume = 133 | issue = 15 | pages = 3015–25 | date = Aug 2006 | pmid = 16835440 | doi = 10.1242/dev.02470 }}</ref><ref name="pmid21035439">{{cite journal | vauthors = Zacharias AL, Lewandoski M, Rudnicki MA, Gage PJ | title = Pitx2 is an upstream activator of extraocular myogenesis and survival | journal = Developmental Biology | volume = 349 | issue = 2 | pages = 395–405 | date = Jan 2011 | pmid = 21035439 | pmc = 3019256 | doi = 10.1016/j.ydbio.2010.10.028 }}</ref>。PITX2的三種轉錄變體PITX2a、PITX2b、PITX2c各自都有不重疊的不同功能.<ref name="pmid10662647">{{cite journal | vauthors = Essner JJ, Branford WW, Zhang J, Yost HJ | title = Mesendoderm and left-right brain, heart and gut development are differentially regulated by pitx2 isoforms | journal = Development | volume = 127 | issue = 5 | pages = 1081–93 | date = Mar 2000 | pmid = 10662647 | doi = }}</ref>。
PITX2在發育中與左—右軸的建立及左右不對稱性的形成有關，比如左{{link-en|側中胚層|lateral mesoderm}}、心臟、肺、脾的不對稱發育及早起胃腸道的彎折。已證明在非人脊椎動物中，PITX2的同源基因亦有這樣的功能。敲除小鼠的Pitx2基因後，會導致身體左側器官形態發育異常。PITX2本身的表達受到ASE增強子和{{link-en|NODAL|NODAL}}蛋白的調控。目前的研究證據顯示NODAL蛋白主要調控頭部的PITX2基因表達，而ASE主要調控控制不對稱發展的PITX2基因的發展，如肝、脾的不對稱發展。在眼部發育中，PITX2能抑制眼外肌的自噬，並能控制其生長<ref name="pmid10021341">{{cite journal | vauthors = Campione M, Steinbeisser H, Schweickert A, Deissler K, van Bebber F, Lowe LA, Nowotschin S, Viebahn C, Haffter P, Kuehn MR, Blum M | title = The homeobox gene Pitx2: mediator of asymmetric left-right signaling in vertebrate heart and gut looping | journal = Development | volume = 126 | issue = 6 | pages = 1225–34 | date = Mar 1999 | pmid = 10021341 | doi = }}</ref><ref name="pmid16835440">{{cite journal | vauthors = Shiratori H, Yashiro K, Shen MM, Hamada H | title = Conserved regulation and role of Pitx2 in situs-specific morphogenesis of visceral organs | journal = Development | volume = 133 | issue = 15 | pages = 3015–25 | date = Aug 2006 | pmid = 16835440 | doi = 10.1242/dev.02470 }}</ref><ref name="pmid21035439">{{cite journal | vauthors = Zacharias AL, Lewandoski M, Rudnicki MA, Gage PJ | title = Pitx2 is an upstream activator of extraocular myogenesis and survival | journal = Developmental Biology | volume = 349 | issue = 2 | pages = 395–405 | date = Jan 2011 | pmid = 21035439 | pmc = 3019256 | doi = 10.1016/j.ydbio.2010.10.028 }}</ref>。PITX2的三種轉錄變體PITX2a、PITX2b、PITX2c各自都有不重疊的不同功能<ref name="pmid10662647">{{cite journal | vauthors = Essner JJ, Branford WW, Zhang J, Yost HJ | title = Mesendoderm and left-right brain, heart and gut development are differentially regulated by pitx2 isoforms | journal = Development | volume = 127 | issue = 5 | pages = 1081–93 | date = Mar 2000 | pmid = 10662647 | doi = }}</ref>。


PITX2亦參與了附肢形態形成。PITX2能調控[[MyoD]]基因的表達，使其在附肢形成過程中一直表達。MyoD基因與骨骼形態發生有關。研究表明Pixt2在肌肉中先於MyoD表達。要激活MyoD基因表達，PITX2首先會募集到MyoD的核心增強子上，然後激活MyoD的表達。Myf5、Myf6基因亦能調控MyoD的表達，但與PITX2之間互不影響。PITX2對附肢發育的調控依賴[[PAX3]]蛋白。在缺乏PAX3的情況下，即使PITX2表達附肢也無法形成。該實驗結果提示在調控通路中PITX2處於PAX3的下游，充當了PAX3和MyoD之間的中間體。總而言之，PITX2在附肢發育中是不可或缺的<ref name="Pitx2 and Myogenesis">{{cite journal | vauthors = L'honoré A, Ouimette JF, Lavertu-Jolin M, Drouin J | title = Pitx2 defines alternate pathways acting through MyoD during limb and somitic myogenesis | journal = Development | volume = 137 | issue = 22 | pages = 3847–56 | date = Nov 2010 | pmid = 20978076 | doi = 10.1242/dev.053421 }}</ref>。
PITX2亦參與了附肢形態形成。PITX2能調控[[MyoD]]基因的表達，使其在附肢形成過程中一直表達。MyoD基因與骨骼形態發生有關。研究表明Pixt2在肌肉中先於MyoD表達。要激活MyoD基因表達，PITX2首先會募集到MyoD的核心增強子上，然後激活MyoD的表達。Myf5、Myf6基因亦能調控MyoD的表達，但與PITX2之間互不影響。PITX2對附肢發育的調控依賴[[PAX3]]蛋白。在缺乏PAX3的情況下，即使PITX2表達附肢也無法形成。該實驗結果提示在調控通路中PITX2處於PAX3的下游，充當了PAX3和MyoD之間的中間體。總而言之，PITX2在附肢發育中是不可或缺的<ref name="Pitx2 and Myogenesis">{{cite journal | vauthors = L'honoré A, Ouimette JF, Lavertu-Jolin M, Drouin J | title = Pitx2 defines alternate pathways acting through MyoD during limb and somitic myogenesis | journal = Development | volume = 137 | issue = 22 | pages = 3847–56 | date = Nov 2010 | pmid = 20978076 | doi = 10.1242/dev.053421 }}</ref>。


另外，有證據表明Pitx2在大鼠體內與性腺生成障礙有關<ref name="pmid21325833">{{cite journal | vauthors = Nandi SS, Ghosh P, Roy SS | title = Expression of PITX2 homeodomain transcription factor during rat gonadal development in a sexually dimorphic manner | journal = Cellular Physiology and Biochemistry | volume = 27 | issue = 2 | pages = 159–70 | year = 2011 | pmid = 21325833 | doi = 10.1159/000325218 }}</ref>。
另外，有證據表明Pitx2在大鼠體內與[[性腺]]生成障礙有關<ref name="pmid21325833">{{cite journal | vauthors = Nandi SS, Ghosh P, Roy SS | title = Expression of PITX2 homeodomain transcription factor during rat gonadal development in a sexually dimorphic manner | journal = Cellular Physiology and Biochemistry | volume = 27 | issue = 2 | pages = 159–70 | year = 2011 | pmid = 21325833 | doi = 10.1159/000325218 }}</ref>。


==臨床意義==
{{transH}}
PITX2基因突變可能導致{{Link-en|阿克森費爾德綜合徵|Axenfeld-Rieger syndrome}}（Axenfeld-Rieger syndrome, ARS）、{{link-en|虹膜發育不良綜合徵|iridogoniodysgenesis, dominant type}}（iridogoniodysgenesis syndrome, IGDS）等表現爲{{link-en|眼前間充質發育不良|Anterior segment mesenchymal dysgenesis}}的病徵<ref name="entrez"/>。
== Clinical significance ==


⚫
在惡性腫瘤中，PITX2常常會過表達。比如，甲狀腺癌<ref name="pmid20372070">{{cite journal | vauthors = Huang Y, Guigon CJ, Fan J, Cheng SY, Zhu GZ | title = Pituitary homeobox 2 (PITX2) promotes thyroid carcinogenesis by activation of cyclin D2 | journal = Cell Cycle | volume = 9 | issue = 7 | pages = 1333–41 | date = Apr 2010 | pmid = 20372070 | doi = 10.4161/cc.9.7.11126 }}</ref>、 卵巢癌<ref>{{cite journal | vauthors = Fung FK, Chan DW, Liu VW, Leung TH, Cheung AN, Ngan HY | title = Increased expression of PITX2 transcription factor contributes to ovarian cancer progression | journal = PLOS ONE | volume = 7 | issue = 5 | page = e37076 | year = 2012 | pmid = 22615897 | doi = 10.1371/journal.pone.0037076 | pmc=3352869}}</ref>和結腸癌<ref>{{cite journal | vauthors = Hirose H, Ishii H, Mimori K, Tanaka F, Takemasa I, Mizushima T, Ikeda M, Yamamoto H, Sekimoto M, Doki Y, Mori M | title = The significance of PITX2 overexpression in human colorectal cancer | journal = Annals of Surgical Oncology | volume = 18 | issue = 10 | pages = 3005–12 | date = Oct 2011 | pmid = 21479692 | doi = 10.1245/s10434-011-1653-z }}</ref>的PITX2表達水平都高於正常的非腫瘤組織。研究人員推測，腫瘤細胞的PITX2表達異常開啓，造成了細胞的惡性增殖。此前的研究表明PITX2會調控[[C-Myc]]以及[[細胞週期蛋白]]D1、D2的表達，這些事實支持上述假說<ref name="pmid12464179">{{cite journal | vauthors = Kioussi C, Briata P, Baek SH, Rose DW, Hamblet NS, Herman T, Ohgi KA, Lin C, Gleiberman A, Wang J, Brault V, Ruiz-Lozano P, Nguyen HD, Kemler R, Glass CK, Wynshaw-Boris A, Rosenfeld MG | title = Identification of a Wnt/Dvl/beta-Catenin --> Pitx2 pathway mediating cell-type-specific proliferation during development | journal = Cell | volume = 111 | issue = 5 | pages = 673–85 | date = Nov 2002 | pmid = 12464179 | doi = 10.1016/s0092-8674(02)01084-x }}</ref><ref name="ReferenceA">{{cite journal | vauthors = Baek SH, Kioussi C, Briata P, Wang D, Nguyen HD, Ohgi KA, Glass CK, Wynshaw-Boris A, Rose DW, Rosenfeld MG | title = Regulated subset of G1 growth-control genes in response to derepression by the Wnt pathway | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 100 | issue = 6 | pages = 3245–3250 | date = Mar 2003 | pmid = 12629224 | doi = 10.1073/pnas.0330217100 | pmc=152277}}</ref><ref name="ReferenceA"/>
Mutations in this gene are associated with [[Axenfeld-Rieger syndrome]] (ARS), [[iridogoniodysgenesis, dominant type|iridogoniodysgenesis syndrome]] (IGDS), and sporadic cases of [[Anterior segment mesenchymal dysgenesis|Peters anomaly]]. This protein plays a role in the terminal differentiation of somatotroph and lactotroph cell phenotypes.<ref name="entrez"/>


研究表明，腎癌組織內，PITX2的表達能提高''{{link-en|ABCB1|ABCB1}}''基因的表達強度。進一步研究表明，PITX2能與''ABCB1''基因的啓動子結合，使該基因表達。該基因編碼的蛋白能夠轉運多種藥物，使細胞對化療藥物的耐藥性增強。如果降低腎癌細胞內PITX2的表達強度，那麼細胞的增殖速度會減緩，化療藥物多柔比星（doxorubicin）對細胞的殺傷力也會增加<ref name="ReferenceB">{{cite journal | vauthors = Lee WK, Chakraborty PK, Thévenod F | title = Pituitary homeobox 2 (PITX2) protects renal cancer cell lines against doxorubicin toxicity by transcriptional activation of the multidrug transporter ABCB1 | journal = International Journal of Cancer. Journal International Du Cancer | volume = 133 | issue = 3 | pages = 556–67 | date = Aug 2013 | pmid = 23354914 | doi = 10.1002/ijc.28060 }}</ref>。
⚫
Pitx2 is overexpressed in many cancers. For example, thyroid,<ref name="pmid20372070">{{cite journal | vauthors = Huang Y, Guigon CJ, Fan J, Cheng SY, Zhu GZ | title = Pituitary homeobox 2 (PITX2) promotes thyroid carcinogenesis by activation of cyclin D2 | journal = Cell Cycle | volume = 9 | issue = 7 | pages = 1333–41 | date = Apr 2010 | pmid = 20372070 | doi = 10.4161/cc.9.7.11126 }}</ref> ovarian,<ref>{{cite journal | vauthors = Fung FK, Chan DW, Liu VW, Leung TH, Cheung AN, Ngan HY | title = Increased expression of PITX2 transcription factor contributes to ovarian cancer progression | journal = PLOS ONE | volume = 7 | issue = 5 | page = e37076 | year = 2012 | pmid = 22615897 | doi = 10.1371/journal.pone.0037076 | pmc=3352869}}</ref> and colon cancer<ref>{{cite journal | vauthors = Hirose H, Ishii H, Mimori K, Tanaka F, Takemasa I, Mizushima T, Ikeda M, Yamamoto H, Sekimoto M, Doki Y, Mori M | title = The significance of PITX2 overexpression in human colorectal cancer | journal = Annals of Surgical Oncology | volume = 18 | issue = 10 | pages = 3005–12 | date = Oct 2011 | pmid = 21479692 | doi = 10.1245/s10434-011-1653-z }}</ref> all have higher levels of Pitx2 compared to noncancerous tissues. Scientists speculate that cancer cells improperly turn on Pitx2, leading to uncontrolled cell proliferation. This is consistent with the role of Pitx2 in regulating the growth-regulating genes [[cyclin D2]],<ref name="pmid12464179">{{cite journal | vauthors = Kioussi C, Briata P, Baek SH, Rose DW, Hamblet NS, Herman T, Ohgi KA, Lin C, Gleiberman A, Wang J, Brault V, Ruiz-Lozano P, Nguyen HD, Kemler R, Glass CK, Wynshaw-Boris A, Rosenfeld MG | title = Identification of a Wnt/Dvl/beta-Catenin --> Pitx2 pathway mediating cell-type-specific proliferation during development | journal = Cell | volume = 111 | issue = 5 | pages = 673–85 | date = Nov 2002 | pmid = 12464179 | doi = 10.1016/s0092-8674(02)01084-x }}</ref> cyclin D1,<ref name="ReferenceA">{{cite journal | vauthors = Baek SH, Kioussi C, Briata P, Wang D, Nguyen HD, Ohgi KA, Glass CK, Wynshaw-Boris A, Rose DW, Rosenfeld MG | title = Regulated subset of G1 growth-control genes in response to derepression by the Wnt pathway | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 100 | issue = 6 | pages = 3245–3250 | date = Mar 2003 | pmid = 12629224 | doi = 10.1073/pnas.0330217100 | pmc=152277}}</ref> and C-Myc.<ref name="ReferenceA"/>


在[[鳞状细胞癌#食道|人食管立方細胞瘤]]（esophageal squamous cell carcinoma（ESCC））中，PITX2的表達水平亦高於正常組織。臨床數據表明PITX2的表達強度與該腫瘤的擴散性成正比。患該癌症的病人，如果腫瘤PITX2表達強度較高，那麼對化療藥物會有較高的耐藥性.醫生因而可以通過PITX2的表達強度來預測食管立方細胞瘤病人接受化療後病情能得到多大程度的緩解<ref name="Zhang J 2577">{{cite journal | vauthors = Zhang JX, Tong ZT, Yang L, Wang F, Chai HP, Zhang F, Xie MR, Zhang AL, Wu LM, Hong H, Yin L, Wang H, Wang HY, Zhao Y | title = PITX2: a promising predictive biomarker of patients' prognosis and chemoradioresistance in esophageal squamous cell carcinoma | journal = International Journal of Cancer. Journal International Du Cancer | volume = 132 | issue = 11 | pages = 2567–2577 | date = Jun 2013 | pmid = 23132660 | doi = 10.1002/ijc.27930 }}</ref>。
In [[renal cancer]], Pitx2 regulates expression of [[ABCB1]], a multidrug transporter, by binding to the promoter region of ABCB1.<ref name="ReferenceB">{{cite journal | vauthors = Lee WK, Chakraborty PK, Thévenod F | title = Pituitary homeobox 2 (PITX2) protects renal cancer cell lines against doxorubicin toxicity by transcriptional activation of the multidrug transporter ABCB1 | journal = International Journal of Cancer. Journal International Du Cancer | volume = 133 | issue = 3 | pages = 556–67 | date = Aug 2013 | pmid = 23354914 | doi = 10.1002/ijc.28060 }}</ref> Increased expression of Pitx2 in renal cancer cells is associated with increased expression of ABCB1.<ref name="ReferenceB"/> Thus, renal cancer cells that overexpress ABCB1 have a greater resistance to chemotherapeutic agents.<ref name="ReferenceB"/> In experiments where Pitx2 expression was decreased, renal cancer cells had decreased cell proliferation and greater susceptibility to doxorubicin treatment, which is consistent with other results.<ref name="ReferenceB"/>


⚫
PITX2的雜合突變可能導致[[法洛四聯症]]、[[室間隔缺損]]、[[房間隔缺損]]、大動脈轉位、{{link-en|心內膜缺損|endocardial cushion defect}}（ECD）等[[先天性心臟病]]<ref name=":0">{{Cite journal|last=Sun|first=Y|date=2016-02-15|title=PITX2 loss-of-function mutation contributes to tetralogy of Fallot|url=|journal=Gene|doi=10.1016/j.gene.2015.12.001|pmid=26657035|volume=577|pages=258–264}}</ref><ref name=":1">{{Cite journal|last=Zhao|first=C|date=2015-04-20|title=PITX2 Loss-of-Function Mutation contributes to Congenital Endocardial Cushion Defect and Axenfold-Rieger Syndrome|journal=PLOS ONE|doi=10.1371/journal.pone.0124409|pmid=25893250|volume=10|pages=e0124409|pmc=4404345}}</ref><ref name=":2">{{Cite journal|last=Dong|first=Wei|date=2014-01-14|title=Novel Pitx2c loss-of-function mutations associated with complex congenital heart disease|url=|journal=International Journal of Molecular Medicine|doi=10.3892/ijmm.2014.168|pmid=}}</ref>。PITX2的突變是由[[可變剪接]]模式的改變引起。PITX2C的變體PITX2C對心血管發生最爲重要。如果該變體不表達，心血管發生就會出現問題。PITX2的一些突變會顯著降低PITX2的轉錄活性，以及PITX2和{{link-en|NKX2|NKX2}}（NKX2在心血管發生中也扮演重要角色）之間的協同活性<ref name=":0" />。由PITX2突變產生的表型多樣，可能是由不同的遺傳背景、表觀遺傳修飾蛋白以及不同/延遲的外顯率造成<ref name=":1" />。值得注意的是PITX2的突變並不是造成先天性心臟病的主導因素，但會影響這些疾病的發展<ref name=":2" />。
In human esophageal [[squamous cell carcinoma]] (ESCC), Pitx2 is overexpressed compared to normal esophageal squamous cells.<ref name="Zhang J 2577">{{cite journal | vauthors = Zhang JX, Tong ZT, Yang L, Wang F, Chai HP, Zhang F, Xie MR, Zhang AL, Wu LM, Hong H, Yin L, Wang H, Wang HY, Zhao Y | title = PITX2: a promising predictive biomarker of patients' prognosis and chemoradioresistance in esophageal squamous cell carcinoma | journal = International Journal of Cancer. Journal International Du Cancer | volume = 132 | issue = 11 | pages = 2567–2577 | date = Jun 2013 | pmid = 23132660 | doi = 10.1002/ijc.27930 }}</ref> In addition, greater expression of Pitx2 is positively correlated with clinical aggressiveness of ESCC.<ref name="Zhang J 2577"/> Also, ESCC patients with high Pitx2 expression did not respond as well to definitive chemoradiotherapy (CRT) compared to ESCC patients with low Pitx2 expression.<ref name="Zhang J 2577"/> Thus, physicians may be able to use Pitx2 expression to predict how ESCC patients will respond to cancer treatment.<ref name="Zhang J 2577"/>


⚫
In [[Congenital heart defect|Congenital Heart Disease]], heterozygous mutations in Pitx2 have been involved in the development of [[Tetralogy of Fallot]], [[ventricular septal defect]]s, [[atrial septal defect]]s, transposition of great arteries, and [[Endocardial cushion defects|endocardial cushion defect]] (ECD).<ref name=":0">{{Cite journal|last=Sun|first=Y|date=February 15, 2016|title=PITX2 loss-of-function mutation contributes to tetralogy of Fallot|url=|journal=Gene|doi=10.1016/j.gene.2015.12.001|pmid=26657035|volume=577|pages=258–264}}</ref><ref name=":1">{{Cite journal|last=Zhao|first=C|date=April 20, 2015|title=PITX2 Loss-of-Function Mutation contributes to Congenital Endocardial Cushion Defect and Axenfold-Rieger Syndrome|journal=PLOS ONE|doi=10.1371/journal.pone.0124409|pmid=25893250|volume=10|pages=e0124409|pmc=4404345}}</ref><ref name=":2">{{Cite journal|last=Dong|first=Wei|date=January 14, 2014|title=Novel Pitx2c loss-of-function mutations associated with complex congenital heart disease|url=|journal=International Journal of Molecular Medicine|doi=10.3892/ijmm.2014.168|pmid=}}</ref> The mutations of the Pitx2 gene are created through [[alternative splicing]]. The isoform of Pitx2 important for cardiogenesis is Pitx2c. The lack of expression of this particular isoform correlates with these congenital defects. Pitx2 mutations significantly reduce transcriptional activity of Pitx2 and synergistic activation between Pitx2 and [[NK2 homeobox 1|NKX2]](also important for development of the heart).<ref name=":0" /> The large phenotypic spectrum due to the mutation of Pitx2 may be attributed to a variety of factors including: different genetic backgrounds, epigenetic modifiers and delayed/complete penetrance.<ref name=":1" /> It is important to note that the mutation of Pitx2 is not defined as the cause of these congenital heart defects, but currently perceived as a risk factor for their development.<ref name=":2" />
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==參考==
==參考==
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* {{cite journal | vauthors = Hjalt TA, Semina EV | title = Current molecular understanding of Axenfeld-Rieger syndrome | journal = Expert Reviews in Molecular Medicine | volume = 7 | issue = 25 | pages = 1–17 | date = Nov 2005 | pmid = 16274491 | doi = 10.1017/S1462399405010082 }}
* {{cite journal | vauthors = Hjalt TA, Semina EV | title = Current molecular understanding of Axenfeld-Rieger syndrome | journal = Expert Reviews in Molecular Medicine | volume = 7 | issue = 25 | pages = 1–17 | date = Nov 2005 | pmid = 16274491 | doi = 10.1017/S1462399405010082 }}
* {{cite journal | vauthors = Murray JC, Bennett SR, Kwitek AE, Small KW, Schinzel A, Alward WL, Weber JL, Bell GI, Buetow KH | title = Linkage of Rieger syndrome to the region of the epidermal growth factor gene on chromosome 4 | journal = Nature Genetics | volume = 2 | issue = 1 | pages = 46–9 | date = Sep 1992 | pmid = 1303248 | doi = 10.1038/ng0992-46 }}
* {{cite journal | vauthors = Murray JC, Bennett SR, Kwitek AE, Small KW, Schinzel A, Alward WL, Weber JL, Bell GI, Buetow KH | title = Linkage of Rieger syndrome to the region of the epidermal growth factor gene on chromosome 4 | journal = Nature Genetics | volume = 2 | issue = 1 | pages = 46–9 | date = Sep 1992 | pmid = 1303248 | doi = 10.1038/ng0992-46 }}
* {{cite journal | vauthors = Walter MA, Mirzayans F, Mears AJ, Hickey K, Pearce WG | title = Autosomal-dominant iridogoniodysgenesis and Axenfeld-Rieger syndrome are genetically distinct | journal = Ophthalmology | volume = 103 | issue = 11 | pages = 1907–15 | date = Nov 1996 | pmid = 8942889 | doi = 10.1016/s0161-6420(96)30408-9 }}
* {{cite journal | vauthors = Walter MA, Mirzayans F, Mears AJ, Hickey K, Pearce WG | title = Autosomal-dominant iridogoniodysgenesis and Axenfeld-Rieger syndrome are genetically distinct | url = https://archive.org/details/sim_ophthalmology_1996-11_103_11/page/1907 | journal = Ophthalmology | volume = 103 | issue = 11 | pages = 1907–15 | date = Nov 1996 | pmid = 8942889 | doi = 10.1016/s0161-6420(96)30408-9 }}
* {{cite journal | vauthors = Semina EV, Reiter R, Leysens NJ, Alward WL, Small KW, Datson NA, Siegel-Bartelt J, Bierke-Nelson D, Bitoun P, Zabel BU, Carey JC, Murray JC | title = Cloning and characterization of a novel bicoid-related homeobox transcription factor gene, RIEG, involved in Rieger syndrome | journal = Nature Genetics | volume = 14 | issue = 4 | pages = 392–9 | date = Dec 1996 | pmid = 8944018 | doi = 10.1038/ng1296-392 }}
* {{cite journal | vauthors = Semina EV, Reiter R, Leysens NJ, Alward WL, Small KW, Datson NA, Siegel-Bartelt J, Bierke-Nelson D, Bitoun P, Zabel BU, Carey JC, Murray JC | title = Cloning and characterization of a novel bicoid-related homeobox transcription factor gene, RIEG, involved in Rieger syndrome | journal = Nature Genetics | volume = 14 | issue = 4 | pages = 392–9 | date = Dec 1996 | pmid = 8944018 | doi = 10.1038/ng1296-392 }}
* {{cite journal | vauthors = Alward WL, Semina EV, Kalenak JW, Héon E, Sheth BP, Stone EM, Murray JC | title = Autosomal dominant iris hypoplasia is caused by a mutation in the Rieger syndrome (RIEG/PITX2) gene | journal = American Journal of Ophthalmology | volume = 125 | issue = 1 | pages = 98–100 | date = Jan 1998 | pmid = 9437321 | doi = 10.1016/S0002-9394(99)80242-6 }}
* {{cite journal | vauthors = Alward WL, Semina EV, Kalenak JW, Héon E, Sheth BP, Stone EM, Murray JC | title = Autosomal dominant iris hypoplasia is caused by a mutation in the Rieger syndrome (RIEG/PITX2) gene | url = https://archive.org/details/sim_american-journal-of-ophthalmology_1998-01_125_1/page/98 | journal = American Journal of Ophthalmology | volume = 125 | issue = 1 | pages = 98–100 | date = Jan 1998 | pmid = 9437321 | doi = 10.1016/S0002-9394(99)80242-6 }}
* {{cite journal | vauthors = Kulak SC, Kozlowski K, Semina EV, Pearce WG, Walter MA | title = Mutation in the RIEG1 gene in patients with iridogoniodysgenesis syndrome | journal = Human Molecular Genetics | volume = 7 | issue = 7 | pages = 1113–7 | date = Jul 1998 | pmid = 9618168 | doi = 10.1093/hmg/7.7.1113 }}
* {{cite journal | vauthors = Kulak SC, Kozlowski K, Semina EV, Pearce WG, Walter MA | title = Mutation in the RIEG1 gene in patients with iridogoniodysgenesis syndrome | journal = Human Molecular Genetics | volume = 7 | issue = 7 | pages = 1113–7 | date = Jul 1998 | pmid = 9618168 | doi = 10.1093/hmg/7.7.1113 }}
* {{cite journal | vauthors = Amendt BA, Sutherland LB, Semina EV, Russo AF | title = The molecular basis of Rieger syndrome. Analysis of Pitx2 homeodomain protein activities | journal = The Journal of Biological Chemistry | volume = 273 | issue = 32 | pages = 20066–72 | date = Aug 1998 | pmid = 9685346 | doi = 10.1074/jbc.273.32.20066 }}
* {{cite journal | vauthors = Amendt BA, Sutherland LB, Semina EV, Russo AF | title = The molecular basis of Rieger syndrome. Analysis of Pitx2 homeodomain protein activities | journal = The Journal of Biological Chemistry | volume = 273 | issue = 32 | pages = 20066–72 | date = Aug 1998 | pmid = 9685346 | doi = 10.1074/jbc.273.32.20066 }}
* {{cite journal | vauthors = Yoshioka H, Meno C, Koshiba K, Sugihara M, Itoh H, Ishimaru Y, Inoue T, Ohuchi H, Semina EV, Murray JC, Hamada H, Noji S | title = Pitx2, a bicoid-type homeobox gene, is involved in a lefty-signaling pathway in determination of left-right asymmetry | journal = Cell | volume = 94 | issue = 3 | pages = 299–305 | date = Aug 1998 | pmid = 9708732 | doi = 10.1016/S0092-8674(00)81473-7 }}
* {{cite journal | vauthors = Yoshioka H, Meno C, Koshiba K, Sugihara M, Itoh H, Ishimaru Y, Inoue T, Ohuchi H, Semina EV, Murray JC, Hamada H, Noji S | title = Pitx2, a bicoid-type homeobox gene, is involved in a lefty-signaling pathway in determination of left-right asymmetry | journal = Cell | volume = 94 | issue = 3 | pages = 299–305 | date = Aug 1998 | pmid = 9708732 | doi = 10.1016/S0092-8674(00)81473-7 }}
* {{cite journal | vauthors = Doward W, Perveen R, Lloyd IC, Ridgway AE, Wilson L, Black GC | title = A mutation in the RIEG1 gene associated with Peters' anomaly | journal = Journal of Medical Genetics | volume = 36 | issue = 2 | pages = 152–5 | date = Feb 1999 | pmid = 10051017 | pmc = 1734311 | doi = 10.1136/jmg.36.2.152 }}
* {{cite journal | vauthors = Doward W, Perveen R, Lloyd IC, Ridgway AE, Wilson L, Black GC | title = A mutation in the RIEG1 gene associated with Peters' anomaly | url = https://archive.org/details/sim_journal-of-medical-genetics_1999-02_36_2/page/152 | journal = Journal of Medical Genetics | volume = 36 | issue = 2 | pages = 152–5 | date = Feb 1999 | pmid = 10051017 | pmc = 1734311 | doi = 10.1136/jmg.36.2.152 }}
* {{cite journal | vauthors = Pellegrini-Bouiller I, Manrique C, Gunz G, Grino M, Zamora AJ, Figarella-Branger D, Grisoli F, Jaquet P, Enjalbert A | title = Expression of the members of the Ptx family of transcription factors in human pituitary adenomas | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 84 | issue = 6 | pages = 2212–20 | date = Jun 1999 | pmid = 10372733 | doi = 10.1210/jc.84.6.2212 }}
* {{cite journal | vauthors = Pellegrini-Bouiller I, Manrique C, Gunz G, Grino M, Zamora AJ, Figarella-Branger D, Grisoli F, Jaquet P, Enjalbert A | title = Expression of the members of the Ptx family of transcription factors in human pituitary adenomas | journal = The Journal of Clinical Endocrinology and Metabolism | volume = 84 | issue = 6 | pages = 2212–20 | date = Jun 1999 | pmid = 10372733 | doi = 10.1210/jc.84.6.2212 }}
* {{cite journal | vauthors = Hjalt TA, Amendt BA, Murray JC | title = PITX2 regulates procollagen lysyl hydroxylase (PLOD) gene expression: implications for the pathology of Rieger syndrome | journal = The Journal of Cell Biology | volume = 152 | issue = 3 | pages = 545–52 | date = Feb 2001 | pmid = 11157981 | pmc = 2196000 | doi = 10.1083/jcb.152.3.545 }}
* {{cite journal | vauthors = Hjalt TA, Amendt BA, Murray JC | title = PITX2 regulates procollagen lysyl hydroxylase (PLOD) gene expression: implications for the pathology of Rieger syndrome | journal = The Journal of Cell Biology | volume = 152 | issue = 3 | pages = 545–52 | date = Feb 2001 | pmid = 11157981 | pmc = 2196000 | doi = 10.1083/jcb.152.3.545 }}
* {{cite journal | vauthors = Priston M, Kozlowski K, Gill D, Letwin K, Buys Y, Levin AV, Walter MA, Héon E | title = Functional analyses of two newly identified PITX2 mutants reveal a novel molecular mechanism for Axenfeld-Rieger syndrome | journal = Human Molecular Genetics | volume = 10 | issue = 16 | pages = 1631–8 | date = Aug 2001 | pmid = 11487566 | doi = 10.1093/hmg/10.16.1631 }}
* {{cite journal | vauthors = Priston M, Kozlowski K, Gill D, Letwin K, Buys Y, Levin AV, Walter MA, Héon E | title = Functional analyses of two newly identified PITX2 mutants reveal a novel molecular mechanism for Axenfeld-Rieger syndrome | journal = Human Molecular Genetics | volume = 10 | issue = 16 | pages = 1631–8 | date = Aug 2001 | pmid = 11487566 | doi = 10.1093/hmg/10.16.1631 }}
* {{cite journal | vauthors = Green PD, Hjalt TA, Kirk DE, Sutherland LB, Thomas BL, Sharpe PT, Snead ML, Murray JC, Russo AF, Amendt BA | title = Antagonistic regulation of Dlx2 expression by PITX2 and Msx2: implications for tooth development | journal = Gene Expression | volume = 9 | issue = 6 | pages = 265–81 | year = 2002 | pmid = 11763998 | doi = }}
* {{cite journal | vauthors = Green PD, Hjalt TA, Kirk DE, Sutherland LB, Thomas BL, Sharpe PT, Snead ML, Murray JC, Russo AF, Amendt BA | title = Antagonistic regulation of Dlx2 expression by PITX2 and Msx2: implications for tooth development | journal = Gene Expression | volume = 9 | issue = 6 | pages = 265–81 | year = 2002 | pmid = 11763998 | doi = }}
* {{cite journal | vauthors = Vincent AL, Billingsley G, Buys Y, Levin AV, Priston M, Trope G, Williams-Lyn D, Héon E | title = Digenic inheritance of early-onset glaucoma: CYP1B1, a potential modifier gene | journal = American Journal of Human Genetics | volume = 70 | issue = 2 | pages = 448–60 | date = Feb 2002 | pmid = 11774072 | pmc = 384919 | doi = 10.1086/338709 }}
* {{cite journal | vauthors = Vincent AL, Billingsley G, Buys Y, Levin AV, Priston M, Trope G, Williams-Lyn D, Héon E | title = Digenic inheritance of early-onset glaucoma: CYP1B1, a potential modifier gene | url = https://archive.org/details/sim_american-journal-of-human-genetics_2002-02_70_2/page/448 | journal = American Journal of Human Genetics | volume = 70 | issue = 2 | pages = 448–60 | date = Feb 2002 | pmid = 11774072 | pmc = 384919 | doi = 10.1086/338709 }}
* {{cite journal | vauthors = Borges AS, Susanna R, Carani JC, Betinjane AJ, Alward WL, Stone EM, Sheffield VC, Nishimura DY | title = Genetic analysis of PITX2 and FOXC1 in Rieger Syndrome patients from Brazil | journal = Journal of Glaucoma | volume = 11 | issue = 1 | pages = 51–6 | date = Feb 2002 | pmid = 11821690 | doi = 10.1097/00061198-200202000-00010 }}
* {{cite journal | vauthors = Borges AS, Susanna R, Carani JC, Betinjane AJ, Alward WL, Stone EM, Sheffield VC, Nishimura DY | title = Genetic analysis of PITX2 and FOXC1 in Rieger Syndrome patients from Brazil | journal = Journal of Glaucoma | volume = 11 | issue = 1 | pages = 51–6 | date = Feb 2002 | pmid = 11821690 | doi = 10.1097/00061198-200202000-00010 }}
* {{cite journal | vauthors = Cox CJ, Espinoza HM, McWilliams B, Chappell K, Morton L, Hjalt TA, Semina EV, Amendt BA | title = Differential regulation of gene expression by PITX2 isoforms | journal = The Journal of Biological Chemistry | volume = 277 | issue = 28 | pages = 25001–10 | date = Jul 2002 | pmid = 11948188 | doi = 10.1074/jbc.M201737200 }}
* {{cite journal | vauthors = Cox CJ, Espinoza HM, McWilliams B, Chappell K, Morton L, Hjalt TA, Semina EV, Amendt BA | title = Differential regulation of gene expression by PITX2 isoforms | journal = The Journal of Biological Chemistry | volume = 277 | issue = 28 | pages = 25001–10 | date = Jul 2002 | pmid = 11948188 | doi = 10.1074/jbc.M201737200 }}

2021年10月17日 (日) 21:50的最新版本

PITX2
已知的結構
PDB直系同源搜索: PDBe RCSB
識別號
别名PITX2；, ARP1, Brx1, IDG2, IGDS, IGDS2, IHG2, IRID2, Otlx2, PTX2, RGS, RIEG, RIEG1, RS, paired like homeodomain 2, ASGD4
外部IDOMIM：601542 MGI：109340 HomoloGene：55454 GeneCards：PITX2
相關疾病
Axenfeld-Rieger syndrome type 1、​虹膜發育不良綜合徵、​ring dermoid of cornea、​Rieger anomaly[1]
基因位置（人类）
4號染色體
染色体4號染色體[2]
4號染色體
PITX2的基因位置
PITX2的基因位置
基因座4q25起始110,617,423 bp[2]
终止110,642,123 bp[2]
RNA表达模式
查阅更多表达数据
直系同源
物種人類小鼠
Entrez

5308

18741

Ensembl

ENSG00000164093

ENSMUSG00000028023

UniProt

Q99697

P97474

mRNA​序列

NM_001042502
​NM_001042504
​NM_001286942
​NM_001287048
​NM_011098

蛋白序列

NP_001035967
​NP_001035969
​NP_001273871
​NP_001273977
​NP_035228

基因位置​（UCSC）Chr 4: 110.62 – 110.64 MbChr 3: 128.99 – 129.01 Mb
PubMed​查找[4][5]
維基數據
檢視/編輯人類檢視/編輯小鼠

PITX2（Paired-like homeodomain transcription factor 2（類成對同源框轉錄因子2）/pituitary homeobox 2（垂體同源框2））是一個位於人第四號染色體上的基因，由其編碼的蛋白為PITX2[6][7][8]。

功能

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PITX2蛋白屬於RIEG/PITX同源框蛋白家族，有一個屬於Bicoid（英语：Bicoid）蛋白家族的同源結構域。從功能上說，PITX2是一種轉錄因子[9]，主要調控前膠原賴氨酰羥化酶（英语：lysyl hydroxylase）（procollagen lysyl hydroxylase）基因的表達。賴氨酰羥化酶參與眼、牙，以及腹部器官的發育過程。PITX2的轉錄調節活性受到催乳素的調節。 已發現人體內的PITX2有三種轉錄變體[8]。

PITX2在發育中與左—右軸的建立及左右不對稱性的形成有關，比如左側中胚層（英语：lateral mesoderm）、心臟、肺、脾的不對稱發育及早起胃腸道的彎折。已證明在非人脊椎動物中，PITX2的同源基因亦有這樣的功能。敲除小鼠的Pitx2基因後，會導致身體左側器官形態發育異常。PITX2本身的表達受到ASE增強子和NODAL（英语：NODAL）蛋白的調控。目前的研究證據顯示NODAL蛋白主要調控頭部的PITX2基因表達，而ASE主要調控控制不對稱發展的PITX2基因的發展，如肝、脾的不對稱發展。在眼部發育中，PITX2能抑制眼外肌的自噬，並能控制其生長[10][11][12]。PITX2的三種轉錄變體PITX2a、PITX2b、PITX2c各自都有不重疊的不同功能[13]。

PITX2亦參與了附肢形態形成。PITX2能調控MyoD基因的表達，使其在附肢形成過程中一直表達。MyoD基因與骨骼形態發生有關。研究表明Pixt2在肌肉中先於MyoD表達。要激活MyoD基因表達，PITX2首先會募集到MyoD的核心增強子上，然後激活MyoD的表達。Myf5、Myf6基因亦能調控MyoD的表達，但與PITX2之間互不影響。PITX2對附肢發育的調控依賴PAX3蛋白。在缺乏PAX3的情況下，即使PITX2表達附肢也無法形成。該實驗結果提示在調控通路中PITX2處於PAX3的下游，充當了PAX3和MyoD之間的中間體。總而言之，PITX2在附肢發育中是不可或缺的[14]。

另外，有證據表明Pitx2在大鼠體內與性腺生成障礙有關[15]。

臨床意義

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PITX2基因突變可能導致阿克森費爾德綜合徵（英语：Axenfeld-Rieger syndrome）（Axenfeld-Rieger syndrome, ARS）、虹膜發育不良綜合徵（英语：iridogoniodysgenesis, dominant type）（iridogoniodysgenesis syndrome, IGDS）等表現爲眼前間充質發育不良（英语：Anterior segment mesenchymal dysgenesis）的病徵[8]。

在惡性腫瘤中，PITX2常常會過表達。比如，甲狀腺癌[16]、 卵巢癌[17]和結腸癌[18]的PITX2表達水平都高於正常的非腫瘤組織。研究人員推測，腫瘤細胞的PITX2表達異常開啓，造成了細胞的惡性增殖。此前的研究表明PITX2會調控C-Myc以及細胞週期蛋白D1、D2的表達，這些事實支持上述假說[19][20][20]

研究表明，腎癌組織內，PITX2的表達能提高ABCB1（英语：ABCB1）基因的表達強度。進一步研究表明，PITX2能與ABCB1基因的啓動子結合，使該基因表達。該基因編碼的蛋白能夠轉運多種藥物，使細胞對化療藥物的耐藥性增強。如果降低腎癌細胞內PITX2的表達強度，那麼細胞的增殖速度會減緩，化療藥物多柔比星（doxorubicin）對細胞的殺傷力也會增加[21]。

在人食管立方細胞瘤（esophageal squamous cell carcinoma（ESCC））中，PITX2的表達水平亦高於正常組織。臨床數據表明PITX2的表達強度與該腫瘤的擴散性成正比。患該癌症的病人，如果腫瘤PITX2表達強度較高，那麼對化療藥物會有較高的耐藥性.醫生因而可以通過PITX2的表達強度來預測食管立方細胞瘤病人接受化療後病情能得到多大程度的緩解[22]。

PITX2的雜合突變可能導致法洛四聯症、室間隔缺損、房間隔缺損、大動脈轉位、心內膜缺損（英语：endocardial cushion defect）（ECD）等先天性心臟病[23][24][25]。PITX2的突變是由可變剪接模式的改變引起。PITX2C的變體PITX2C對心血管發生最爲重要。如果該變體不表達，心血管發生就會出現問題。PITX2的一些突變會顯著降低PITX2的轉錄活性，以及PITX2和NKX2（英语：NKX2）（NKX2在心血管發生中也扮演重要角色）之間的協同活性[23]。由PITX2突變產生的表型多樣，可能是由不同的遺傳背景、表觀遺傳修飾蛋白以及不同/延遲的外顯率造成[24]。值得注意的是PITX2的突變並不是造成先天性心臟病的主導因素，但會影響這些疾病的發展[25]。

參考

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  1. ^ 與PITX2相關的疾病；在維基數據上查看/編輯參考. 
  2. ^ 2.0 2.1 2.2 GRCh38: Ensembl release 89: ENSG00000164093 - Ensembl, May 2017
  3. ^ 3.0 3.1 3.2 GRCm38: Ensembl release 89: ENSMUSG00000028023 - Ensembl, May 2017
  4. ^ Human PubMed Reference:. National Center for Biotechnology Information, U.S. National Library of Medicine. 
  5. ^ Mouse PubMed Reference:. National Center for Biotechnology Information, U.S. National Library of Medicine. 
  6. ^ Arakawa H, Nakamura T, Zhadanov AB, Fidanza V, Yano T, Bullrich F, Shimizu M, Blechman J, Mazo A, Canaani E, Croce CM. Identification and characterization of the ARP1 gene, a target for the human acute leukemia ALL1 gene. Proceedings of the National Academy of Sciences of the United States of America. Apr 1998, 95 (8): 4573–8. PMC 22531 可免费查阅. PMID 9539779. doi:10.1073/pnas.95.8.4573. 
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拓展閱讀

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外部連結

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PITX2引用了美国国家医学图书馆提供的資料，这些資料属于公共领域。

检索自“https://zh.wikipedia.org/zhwiki/w/index.php?title=PITX2&oldid=68257292”