Send to

Choose Destination
Pediatr Hematol Oncol. 2019 Oct 29:1-18. doi: 10.1080/08880018.2019.1682090. [Epub ahead of print]

Identification of novel Nrf2/Keap1 pathway mutations in pediatric acute lymphoblastic leukemia.

Author information

Faculty of Medicine, Medical Biology, Nigde Omer Halisdemir University, Nigde, Turkey.
Vocational School of Health Services, Eskisehir Osmangazi University, Eskisehir, Turkey.
Central Research Laboratory Application and Research Center, Eskisehir Osmangazi University, Eskisehir, Turkey.
Ankara University Stem Cell Institute, Ankara, Turkey.
Faculty of Science Literature, Department of Biotechnology, Nigde Omer Halisdemir University, Nigde, Turkey.


Acute lymphoblastic leukemia (ALL) is a malignancy of lymphoid progenitor cells, characterized by a wide range of biological and clinical heterogeneity. Oxidative stress is a common problem observed in carcinogenesis and it is involved in developing treatment resistance. Nuclear Factor Erythroid-2-Like 2 (Nrf2) transcription factor is the main regulator of antioxidant responses. The levels of reactive oxygen species (ROS) are tightly controlled and regulated by Nrf2 and its suppressor protein Kelch-like ECH-associated protein 1 (Keap1). Recently, many studies have shown that most of the genes in the Nrf2/Keap1/nuclear factor kappa-B (NF-κB)/phosphotyrosine-independent ligand for the Lck SH2 domain Of 62 KDa (p62) pathway show abnormally high mutational variations in cancer. However, variations in the Nrf2/Keap1/NF-κB1/p62 pathway in pediatric ALL have not been thoroughly investigated, yet. Thirty children, who were diagnosed with pediatirc ALL were included in the study. The Nrf2/Keap1/NF-κB1/p62 pathway variants were analyzed by DNA sequencing analysis. The PolyPhen-2 program was used for identifying pathogenic mutations. Our study examined the molecular dynamics (MD) perspectives of the effect of A159T and E121K mutations on protein stability for the first time in the literature by using the GROMACS45 software package utilizing the OPSLAA force field. Of the detected 17 nucleotide changes, 6 were novel. The study predicted the potential pathological effect of two mutations p. A159T and p.E121K in the Keap1 gene. The MD perspectives revealed that the E121K mutant's observed structural behavior accounted for the key role of His-129 and E121K, where E121K exhibited much higher drift compared to His-129. For a future perspective, it would be meaningful to study the protein-small molecule interactions of the Keap1 protein to elaborate on the drug effects in patients carrying these mutations.


Molecular dynamics; NF-κB1/p105; Nrf2/Keap1 pathway; mutation; pediatric leukemia

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center