[Splicing factor mutations in myelodysplastic syndromes].

Splicing factor mutations represent a novel class of driver mutations in myelodysplastic syndromes, where four genes, including SF3B1, SRSF2, U2AF1, and ZRSR2, are most frequently affected. SF3B1 and SRSF2 mutations show prominent specificity to the syndrome subtypes characterized by increased ring sideroblasts and chronic myelomonocytic leukemia, respectively. These mutations are suspected to be involved in the pathogenesis of the above mentioned syndromes most likely via abnormal RNA splicing. However, the precise mechanism and target genes have not been fully understood. Splicing alterations induced by these mutations are extensively studied using RNA sequencing. SF3B1 mutations caused misrecognition of 3' splice sites. Target genes included those involved in mitochondrial iron metabolism or heme biosynthesis, such as ABCB7 and PPOX, suggesting a role in the abnormal erythropoiesis associated with increased ring sideroblasts. By contrast, SRSF2 and U2AF1 mutations were mainly associated with alternative exon usage in hundreds of genes. The targets included genes of which mutations are definitive or putative drivers in myeloid malignancies. Protein structure modeling and experiments with cell lines and mouse models supported these findings. ZRSR2 mutations were associated with the retention of U12-type introns, and this is consistent with the known role of ZRSR2 as an essential component of the U12-type spliceosome. Further studies are warranted to determine the biological effects of splicing alterations.