Reversible dasatinib-related pulmonary arterial hypertension in a CML patient.

A 59-year-old man diagnosed with the chronic phase of chronic myeloid leukemia (CML) in June 2011 was started on dasatinib (100 mg/day). He had no signs of pleural effusion (PE) or right heart failure before treatment, but symptoms of PE and dyspnea (New York Heart Association class III) appeared in January 2013 and May 2014, respectively. Doppler transthoracic echocardiography and right heart catheterization revealed pulmonary arterial hypertension (PAH) with an estimated pulmonary artery systolic pressure (PASP) of 80 mmHg and estimated mean pulmonary artery pressure of 29 mmHg. Rheumatoid factor, antinuclear antibody, dsDNA antibody, and SCL70 were not elevated, and computed tomography confirmed the absence of a pulmonary embolism. Therefore, dasatinib-related PAH was diagnosed and treatment with this agent was discontinued. The PASP had decreased to 51 and 40 mmHg at one month and one year, respectively, after dasatinib discontinuation. This patient developed PAH while receiving dasatinib administration and only discontinuation of this agent improved his symptoms. The possibility that dasatinib can cause PAH must be considered before administering this agent to patients with CML.

A mitochondrial gene involved in cytochrome c maturation (ccmC) is expressed as a precursor with a long NH2-terminal extension in sugar beet.

Extensive genome rearrangement is one of the major mechanisms of angiosperm mitochondrial evolution. As a by-product, some angiosperm mitochondrial genes exhibit divergent organization, but not all of these genes have been fully characterized. Sugar beet ccmC, which plays an important role in cytochrome c maturation, harbors a unique extended NH(2) terminal region of 277 amino acid residues (N-extension) instead of a conserved translational initiation codon. The 5' termini of two major RNA species were determined by primer extension analysis, which revealed that the larger transcript covered the entire N-extension. Nucleotide sequencing of the cDNA revealed that a total of 31 C-to-U RNA editing events occurred in the N-extension and the ccmC-homologous region (ccmC-core region), resulting in improvement of amino acid sequence conservation. Antiserum was raised against a synthetic peptide corresponding to the ccmC-core region and was used for protein gel blot analysis of sugar beet and radish mitochondrial proteins. The detected 29.5-kDa signal band is shared by sugar beet and radish. Two additional larger signal bands are exclusively detected from sugar beet. The largest signal band is also detected by anti-N-extension antiserum. Our results indicate that sugar beet ccmC is translated as a long precursor with N-extension.