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Richard M, Celeny D, Neerman-Arbez M. Mutations Accounting for Congenital Fibrinogen Disorders: An Update. Semin Thromb Hemost 2022; 48:889-903. [PMID: 35073585 DOI: 10.1055/s-0041-1742170] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Fibrinogen is a complex protein that plays a key role in the blood clotting process. It is a hexamer composed of two copies of three distinct chains: Aα, Bβ, and γ encoded by three genes, FGA, FGB, and FGG, clustered on the long arm of chromosome 4. Congenital fibrinogen disorders (CFDs) are divided into qualitative deficiencies (dysfibrinogenemia, hypodysfibrinogenemia) in which the mutant fibrinogen molecule is present in the circulation and quantitative deficiencies (afibrinogenemia, hypofibrinogenemia) with no mutant molecule present in the bloodstream. Phenotypic manifestations are variable, patients may be asymptomatic, or suffer from bleeding or thrombosis. Causative mutations can occur in any of the three fibrinogen genes and can affect one or both alleles. Given the large number of studies reporting on novel causative mutations for CFDs since the review on the same topic published in 2016, we performed an extensive search of the literature and list here 120 additional mutations described in both quantitative and qualitative disorders. The visualization of causative single nucleotide variations placed on the coding sequences of FGA, FGB, and FGG reveals important structure function insight for several domains of the fibrinogen molecule.
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Affiliation(s)
- Maxime Richard
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - David Celeny
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Zhou W, Huang Y, Wei J, Wang JL, Huang B, Zhou X, Yan J, Wu Y, Lin F, Wen W. A novel fibrinogen γ-chain frameshift mutation, p. Cys365Phefs*41, causing hypofibrinogenemia with bleeding phenotype in a Chinese family. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1308. [PMID: 34532445 PMCID: PMC8422118 DOI: 10.21037/atm-21-3207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/05/2021] [Indexed: 11/08/2022]
Abstract
Background Congenital hypofibrinogenemia is a rare bleeding disease that is classified as the quantitative deficient type. In the present study, investigated the relationship between the genotype and phenotype in a family with hypofibrinogenemia. Methods The proband was aware of a predisposition to bleeding. Functional analysis was performed for her all family members, including coagulation function tests, thrombus molecular markers, thromboelastography, scanning electron microscopy, DNA sequencing, and high-performance liquid chromatography-mass spectrometry (HPLC-MS). Pathogenicity analysis and protein modeling of mutant amino acids were also performed. Results A novel heterozygous mutation in c.1094delG was detected in FGG exon 8, which resulted in p. Cys365Phefs*41 (containing the signal peptide) in the proband and her mother, who showed a corresponding decrease in fibrinogen function and levels. Thromboelastography indicated that the strength of their blood clots decreased and they had an increased risk of bleeding. The proband fibrin network structure was looser than healthy controls, with large pores in the network, which increased the permeability of lytic enzymes. Results of HPLC-MS showed a lack of mutant peptide chain expression in their plasma, indicating that the family had congenital hypofibrinogenemia, with a clinical phenotype that is related to the degree of fibrinogen deficiency. The mutation truncated the γ-peptide chain and destroyed the functional structure of fibrinogen, including the γ352Cys-γ365Cys disulfide bond. The truncated peptide chains may also lead to nonsense-mediated decay. Conclusions The mutation induced a structural change at the carboxyl-terminal of the fibrinogen molecule, leading to fibrinogen secretion dysfunction.
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Affiliation(s)
- Weijie Zhou
- Clinical Laboratory, The Affiliated Shunde Hospital of Jinan University, Foshan, China.,Clinical Laboratory Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Reproductive Genetics Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.,Clinical Laboratory, The People's Hospital of Baise, Baise, China
| | - Yan Huang
- Department of Hematology, The People's Hospital of Baise, Baise, China
| | - Jie Wei
- Department of Hematology, The People's Hospital of Baise, Baise, China
| | - Jun Li Wang
- Reproductive Genetics Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Boming Huang
- Clinical Laboratory, The People's Hospital of Baise, Baise, China
| | - Xiaoxuan Zhou
- Clinical Laboratory, The People's Hospital of Baise, Baise, China
| | - Jie Yan
- Clinical Laboratory, The Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yangyang Wu
- Clinical Laboratory, The Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Faquan Lin
- Clinical Laboratory, The Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Wangrong Wen
- Clinical Laboratory, The Affiliated Shunde Hospital of Jinan University, Foshan, China.,Clinical Laboratory Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Zhou P, Yu M, Peng Y, Ma P, Wan L. Identification and characterization of novel mutations in Chinese patients with congenital fibrinogen disorders. Blood Cells Mol Dis 2020; 86:102489. [PMID: 32877852 DOI: 10.1016/j.bcmd.2020.102489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Congenital fibrinogen disorders are characterized by heterogeneous clinical manifestations with mutations in the fibrinogen gene cluster. We aimed to describe the molecular genetics and clinical manifestations of fibrinogen abnormalities and perform genotype-phenotype correlations. MATERIALS AND METHODS Genetic analysis of fibrinogen genes was performed by direct sequencing. The effect of the specific missense variants on fibrinogen structure and function was analyzed using PROVEAN and PolyPhen-2 algorithms and was predicted by protein modeling. RESULTS Thirteen mutations, including five novel mutations, were identified in the three fibrinogen genes. There was poor correlation between genotypes and phenotypes. All but one of the novel mutations in subjects were predicted to be deleterious. Protein modeling predicted that multiple ienteractions with surrounding residues for novel variants were likely to result in congenital fibrinogen disorders. CONCLUSION This study in a relatively large cohort of Chinese patients with congenital fibrinogen disorders enabled the identification of five new fibrinogen missense mutations. In silico modeling may represent a valuable tool for understanding amino acid residues from novel variants leading to congenital fibrinogen disorders, but it should be followed by functional studies. Clinical presentation of fibrinogen disorders was variable, possibly due to genetic and environmental modifiers.
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Affiliation(s)
- Puhui Zhou
- Department of Medical Laboratory, First Affiliated Hospital of Nanchang University, People's Republic of China.
| | - Man Yu
- Department of Medical Laboratory, First Affiliated Hospital of Nanchang University, People's Republic of China
| | - Yan Peng
- Department of Medical Laboratory, First Affiliated Hospital of Nanchang University, People's Republic of China
| | - Pengpeng Ma
- The Center for Prenatal Diagnosis, Jiangxi Maternal and Child Health Hospital, People's Republic of China
| | - Lagen Wan
- Department of Medical Laboratory, First Affiliated Hospital of Nanchang University, People's Republic of China
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Fibrinogen Clauss and prothrombin time derived method ratio can differentiate dysfibrinogenemia from hypofibrinogenemia and hyperfibrinogenemia. Thromb Res 2020; 194:197-199. [PMID: 32788118 DOI: 10.1016/j.thromres.2020.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/10/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022]
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