1
|
Lin HY, Lin CY, Kuo SF, Lin JS, Lin PT, Huang YC, Hsieh HN, Shen MC. Inherited coagulation factor VII deficiency in Taiwan: Two novel F7 variants with relevant regional features in 33 patients. Haemophilia 2024; 30:1096-1101. [PMID: 38783550 DOI: 10.1111/hae.15054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/05/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Hsuan-Yu Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ching-Yeh Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Su-Feng Kuo
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Te Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ying-Chih Huang
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Han-Ni Hsieh
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Ching Shen
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
2
|
Andersen E, Chollet ME, Sletten M, Stavik B, Skarpen E, Backe PH, Thiede B, Glosli H, Henriksson CE, Iversen N. Molecular Characterization of Two Homozygous Factor VII Variants Associated with Intracranial Bleeding. Thromb Haemost 2021; 121:1588-1598. [PMID: 33742435 DOI: 10.1055/a-1450-8568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Clinical parameters have been extensively studied in factor (F) VII deficiency, but the knowledge of molecular mechanisms of this disease is scarce. We report on three probands with intracranial bleeds at an early age, one of which had concomitant high titer of FVII inhibitor. The aim of the present study was to identify the causative mutations and to elucidate the underlying molecular mechanisms. All nine F7 exons were sequenced in the probands and the closest family members. A homozygous deletion in exon 1, leading to a frame shift and generation of a premature stop codon (p.C10Pfs*16), was found in proband 1. Probands 2 and 3 (siblings) were homozygous for a missense mutation in exon 8, resulting in a glycine (G) to arginine (R) substitution at amino acid 240 (p.G240R). All probands had severely reduced FVII activity (FVII:C < 1 IU/dL). Treatment consisted of recombinant FVIIa and/or plasma concentrate, and proband 1 developed a FVII inhibitor shortly after initiation of treatment. The FVII variants were overexpressed in mammalian cell lines. No FVII protein was produced in cells expressing the p.C10Pfs*16 variant, and the inhibitor development in proband 1 was likely linked to the complete absence of circulating FVII. Structural analysis suggested that the G to R substitution in FVII found in probands 2 and 3 would destabilize the protein structure, and cell studies demonstrated a defective intracellular transport and increased endoplasmic reticulum stress. The molecular mechanism underlying the p.G240R variant could be reduced secretion caused by protein destabilization and misfolding.
Collapse
Affiliation(s)
- Elisabeth Andersen
- Department of Hematology, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Maria Eugenia Chollet
- Department of Hematology, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Marit Sletten
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Benedicte Stavik
- Department of Hematology, Oslo University Hospital, Oslo, Norway.,Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Skarpen
- Core Facility for Advanced Light Microscopy, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Paul Hoff Backe
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.,Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Bernd Thiede
- Department of Biosciences, University of Oslo, Oslo, Norway
| | - Heidi Glosli
- Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Centre for Rare Disorders, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Carola Elisabeth Henriksson
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nina Iversen
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
3
|
Traivaree C, Monsereenusorn C, Meekaewkunchorn A, Laoyookhong P, Suwansingh S, Boonyawat B. Genotype and phenotype correlation in intracranial hemorrhage in neonatal factor VII deficiency among Thai children. APPLICATION OF CLINICAL GENETICS 2017; 10:37-41. [PMID: 28684918 PMCID: PMC5484628 DOI: 10.2147/tacg.s139788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Congenital factor VII (FVII) deficiency is a rare inherited coagulopathy. The clinical manifestations and clinical findings vary widely, ranging from asymptomatic to life-threatening bleeding, including intracranial hemorrhage (ICH), with prolonged prothrombin time, normal partial thromboplastin time and normal platelet counts, which are confirmed by the low level of FVII assay. Treatment consists of fresh frozen plasma (FFP), prothrombin complex concentrates (PCCs), and recombinant activated FVII to treat bleeding and prophylactic therapy. Here, we report four patients with FVII levels <5% (severe type) who presented ICH during the neonatal period. The IVS6+1G>T was the most common (50%) mutation identified in our study, followed by the K376X nonsense mutation (37.5%). In our study, we found that genetic information affected the severity of congenital FVII deficiency with ICH.
Collapse
Affiliation(s)
- Chanchai Traivaree
- Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine
| | - Chalinee Monsereenusorn
- Division of Hematology/Oncology, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine
| | | | - Premsak Laoyookhong
- Division of Neonatology, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Bangkok
| | - Saranya Suwansingh
- Division of Hematology/Oncology, Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai
| | - Boonchai Boonyawat
- Division of Genetics, Department of Pediatrics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| |
Collapse
|
4
|
Jin Y, Hao X, Cheng X, Yang L, Liu H, Wang M. [Analysis of clinical features and genotype in an inherited coagulation factor Ⅶ deficiency pedigree]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2015; 36:427-30. [PMID: 26031533 PMCID: PMC7342583 DOI: 10.3760/cma.j.issn.0253-2727.2015.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Yanhui Jin
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiuping Hao
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoli Cheng
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Lihong Yang
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Huanle Liu
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Mingshan Wang
- Laboratory Medicine Center of the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| |
Collapse
|
5
|
A novel homozygous missense mutation in the factor VII gene of severe factor VII deficiency in a newborn baby. Blood Coagul Fibrinolysis 2009; 20:161-4. [PMID: 19786945 DOI: 10.1097/mbc.0b013e3283258028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A term male infant born to nonconsanguineous parents was admitted to the hospital for evaluation of lethargy and a pale appearance on the third day of life. He had anemia from an intracranial hemorrhage, and his coagulation factor assay revealed that his bleeding episode was due to severe congenital factor VII deficiency (5% of normal activity). An A-to-G point mutation in the acceptor splice site of intron 5 was identified at nucleotide position 9418. Sequence analysis of the factor VII gene in the parents revealed that they were both heterozygous for a G-to-A transversion at nucleotide position 9418 (IVS5-1) between intron 5 and exon 6. A genetic study involving a patient with a congenitally inherited disease and the parents can confirm the genetic background of the disease and can be used for prenatal guidance to exclude severe bleeding disorders.
Collapse
|
6
|
Yu T, Wang X, Ding Q, Fu Q, Dai J, Lu Y, Xi X, Wang H. Using a minigene approach to characterize a novel splice site mutation in human F7 gene causing inherited factor VII deficiency in a Chinese pedigree. Haemophilia 2009; 15:1262-6. [PMID: 19601987 DOI: 10.1111/j.1365-2516.2009.02064.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Factor VII deficiency which transmitted as an autosomal recessive disorder is a rare haemorrhagic condition. The aim of this study was to identify the molecular genetic defect and determine its functional consequences in a Chinese pedigree with FVII deficiency. The proband was diagnosed as inherited coagulation FVII deficiency by reduced plasma levels of FVII activity (4.4%) and antigen (38.5%). All nine exons and their flanking sequence of F7 gene were amplified by polymerase chain reaction (PCR) for the proband and the PCR products were directly sequenced. The compound heterozygous mutations of F7 (NM_000131.3) c.572-1G>A and F7 (NM_000131.3) c.1165T>G; p.Cys389Gly were identified in the proband's F7 gene. To investigate the splicing patterns associated with F7 c.572-1G>A, ectopic transcripts in leucocytes of the proband were analyzed. F7 minigenes, spanning from intron 4 to intron 7 and carrying either an A or a G at position -1 of intron 5, were constructed and transiently transfected into human embryonic kidney (HEK) 293T cells, followed by RT-PCR analysis. The aberrant transcripts from the F7 c.572-1G>A mutant allele were not detected by ectopic transcription study. Sequencing of the RT-PCR products from the mutant transfectant demonstrated the production of an erroneously spliced mRNA with exon 6 skipping, whereas a normal splicing occurred in the wide type transfectant. The aberrant mRNA produced from the F7 c.572-1G>A mutant allele is responsible for the factor VII deficiency in this pedigree.
Collapse
Affiliation(s)
- T Yu
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Wu Y, Tu X, Lian Y, Chen F, Lan F, Zhu Z. Characterization of a Cys329Gly mutation causing hereditary factor VII deficiency. Acta Haematol 2006; 116:96-100. [PMID: 16914903 DOI: 10.1159/000093638] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2005] [Accepted: 10/03/2005] [Indexed: 11/19/2022]
Abstract
We have previously reported a homozygous Cys329Gly mutation in a Chinese patient with factor VII (FVII) deficiency. Others have found a heterozygous Cys329Gly mutation in the F7 gene from patients of three different pedigrees. However, none of the reports included the expression and characterization of the mutant FVII in vitro. To investigate the effect of Cys329Gly on FVII function, we carried out transient transfections of baby hamster kidney cells (BHK-21) with a mutant FVII construct and compared the results to those obtained using a wild-type FVII construct and vector control. The results demonstrate that the level of FVII:Ag secreted into the medium by transfected BHK-21 cells with mutant construct was not affected, but the coagulation activity of the mutant FVII was undetectable. We conclude that Cys329 is critical to FVII coagulation, and the replacement of cysteine 329 by glycine leads to the loss of coagulation activity in the patients, possibly the molecular basis for FVII deficiency in the patients.
Collapse
Affiliation(s)
- Yushui Wu
- Medical Laboratory Center, Fuzhou General Hospital, Fuzhou, China.
| | | | | | | | | | | |
Collapse
|
8
|
Shen MC, Lin JS, Lin DSY, Hsu SC, Lin B. A first Taiwanese Chinese family of type 2B von Willebrand disease with R1306W mutation. Thromb Res 2004; 112:291-5. [PMID: 15041272 DOI: 10.1016/j.thromres.2003.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2003] [Revised: 11/24/2003] [Accepted: 11/24/2003] [Indexed: 12/01/2022]
Abstract
Clinical, laboratory and genetic defect of a Taiwanese family with type 2B von Willebrand disease (VWD) were studied. The proband was a 55-year-old woman who gave birth to two daughters and one son aged 30, 29 and 27, respectively. All had abnormal mucocutaneous bleedings since their childhood. In proband, PT, PTT and platelet count were normal; template bleeding time was 14 min; VIII:C was 51%, von Willebrand factor antigen (VWF:Ag), 42% and von Willerand factor ristocetin-cofactor (VWF:RCo, 15%); ristocetin-induced platelet aggregation (RIPA) at 0.3 and 0.6 mg/ml of ristocetin was 16% and 68%, respectively. The enhanced response to ristocetin was identified to be in plasma, not in platelet itself, by mixing studies. Analysis of von Willebrand factor (VWF) multimer of plasma but not of platelets showed absence of high-molecular weight (HMW) multimer. All three children had similar laboratory findings. Exon 28 of VWF gene was amplified using polymerase chain reaction (PCR) and sequenced. The proband and three children were all found to be heterozygous for C to T transition at nucleotide 3916 resulting in Arg 1306 Trp (R1306W) substitution. This mutation in the glycoprotein Ib (GPIb)-binding site has been found to increase the affinity of plasma VWF for platelets, and thus cause loss of HMW multimers and often thrombocytopenia. In conclusion, a first report of type 2B VWD in a Taiwanese Chinese family who show R1306W mutation in VWF gene was described.
Collapse
Affiliation(s)
- Ming-Ching Shen
- Department of Laboratory Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | | | | | | | | |
Collapse
|