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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: 15] [Impact Index Per Article: 7.5] [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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Ceznerová E, Kaufmanová J, Sovová Ž, Štikarová J, Loužil J, Kotlín R, Suttnar J. Structural and Functional Characterization of Four Novel Fibrinogen Mutations in FGB Causing Congenital Fibrinogen Disorder. Int J Mol Sci 2022; 23:ijms23020721. [PMID: 35054908 PMCID: PMC8775743 DOI: 10.3390/ijms23020721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 01/27/2023] Open
Abstract
Congenital fibrinogen disorders are caused by mutations in genes coding for fibrinogen and may lead to various clinical phenotypes. Here, we present a functional and structural analysis of 4 novel variants located in the FGB gene coding for fibrinogen Bβ chain-heterozygous missense BβY416C and BβA68S, homozygous nonsense BβY345*, and heterozygous nonsense BβW403* mutations. The cases were identified by coagulation screening tests and further investigated by various methods. Fibrin polymerization had abnormal development with decreased maximal absorbance in all patients. Plasmin-induced fibrin degradation revealed different lytic phases of BβY416C and BβW403* than those of the control. Fibrinopeptide cleavage measured by reverse phase high pressure liquid chromatography of BβA68S showed impaired release of fibrinopeptide B. Morphological properties, studied through scanning electron microscopy, differed significantly in the fiber thickness of BβY416C, BβA68S, and BβW403*, and in the fiber density of BβY416C and BβW403*. Finally, homology modeling of BβA68S showed that mutation caused negligible alternations in the protein structure. In conclusion, all mutations altered the correct fibrinogen function or structure that led to congenital fibrinogen disorders.
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Affiliation(s)
- Eliška Ceznerová
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Technická 5, 16628 Prague, Czech Republic;
| | - Jiřina Kaufmanová
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Technická 5, 16628 Prague, Czech Republic;
| | - Žofie Sovová
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
| | - Jana Štikarová
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
| | - Jan Loužil
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
| | - Roman Kotlín
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
- Correspondence: ; Tel.: +420-221-977-612
| | - Jiří Suttnar
- Department of Biochemistry, Institute of Hematology and Blood Transfusion, U Nemocnice 2094/1, 12800 Prague, Czech Republic; (E.C.); (Ž.S.); (J.Š.); (J.L.); (J.S.)
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Simurda T, Vilar R, Zolkova J, Ceznerova E, Kolkova Z, Loderer D, Neerman-Arbez M, Casini A, Brunclikova M, Skornova I, Dobrotova M, Grendar M, Stasko J, Kubisz P. A Novel Nonsense Mutation in FGB (c.1421G>A; p.Trp474Ter) in the Beta Chain of Fibrinogen Causing Hypofibrinogenemia with Bleeding Phenotype. Biomedicines 2020; 8:biomedicines8120605. [PMID: 33322159 PMCID: PMC7763967 DOI: 10.3390/biomedicines8120605] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/26/2022] Open
Abstract
Congenital hypofibrinogenemia is a rare bleeding disorder characterized by a proportional decrease of functional and antigenic fibrinogen levels. Hypofibrinogenemia can be considered the phenotypic expression of heterozygous loss of function mutations occurring within one of the three fibrinogen genes (FGA, FGB, and FGG). Clinical manifestations are highly variable; most patients are usually asymptomatic, but may appear with mild to severe bleeding or thrombotic complications. We have sequenced all exons of the FGA, FGB, and FGG genes using the DNA isolated from the peripheral blood in two unrelated probands with mild hypofibrinogenemia. Coagulation screening, global hemostasis, and functional analysis tests were performed. Molecular modeling was used to predict the defect of synthesis and structural changes of the identified mutation. DNA sequencing revealed a novel heterozygous variant c.1421G>A in exon 8 of the FGB gene encoding a Bβ chain (p.Trp474Ter) in both patients. Clinical data from patients showed bleeding episodes. Protein modelling confirmed changes in the secondary structure of the molecule, with the loss of three β sheet arrangements. As expected by the low fibrinogen levels, turbidity analyses showed a reduced fibrin polymerisation and imaging difference in thickness fibrin fibers. We have to emphasize that our patients have a quantitative fibrinogen disorder; therefore, the reduced function is due to the reduced concentration of fibrinogen, since the Bβ chains carrying the mutation predicted to be retained inside the cell. The study of fibrinogen molecules using protein modelling may help us to understand causality and effect of novel genetic mutations.
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Affiliation(s)
- Tomas Simurda
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
- Correspondence: ; Tel.: +421-43-4203232; Fax: +421-43-4132061
| | - Rui Vilar
- Department of Genetic Medicine and Development, University Medical School of Geneva, 1211 Geneva, Switzerland; (R.V.); (M.N.-A.)
| | - Jana Zolkova
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
| | - Eliska Ceznerova
- Institute of Hematology and Blood Transfusion, 128 20 Prague, Czech Republic;
| | - Zuzana Kolkova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.K.); (D.L.); (M.G.)
| | - Dusan Loderer
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.K.); (D.L.); (M.G.)
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, University Medical School of Geneva, 1211 Geneva, Switzerland; (R.V.); (M.N.-A.)
| | - Alessandro Casini
- Division of Angiology and Hemostasis, University Hospitals of Geneva and Faculty of Medicine, 1205 Geneva, Switzerland;
| | - Monika Brunclikova
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
| | - Ingrid Skornova
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
| | - Miroslava Dobrotova
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
| | - Marian Grendar
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (Z.K.); (D.L.); (M.G.)
| | - Jan Stasko
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
| | - Peter Kubisz
- National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, 03601 Martin, Slovakia; (J.Z.); (M.B.); (I.S.); (M.D.); (J.S.); (P.K.)
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