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Guillet B, Pawlowski M, Boisseau P, Répessé Y, Beurrier P, Bayart S, Delavenne X, Trossaërt M, Lenting PJ. Genotype-Dependent Response to Desmopressin in Hemophilia A and Proposal of a Predictive Response Score. Thromb Haemost 2024. [PMID: 38759975 DOI: 10.1055/a-2329-3375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Desmopressin (DDAVP) is used in patients with moderate/mild hemophilia A (PWMHs) to increase their factor VIII (FVIII) level and, if possible, normalize it. However, its effectiveness varies between individuals. The GIDEMHA study aims to investigate the influence of F8 gene variants. MATERIAL AND METHODS The study collected the trajectory of FVIII levels from therapeutic intravenous DDAVP tests in four French hemophilia treatment centers. A pharmacological analysis was performed associated with efficacy scores according to F8 variants: absolute and relative responses, as well as new scores: absolute duration (based on duration with FVIII ≥ 0.50 IU.mL-1) and relative duration (based on half-life). RESULTS From enrolled 439 PWMHs, 327 had a hot-spot F8 variant (with ≥5 PWMHs). For these, the median (min-max) basal and peak FVIII were 0.20 (0.02-0.040) and 0.74 (0.14-2.18) IU.mL-1 respectively, with FVIII recovery being 3.80 IU.ml-1 (1.15-14.75). The median FVIII half-life was 3.9 hours (0.7-15.9 hours). FVIII was normalized (≥0.50 IU.mL-1) in 224/327 PWMHs (69%) and the median time with normalized FVIII was 3.9 hours (0.0-54.1 hours). Following the response profiles to DDAVP defined by the four efficacy scores, four groups of F8 variants were isolated, and then compared using survival curves with normalized FVIII (p < 0.0001): "long-lastingly effective" [p.(Glu739Lys), p.(Ser2030Asn), p.(Arg2178His), p.(Gln2208Glu), and T-stretch deletion in intron 13]; "moderately effective" [p.(Ser112Phe), p.(Ala219Thr), p.(Thr2105Ile), p.Phe2146Ser), and p.(Asp2150Asn)]; "moderately ineffective" [p.Ala81Asp), p.(Gln324Pro), p.(Tyr492His), p.(Arg612Cys), p.(Met701Val), p.(Val2035Asn), and p.(Arg2178Cys)]; and "frequently ineffective" [c.-219C > T, p.(Cys2040Tyr), p.(Tyr2169His), p.(Pro2319Leu), and p.(Arg2326Gln)]. CONCLUSION In view of our data, we propose indications for DDAVP use in PWMH based on F8 variants for minor and major invasive procedures.
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Affiliation(s)
- Benoît Guillet
- CRH, CRC-MHC (Centre de Référence de l'Hémophilie, Centre de Ressource et de Compétence des Maladies Hémorragiques Constitutionnelles), University Hospital, Rennes, France
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en santé, Environnement et Travail). UMR_S 1085, Rennes, France
| | - Maxime Pawlowski
- CRH, CRC-MHC (Centre de Référence de l'Hémophilie, Centre de Ressource et de Compétence des Maladies Hémorragiques Constitutionnelles), University Hospital, Rennes, France
| | - Pierre Boisseau
- Laboratoire de Génétique Moléculaire, Service de Génétique Médicale, CHU de Nantes, France
| | - Yohann Répessé
- Haemophilia Treatment Center, University Hospital of Caen, Caen, France
| | - Philippe Beurrier
- Haemophilia Treatment Center, University Hospital of Angers, Pays de la Loire, France
| | - Sophie Bayart
- CRH, CRC-MHC (Centre de Référence de l'Hémophilie, Centre de Ressource et de Compétence des Maladies Hémorragiques Constitutionnelles), University Hospital, Rennes, France
| | - Xavier Delavenne
- INSERM, UMR 1059, Dysfonction Vasculaire et de l'Hémostase, Université de Lyon, Saint Etienne, France
- Laboratoire de Pharmacologie - Toxicologie, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marc Trossaërt
- Haemophilia Treatment Center, University Hospital of Nantes, Nantes, France
| | - Peter J Lenting
- Laboratory for Hemostasis, Inflammation & Thrombosis, Unité Mixe de Recherche 1176, Institut National de la Santé et de la Recherche Médicale, Université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France
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Pezeshkpoor B, Berkemeier AC, Czogalla KJ, Oldenburg J, El-Maarri O. Evidence of pathogenicity of a mutation in 3' untranslated region causing mild haemophilia A. Haemophilia 2016; 22:598-603. [PMID: 27216882 DOI: 10.1111/hae.12923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Despite the high mutation detection rate, in a small group of haemophilia A patients, using current screening methods, no causal mutation in F8 can be detected. In such cases, the causal mutation might be in the non-coding sequences of F8. AIM Rarely, mutations in non-coding sequences reveal a pivotal role. Here, we analysed a mild haemophilia A patient harbouring a mutation in the 3' untranslated region (UTR) of F8 and elucidated the molecular mechanism leading to haemophilia phenotype. METHODS To find the causal mutation, the complete F8 genomic region was analysed by next generation sequencing. The effect of the identified alteration on F8 expression was evaluated in silico and analysed for the splicing effect at mRNA level. Moreover, in vitro studies using a luciferase reporter system were performed to functionally analyse the mutation. RESULTS We identified an alteration in the 3' UTR (c.*56G>T) as the only change in F8 gene. Pedigree analysis showed a segregation pattern for three affected members for the presumptive mutation. Moreover, the variant was predicted in silico to create a new donor splice site, which was also detected at mRNA level, resulting in a 159 bp deletion in 3' UTR of F8. Finally, the variant showed reduced expression of the gene reporter firefly luciferase in cell line expression analysis. CONCLUSION Our results advocate the patient specific c.*56G>T base change in the 3' UTR to be a disease-associated mutation leading to alternative splicing explaining the mild haemophilia A phenotype.
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Affiliation(s)
- B Pezeshkpoor
- Institute of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.,Center for Rare Diseases Bonn (ZSEB), University Clinic Bonn, Bonn, Germany
| | - A-C Berkemeier
- Institute of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.,Center for Rare Diseases Bonn (ZSEB), University Clinic Bonn, Bonn, Germany
| | - K J Czogalla
- Institute of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.,Center for Rare Diseases Bonn (ZSEB), University Clinic Bonn, Bonn, Germany
| | - J Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.,Center for Rare Diseases Bonn (ZSEB), University Clinic Bonn, Bonn, Germany
| | - O El-Maarri
- Institute of Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.,Department of Natural Sciences, Lebanese American University, Byblos/Beirut, Lebanon
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Nougier C, Roualdes O, Fretigny M, d'Oiron R, Costa C, Negrier C, Vinciguerra C. Characterization of four novel molecular changes in the promoter region of the factor VIII gene. Haemophilia 2013; 20:e149-56. [DOI: 10.1111/hae.12346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 01/10/2023]
Affiliation(s)
- C. Nougier
- Service d'Hématologie Biologique; HCL, Hôpital Edouard Herriot; Lyon France
- EAM 4174 Hémostase, Inflammation et Sepsis; Université Claude Bernard Lyon 1; Lyon France
| | - O. Roualdes
- Service d'Hématologie Biologique; HCL, Hôpital Edouard Herriot; Lyon France
- EAM 4174 Hémostase, Inflammation et Sepsis; Université Claude Bernard Lyon 1; Lyon France
| | - M. Fretigny
- Service d'Hématologie Biologique; HCL, Hôpital Edouard Herriot; Lyon France
| | - R. d'Oiron
- Centre de Traitement pour Hémophiles, AP-HP Hôpital Bicêtre; Université Paris XI; le Kremlin-Bicêtre France
| | - C. Costa
- Département de Génétique; CHU Henri Mondor-AP-HP; Créteil France
| | - C. Negrier
- Service d'Hématologie Biologique; HCL, Hôpital Edouard Herriot; Lyon France
- EAM 4174 Hémostase, Inflammation et Sepsis; Université Claude Bernard Lyon 1; Lyon France
| | - C. Vinciguerra
- Service d'Hématologie Biologique; HCL, Hôpital Edouard Herriot; Lyon France
- EAM 4174 Hémostase, Inflammation et Sepsis; Université Claude Bernard Lyon 1; Lyon France
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Castaman G, Giacomelli SH, Mancuso ME, D'Andrea G, Santacroce R, Sanna S, Santagostino E, Mannucci PM, Goodeve A, Rodeghiero F. Deep intronic variations may cause mild hemophilia A. J Thromb Haemost 2011; 9:1541-8. [PMID: 21689372 DOI: 10.1111/j.1538-7836.2011.04408.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In about 10% of patients with mild hemophilia A, no candidate gene mutations are apparent after complete gene sequencing. AIM OF THE STUDY To analyze factor VIII gene (F8) mRNA for mutations in five families with mild hemophilia A with no apparent genomic mutation and a reduced response to desmopressin. RESULTS In four cases, mRNA studies revealed the presence of an abnormal mRNA transcript in addition to normal F8 mRNA. Sequencing of the abnormal transcripts revealed complex abnormalities, which allowed the identification of three different intronic variations (c.2113+1152delA, c.5587-93C>T and c.5999-277G>A) at the DNA level, absent from 387 normal alleles. By in silico analysis, c.2113+1152delA and c.5587-93C>T were strongly predicted to result in the generation of new splice sites with the introduction of premature termination codons, while c.5999-277G>A was predicted to generate a new protein with 30 additional amino acids. However, these predictions were not homogeneous across the different mutations and programs used. The detrimental effect of two mutations was also confirmed by in vitro expression studies. These changes were also identified in related female carriers and in other mild HA patients not included in the original study. No mRNA abnormality was identified in the remaining patient. CONCLUSIONS Although rare, deep intronic variations may be responsible for mild hemophilia A where no other F8 mutations have been identified and may be associated with a reduced biologic response to desmopressin. F8 mRNA analysis is a useful tool for the identification of deep intronic variation not detectable by standard DNA sequencing.
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Affiliation(s)
- G Castaman
- Department of Cell Therapy and Hematology, Hemophilia and Thrombosis Center, San Bortolo Hospital, Vicenza, Italy.
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RICCARDI F, TAGLIAFERRI A, MARTORANA D, RIVOLTA GF, VALDRÈ L, RODORIGO G, BIASOLI C, D’INCÀ M, SERINO ML, MACCHI S, VINCENZI D, ARBASI M, PEDRAZZI P, VOLTA M, DI PERNA C, IPPOLITO L, SAVI M, NERI TM. Spectrum of F8 gene mutations in haemophilia A patients from a region of Italy: identification of 23 new mutations. Haemophilia 2010; 16:791-800. [DOI: 10.1111/j.1365-2516.2010.02228.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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