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Bester C, Kloppers JF, van Rensburg WJJ. Genetic variant detection in a South African haemophilia B population. Haemophilia 2024; 30:765-773. [PMID: 38462783 DOI: 10.1111/hae.14978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Haemophilia B is characterised by a deficiency of factor IX (FIX) protein due to genetic variants in the FIX gene (F9). Genetic testing may have a vital role in effectively managing haemophilia B. However, in many developing countries, comprehensive genetic variant detection is unavailable. This study aimed to address the lack of genetic data in our country by conducting genetic variant detection on people affected by haemophilia B in our region. METHODS Twenty-one participants were screened with a direct Sanger sequencing method to identify variants in the F9 gene. The identified variants were then compared to previously published variants and/or to a reference database. RESULTS AND DISCUSSION A total of ten F9 genetic changes were detected, with five of them being novel. These identified variants were distributed across different domains of the FIX protein. Only one participant had a history of inhibitor formation against FIX replacement therapy. Notably, this participant had two distinct genetic changes present adjacent to each other. Thus, we hypothesise that the presence of multiple variants within the same functional region of the gene may increase the risk for inhibitor development. CONCLUSION The discovery of novel pathogenic variations in the F9 gene highlights the importance of genetic analysis in specific geographical regions. The possible link between a complex variant and inhibitor formation illustrates the potential role that genetic screening has as a pre-treatment tool in predicting treatment reactions and outcomes.
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Affiliation(s)
- Chené Bester
- Faculty of Health Sciences, Human Molecular Biology Unit, School of Biomedical Sciences, University of the Free State, Bloemfontein, South Africa
| | - Jean F Kloppers
- Faculty of Health Sciences, Department of Haematology and Cell Biology, School of Pathology, University of the Free State, Bloemfontein, South Africa
- National Health Laboratory Service, Universitas Academic Business Unit, Bloemfontein, South Africa
| | - Walter J Janse van Rensburg
- Faculty of Health Sciences, Human Molecular Biology Unit, School of Biomedical Sciences, University of the Free State, Bloemfontein, South Africa
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Cao Q, Hao Z, Li C, Chen X, Gao M, Jiang N, Liu H, Shen Y, Yang H, Zhang S, Yang A, Li W, Tie JK, Shen G. Molecular basis of inherited protein C deficiency results from genetic variations in the signal peptide and propeptide regions. J Thromb Haemost 2023; 21:3124-3137. [PMID: 37393002 PMCID: PMC10592384 DOI: 10.1016/j.jtha.2023.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Inherited protein C deficiency (PCD) caused by mutations in protein C (PC) gene (PROC) increases the risk of thrombosis. Missense mutations in PC's signal peptide and propeptide have been reported in patients with PCD, but their pathogenic mechanisms, except mutations in R42 residue, remain unclear. OBJECTIVES To investigate the pathogenic mechanisms of inherited PCD caused by 11 naturally occurring missense mutations in PC's signal peptide and propeptide. METHODS Using cell-based assays, we evaluated the impact of these mutations on various aspects such as activities and antigens of secreted PC, intracellular PC expression, subcellular localization of a reporter protein, and propeptide cleavage. Additionally, we investigated their effect on pre-messenger RNA (pre-mRNA) splicing using a minigene splicing assay. RESULTS Our data revealed that certain missense mutations (L9P, R32C, R40C, R38W, and R42C) disrupted PC secretion by impeding cotranslational translocation to the endoplasmic reticulum or causing endoplasmic reticulum retention. Additionally, some mutations (R38W and R42L/H/S) resulted in abnormal propeptide cleavage. However, a few missense mutations (Q3P, W14G, and V26M) did not account for PCD. Using a minigene splicing assay, we observed that several variations (c.8A>C, c.76G>A, c.94C>T, and c.112C>T) increased the incidence of aberrant pre-mRNA splicing. CONCLUSION Our findings suggest that variations in PC's signal peptide and propeptide have varying effects on the biological process of PC, including posttranscriptional pre-mRNA splicing, translation, and posttranslational processing. Additionally, a variation could affect the biological process of PC at multiple levels. Except for W14G, our results provide a clear understanding of the relationship between PROC genotype and inherited PCD.
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Affiliation(s)
- Qing Cao
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China; Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Zhenyu Hao
- College of Bioscience and Biotechnology, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China
| | - Cheng Li
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China
| | - Xuejie Chen
- Department of Biology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meng Gao
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China
| | - Nan Jiang
- College of Bioscience and Biotechnology, Yangzhou University, Yangzhou, Jiangsu, People's Republic of China
| | - Hongli Liu
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China; Department of Cell Biology, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Yan Shen
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China
| | - Haiping Yang
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China; First Affiliated Hospital, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China
| | - Shujuan Zhang
- Department of Cell Biology, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Aiying Yang
- Department of Cell Biology, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Weikai Li
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Jian-Ke Tie
- Department of Biology, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
| | - Guomin Shen
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang, Henan, People's Republic of China; Department of Cell Biology, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China.
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Lu L, Wang L, Shen W, Fang S, Zhao L, Hu X, Yang L, Wang G. Molecular pathogenesis of a novel Met394Thr variant causing hemophilia B. Mol Genet Genomic Med 2023; 11:e2147. [PMID: 36795372 PMCID: PMC10178796 DOI: 10.1002/mgg3.2147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Hemophilia B (HB), a rare bleeding disorder, shows X-linked recessive inheritance and is caused by heterogeneous variants in the FIX gene (F9) encoding coagulation factor IX (FIX). This study aimed to investigate the molecular pathogenesis of a novel Met394Thr variant causing HB. METHODS We used Sanger sequencing to analyze F9 sequence variants in members of a Chinese family with moderate HB. Subsequently, we performed in vitro experiments on the identified novel FIX-Met394Thr variant. In addition, we performed bioinformatics analysis of the novel variant. RESULTS We identified a novel missense variant (c.1181T>C, p.Met394Thr) in a Chinese family with moderate HB in the proband. The proband's mother and grandmother were carriers for the variant. The identified FIX-Met394Thr variant did not affect the transcription of F9 and the synthesis and secretion of FIX protein. The variant may, therefore, affect the physiological function of FIX protein by disrupting its spatial conformation. In addition, another variant (c.88+75A>G) in intron 1 of F9 was identified in the grandmother, which may also affect FIX protein function. CONCLUSION We identified FIX-Met394Thr as a novel causative variant of HB. Further understanding of the molecular pathogenesis underlying FIX deficiency may guide novel strategies for precision HB therapy.
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Affiliation(s)
- Linna Lu
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Lingyu Wang
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Wukang Shen
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Shuai Fang
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Lidong Zhao
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Xuchen Hu
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Linhua Yang
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
| | - Gang Wang
- Institute of HematologyThe Second Hospital of Shanxi Medical UniversityTaiyuanPeople's Republic of China
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Shen G, Gao M, Cao Q, Li W. The Molecular Basis of FIX Deficiency in Hemophilia B. Int J Mol Sci 2022; 23:ijms23052762. [PMID: 35269902 PMCID: PMC8911121 DOI: 10.3390/ijms23052762] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 12/15/2022] Open
Abstract
Coagulation factor IX (FIX) is a vitamin K dependent protein and its deficiency causes hemophilia B, an X-linked recessive bleeding disorder. More than 1000 mutations in the F9 gene have been identified in hemophilia B patients. Here, we systematically summarize the structural and functional characteristics of FIX and the pathogenic mechanisms of the mutations that have been identified to date. The mechanisms of FIX deficiency are diverse in these mutations. Deletions, insertions, duplications, and indels generally lead to severe hemophilia B. Those in the exon regions generate either frame shift or inframe mutations, and those in the introns usually cause aberrant splicing. Regarding point mutations, the bleeding phenotypes vary from severe to mild in hemophilia B patients. Generally speaking, point mutations in the F9 promoter region result in hemophilia B Leyden, and those in the introns cause aberrant splicing. Point mutations in the coding sequence can be missense, nonsense, or silent mutations. Nonsense mutations generate truncated FIX that usually loses function, causing severe hemophilia B. Silent mutations may lead to aberrant splicing or affect FIX translation. The mechanisms of missense mutation, however, have not been fully understood. They lead to FIX deficiency, often by affecting FIX’s translation, protein folding, protein stability, posttranslational modifications, activation to FIXa, or the ability to form functional Xase complex. Understanding the molecular mechanisms of FIX deficiency will provide significant insight for patient diagnosis and treatment.
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Affiliation(s)
- Guomin Shen
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang 471023, China
- School of Basic Medical Science, Henan University of Science and Technology, Luoyang 471023, China
| | - Meng Gao
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang 471023, China
- School of Basic Medical Science, Henan University of Science and Technology, Luoyang 471023, China
| | - Qing Cao
- Henan International Joint Laboratory of Thrombosis and Hemostasis, Henan University of Science and Technology, Luoyang 471023, China
- School of Basic Medical Science, Henan University of Science and Technology, Luoyang 471023, China
| | - Weikai Li
- Department of Biochemistry and Molecular Biophysics, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
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Kulkarni S, Hegde R, Hegde S, Kulkarni SS, Hanagvadi S, Das KK, Kolagi S, Gai PB, Bulagouda R. Mutation analysis and characterisation of F9 gene in haemophilia- B population of India. Blood Res 2021; 56:252-258. [PMID: 34880139 PMCID: PMC8721457 DOI: 10.5045/br.2021.2021016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background Hemophilia B (HB) is an X-linked bleeding disorder resulting from coagulation factor IX defects. Over 3,000 pathogenic, HB-associated mutations in the F9 gene have been identified. We aimed to investigate the role of F9 variants in 150 HB patients using sequencing technology. Methods F9 gene sequences were amplified from peripheral blood-derived DNA and sequenced on an Applied Biosystems (ABI) 3500 Sanger sequencing platform. Functional and structural predictions of mutant FIX were analyzed. Results Among 150 HB patients, 102 (68%), 30 (20%), and 18 (12%) suffered from severe, moderate, and mild HB, respectively. Genetic analysis identified 16 mutations, including 3 novel mutations. Nine mutations (7 missense and 2 stop-gain) were found to be pathogenic. Only 3 mutations (c.127C>T, c.470G>A, and c.1070G>A) were associated with different severities. While 2 mutations were associated with mild HB cases (c.304C>T and c.580A>G), 2 (c.195G>A and c.1385A>G) and 3 mutations (c.223C>T, c.1187G>A, and c.1232G>A) resulted in moderate and severe disease, respectively. Additionally, 1 mutation each was associated with mild-moderate (c.*1110A>G) and mild-severe HB disease (c.197A>T), 4 mutations were associated with moderate-severe HB cases (c.314A>G, c.198A>T, c.676C>T, and c.1094C>A). FIX concentrations were lower in the mutated group (5.5±2.5% vs. 8.0±2.5%). Novel p.E66D and p.S365 mutations were predicted to be pathogenic based on changes in FIX structure and function. Conclusion Novel single nucleotide polymorphisms (SNPs) largely contributed to the pathogenesis of HB. Our study strongly suggests that population-based genetic screening will be particularly helpful to identify risk prediction and carrier detection tools for Indian HB patients.
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Affiliation(s)
- Sujayendra Kulkarni
- Human Genetics Laboratory, Department of Anatomy, Shri B.M Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, India.,Division of Human Genetics (Central Research Lab), Bagalkot, India
| | - Rajat Hegde
- Karnataka Institute for DNA Research (KIDNAR), Dharwad, India
| | - Smita Hegde
- Karnataka Institute for DNA Research (KIDNAR), Dharwad, India
| | | | - Suresh Hanagvadi
- Department of Pathology, J. J. M. Medical College, Davangere, Karnataka, India
| | - Kusal K Das
- Laboratory of Vascular Physiology and Medicine, Department of Physiology, Shri B. M. Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, India
| | - Sanjeev Kolagi
- Department of Anatomy, S. Nijaliangappa Medical College, HSK Hospital and Research Center, Bagalkot, India
| | - Pramod B Gai
- Karnataka Institute for DNA Research (KIDNAR), Dharwad, India
| | - Rudragouda Bulagouda
- Human Genetics Laboratory, Department of Anatomy, Shri B.M Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, India
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