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Palma-Barqueros V, Bastida JM, López Andreo MJ, Zámora-Cánovas A, Zaninetti C, Ruiz-Pividal JF, Bohdan N, Padilla J, Teruel-Montoya R, Marín-Quilez A, Revilla N, Sánchez-Fuentes A, Rodriguez-Alen A, Benito R, Vicente V, Iturbe T, Greinacher A, Lozano ML, Rivera J. Platelet transcriptome analysis in patients with germline RUNX1 mutations. J Thromb Haemost 2023; 21:1352-1365. [PMID: 36736831 DOI: 10.1016/j.jtha.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Germline mutations in RUNX1 can cause a familial platelet disorder that may lead to acute myeloid leukemia, an autosomal dominant disorder characterized by moderate thrombocytopenia, platelet dysfunction, and a high risk of developing acute myeloid leukemia or myelodysplastic syndrome. Discerning the pathogenicity of novel RUNX1 variants is critical for patient management. OBJECTIVES To extend the characterization of RUNX1 variants and evaluate their effects by transcriptome analysis. METHODS Three unrelated patients with long-standing thrombocytopenia carrying heterozygous RUNX1 variants were included: P1, who is a subject with recent development of myelodysplastic syndrome, with c.802 C>T[p.Gln268∗] de novo; P2 with c.586A>G[p.Thr196Ala], a variant that segregates with thrombocytopenia and myeloid neoplasia in the family; and P3 with c.476A>G[p.Asn159Ser], which did not segregate with thrombocytopenia or neoplasia. Baseline platelet evaluations were performed. Ultrapure platelets were prepared for platelet transcriptome analysis. RESULTS In P1 and P2, but not in P3, transcriptome analysis confirmed aberrant expression of genes recognized as RUNX1 targets. Data allowed grouping patients by distinct gene expression profiles, which were partitioned with clinical parameters. Functional studies and platelet mRNA expression identified alterations in the actin cytoskeleton, downregulation of GFI1B, defective GPVI downstream signaling, and reduction of alpha granule proteins, such as thrombospondin-1, as features likely implicated in thrombocytopenia and platelet dysfunction. CONCLUSION Platelet phenotype, familial segregation, and platelet transcriptomics support the pathogenicity of RUNX1 variants p.Gln268∗ and p.Thr196Ala, but not p.Asn159Ser. This study is an additional proof of concept that platelet RNA analysis could be a tool to help classify pathogenic RUNX1 variants and identify novel RUNX1 targets.
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Affiliation(s)
- Verónica Palma-Barqueros
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - José María Bastida
- Department of Hematology, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Salamanca, Spain
| | | | - Ana Zámora-Cánovas
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Carlo Zaninetti
- Institut für Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Juan Francisco Ruiz-Pividal
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Natalia Bohdan
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - José Padilla
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Raúl Teruel-Montoya
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Ana Marín-Quilez
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain; Department of Hematology, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Salamanca, Spain
| | - Nuria Revilla
- Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, Instituto Investigación Sanitaria FJD (IIS-FJD), Madrid, Spain
| | - Ana Sánchez-Fuentes
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Agustín Rodriguez-Alen
- Servicio de Hematología, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Rocío Benito
- Department of Hematology, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca (USAL), Salamanca, Spain
| | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - Teodoro Iturbe
- Servicio de Hematología, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain
| | - Andreas Greinacher
- Institut für Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - María Luisa Lozano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain
| | - José Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, CIBERER-U765, Murcia, Spain.
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Palma-Barqueros V, Bury L, Kunishima S, Lozano ML, Rodríguez-Alen A, Revilla N, Bohdan N, Padilla J, Fernández-Pérez MP, de la Morena-Barrio ME, Marín-Quiles A, Benito R, López-Fernández MF, Marcellini S, Zamora-Cánovas A, Vicente V, Martínez C, Gresele P, Bastida JM, Rivera J. Expanding the genetic spectrum of TUBB1-related thrombocytopenia. Blood Adv 2021; 5:5453-5467. [PMID: 34516618 PMCID: PMC8714720 DOI: 10.1182/bloodadvances.2020004057] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 06/20/2021] [Indexed: 11/20/2022] Open
Abstract
β1-Tubulin plays a major role in proplatelet formation and platelet shape maintenance, and pathogenic variants in TUBB1 lead to thrombocytopenia and platelet anisocytosis (TUBB1-RT). To date, the reported number of pedigrees with TUBB1-RT and of rare TUBB1 variants with experimental demonstration of pathogenicity is limited. Here, we report 9 unrelated families presenting with thrombocytopenia carrying 6 β1-tubulin variants, p.Cys12LeufsTer12, p.Thr107Pro, p.Gln423*, p.Arg359Trp, p.Gly109Glu, and p.Gly269Asp, the last of which novel. Segregation studies showed incomplete penetrance of these variants for platelet traits. Indeed, most carriers showed macrothrombocytopenia, some only increased platelet size, and a minority had no abnormalities. Moreover, only homozygous carriers of the p.Gly109Glu variant displayed macrothrombocytopenia, highlighting the importance of allele burden in the phenotypic expression of TUBB1-RT. The p.Arg359Trp, p.Gly269Asp, and p.Gly109Glu variants deranged β1-tubulin incorporation into the microtubular marginal ring in platelets but had a negligible effect on platelet activation, secretion, or spreading, suggesting that β1-tubulin is dispensable for these processes. Transfection of TUBB1 missense variants in CHO cells altered β1-tubulin incorporation into the microtubular network. In addition, TUBB1 variants markedly impaired proplatelet formation from peripheral blood CD34+ cell-derived megakaryocytes. Our study, using in vitro modeling, molecular characterization, and clinical investigations provides a deeper insight into the pathogenicity of rare TUBB1 variants. These novel data expand the genetic spectrum of TUBB1-RT and highlight a remarkable heterogeneity in its clinical presentation, indicating that allelic burden or combination with other genetic or environmental factors modulate the phenotypic impact of rare TUBB1 variants.
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Affiliation(s)
- Verónica Palma-Barqueros
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - Loredana Bury
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Shinji Kunishima
- Department of Medical Technology, Gifu University of Medical Science, Seki, Japan
| | - María Luisa Lozano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - Augustín Rodríguez-Alen
- Servicio de Hematología y Hemoterapia, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Nuria Revilla
- Servicio de Hematología, Hospital Universitario Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Natalia Bohdan
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - José Padilla
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - María P. Fernández-Pérez
- Servicio de Hematología, Hospital Universitario Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - María Eugenia de la Morena-Barrio
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - Ana Marín-Quiles
- Instituto de Investigación Biomédica de Salamanca, Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, Universidad de Salamanca-Consejo Superior de Investigaciones Científicas
| | - Rocío Benito
- Instituto de Investigación Biomédica de Salamanca, Instituto de Biología Molecular y Celular del Cáncer, Centro de Investigación del Cáncer, Universidad de Salamanca-Consejo Superior de Investigaciones Científicas
| | | | | | - Ana Zamora-Cánovas
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
| | - Constantino Martínez
- Servicio de Hematología, Hospital Universitario Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Paolo Gresele
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - José M. Bastida
- Departamento de Hematología, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain
| | - José Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Centro de Investigacién Biomódica en Red de Enfermedades Raras-U765, Murcia, Spain
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Palma-Barqueros V, Crescente M, de la Morena ME, Chan MV, Almarza E, Revilla N, Bohdan N, Miñano A, Padilla J, Allan HE, Maffucci T, Edin ML, Zeldin DC, Mesa-Nuñez C, Damian C, Marín-Quilez A, Benito R, Martínez-Martínez I, Bermejo N, Casas-Aviles I, Alen AR, González-Porras JR, Hernández-Rivas JM, Vicente V, Corral J, Lozano ML, Warner TD, Bastida JM, Rivera J. A novel genetic variant in PTGS1 affects N-glycosylation of cyclooxygenase-1 causing a dominant-negative effect on platelet function and bleeding diathesis. Am J Hematol 2021; 96:E83-E88. [PMID: 33326144 PMCID: PMC10938055 DOI: 10.1002/ajh.26076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Verónica Palma-Barqueros
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Marilena Crescente
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom
| | - María Eugenia de la Morena
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Melissa V Chan
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom
- The National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, USA
| | - Elena Almarza
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT)/Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) and Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM). Madrid, Spain
| | - Nuria Revilla
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Natalia Bohdan
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Antonia Miñano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - José Padilla
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Harriet E Allan
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom
| | - Tania Maffucci
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Matthew L. Edin
- National Institutes of Health, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Darryl. C. Zeldin
- National Institutes of Health, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Cristina Mesa-Nuñez
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT)/Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) and Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM). Madrid, Spain
| | - Carlos Damian
- Division of Hematopoietic Innovative Therapies, Centro de Investigaciones Energéticas Medioambientales y Tecnológicas (CIEMAT)/Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) and Advanced Therapies Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD/UAM). Madrid, Spain
| | - Ana Marín-Quilez
- IBSAL, IBMCC, CIC, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Rocío Benito
- IBSAL, IBMCC, CIC, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Irene Martínez-Martínez
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Nuria Bermejo
- Servicio de Hematología, Hospital San Pedro de Alcántara, Complejo Universitario de Cáceres, Cáceres, Spain
| | - Ignacio Casas-Aviles
- Servicio de Hematología, Hospital San Pedro de Alcántara, Complejo Universitario de Cáceres, Cáceres, Spain
| | - Agustín Rodríguez Alen
- Servicio de Hematología y Hemoterapia, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Spain
| | | | - Jesús María Hernández-Rivas
- IBSAL, IBMCC, CIC, Universidad de Salamanca-CSIC, Salamanca, Spain
- Departamento de Hematología, Hospital Universitario de Salamanca, Salamanca-IBSAL
| | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Javier Corral
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - María Luisa Lozano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Timothy D. Warner
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University London, 4 Newark Street, London, E1 2AT, United Kingdom
| | - José María Bastida
- Departamento de Hematología, Hospital Universitario de Salamanca, Salamanca-IBSAL
- On behalf of the “Grupo Español de Alteraciones Plquetarias Congénitas, (GEAPC)”; Hemorrhagic Diathesis Working Group, SETH
| | - José Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
- On behalf of the “Grupo Español de Alteraciones Plquetarias Congénitas, (GEAPC)”; Hemorrhagic Diathesis Working Group, SETH
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Palma-Barqueros V, Bohdan N, Revilla N, Vicente V, Bastida JM, Rivera J. PTGS1 gene variations associated with bleeding and platelet dysfunction. Platelets 2020; 32:710-716. [PMID: 32584621 DOI: 10.1080/09537104.2020.1782370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Natalia Bohdan
- Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Nuria Revilla
- Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - Vicente Vicente
- Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain
| | - José M Bastida
- Department of Hematology, IBSAL-Hospital Universitario de Salamanca, Salamanca, Spain.,On Behalf of the "Inherited Platelet Disorders Project", Hemorrhagic Diathesis Working Group, SETH
| | - José Rivera
- Universidad de Murcia, IMIB-Arrixaca, CIBERER-U765, Murcia, Spain.,On Behalf of the "Inherited Platelet Disorders Project", Hemorrhagic Diathesis Working Group, SETH
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Palma-Barqueros V, Torregrosa JM, Caparrós-Pérez E, Mota-Pérez N, Bohdan N, Llanos MDC, Begonja AJ, Sola-Visner M, Vicente V, Teruel-Montoya R, Rivera J, Ferrer-Marín F. Developmental Differences in Platelet Inhibition Response to Prostaglandin E1. Neonatology 2020; 117:15-23. [PMID: 31786577 DOI: 10.1159/000504173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The mechanisms underlying neonatal platelets hyporesponsiveness are not fully understood. While previous studies have demonstrated developmental impairment of agonist-induced platelet activation, differences in inhibitory signaling pathways have been scarcely investigated. OBJECTIVE To compare neonatal and adult platelets with regard to inhibition of platelet reactivity by prostaglandin E1 (PGE1). METHODS Platelet-rich plasma from umbilical cord (CB) or adult blood was incubated with PGE1 (0-1 μM). We assessed aggregation in response to adenosine diphosphate (ADP), collagen, and thrombin receptor activating peptide as well as cyclic adenosine 3'5'-monophosphate (cAMP) levels (ELISA). Gαs, Gαi2, and total- and phospho-protein kinase A (PKA) were evaluated in adult and CB ultrapure and washed platelets, respectively, by immunoblotting. RESULTS Neonatal (vs. adult) platelets display hypersensitivity to inhibition by PGE1 of platelet aggregation induced by ADP and collagen (PGE1 IC50: 14 and 117 nM for ADP and collagen, respectively, vs. 149 and 491 nM in adults). They also show increased basal and PGE1-induced cAMP levels. Mechanistically, PGE1 acts by binding to the prostanoid receptor IP (prostacyclin receptor), which couples to the Gαs protein-adenylate cyclase axis and increases intracellular levels of cAMP. cAMP activates PKA, which phosphorylates different target inhibitor proteins. Neonatal platelets showed higher basal and PGE1-induced cAMP levels, higher Gαs protein expression, and a trend to increased PKA-dependent protein phosphorylation compared to adult platelets. CONCLUSION Neonatal platelets have a functionally increased PGE1-cAMP-PKA axis. This finding supports a downregulation of inhibitory when going from neonate to adult contributing to neonatal platelet hyporesponsiveness.
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Affiliation(s)
- Verónica Palma-Barqueros
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - José Miguel Torregrosa
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain.,Praticien Hospitalier at Service d'Hématologie Oncologique, Pole Régional de Cancérologie, University Hospital of Poitiers, Poitiers, France
| | - Eva Caparrós-Pérez
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - Nerea Mota-Pérez
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - Natalia Bohdan
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | | | | | - Martha Sola-Visner
- Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - Raúl Teruel-Montoya
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - José Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain
| | - Francisca Ferrer-Marín
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Murcia, Spain, .,Grado de Medicina, Universidad Católica de Murcia, Murcia, Spain,
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Palma-Barqueros V, Ruiz-Pividal J, Bohdan N, Vicente V, Bastida JM, Lozano M, Rivera J. RASGRP2 gene variations associated with platelet dysfunction and bleeding. Platelets 2019; 30:535-539. [PMID: 30849270 DOI: 10.1080/09537104.2019.1585528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This manuscript reviews pathogenic variants in RASGRP2, which are the cause of a relatively new autosomal recessive and nonsyndromic inherited platelet function disorder, referred to as platelet-type bleeding disorder-18 (BDPLT18)(OMIM:615888). To date, 18 unrelated BDPLT18 pedigrees have been reported, harboring 19 different homozygous or compound heterozygous RASGRP2 variants. Patients with this disease present with lifelong moderate to severe bleeding, with epistaxis as the most common and relevant bleeding symptom. Biologically, they exhibit normal platelet count and morphology, reduced aggregation responses to ADP, epinephrine and low-dose collagen, and impaired αIIbβ3 integrin activation (fibrinogen or PAC-1 binding) in response to most agonists except PMA. Diagnosis is confirmed by genetic analysis of RASGRP2.
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Affiliation(s)
- Verónica Palma-Barqueros
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain
| | - Juan Ruiz-Pividal
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain
| | - Natalia Bohdan
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain
| | - Vicente Vicente
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain
| | - Jose Maria Bastida
- b Department of Hematology , IBSAL-Hospital Universitario de Salamanca , Salamanca , Spain
| | - María Lozano
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain.,c On behalf of the "Inherited Platelet Disorders Project", Hemorrhagic Diathesis Working Group SETH
| | - José Rivera
- a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain.,c On behalf of the "Inherited Platelet Disorders Project", Hemorrhagic Diathesis Working Group SETH
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Bastida JM, Morais S, Palma-Barqueros V, Benito R, Bermejo N, Karkucak M, Trapero-Marugan M, Bohdan N, Pereira M, Marin-Quilez A, Oliveira J, Yucel Y, Santos R, Padilla J, Janusz K, Lau C, Martin-Izquierdo M, Couto E, Francisco Ruiz-Pividal J, Vicente V, Hernández-Rivas JM, González-Porras JR, Luisa Lozano M, Lima M, Rivera J. Identification of novel variants in ten patients with Hermansky-Pudlak syndrome by high-throughput sequencing. Ann Med 2019; 51:141-148. [PMID: 30990103 PMCID: PMC7857454 DOI: 10.1080/07853890.2019.1587498] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Hermansky-Pudlak syndrome (HPS) is a rare inherited platelet disorder characterized by bleeding diathesis, oculocutaneous albinism (OCA) and a myriad of often-serious clinical complications. Methods: We established the clinical and laboratory phenotype and genotype of six unrelated pedigrees comprising ten patients with clinical suspicion of HPS; including platelet aggregation, flow cytometry, platelet dense granule content, electron microscopy and high-throughput sequencing (HTS). Results: The clinical presentation showed significant heterogeneity and no clear phenotype-genotype correlations. HTS revealed two known and three novel disease-causing variants. The Spanish patients carried a homozygous p.Pro685Leufs17* deletion (n = 2) in HPS4, or the novel p.Arg822* homozygous variant (n = 1) in HPS3. In the case of two Turkish sisters, a novel missense homozygous HPS4 variant (p.Leu91Pro) was found. In two Portuguese families, genetic studies confirmed a previously reported nonsense variant (p.Gln103*) in DTNBP1 in three patients and a novel duplication (p.Leu22Argfs*33) in HPS6 in two unrelated patients. Conclusions: Our findings expand the mutational spectrum of HPS, which may help in investigating phenotype-genotype relationships and assist genetic counselling for affected individuals. This approach is a proof of principle that HTS can be considered and used in the first-line diagnosis of patients with biological and clinical manifestations suggestive of HPS. Key messages We established the relationships between the clinical and laboratory phenotype and genotype of six unrelated pedigrees comprising ten patients with clinical suspicion of HPS. Molecular analysis is useful in confirming the diagnosis and may offer some prognostic information that will aid in optimizing monitoring and surveillance for early detection of end-organ damage. This approach is a proof of principle that HTS can be considered and used in the first-line diagnosis of patients with biological and clinical manifestations suggestive of HPS.
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Affiliation(s)
- Jose María Bastida
- a Department of Hematology , University Hospital of Salamanca-IBSAL , Salamanca , Spain
| | - Sara Morais
- b Department of Hematology, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Veronica Palma-Barqueros
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Rocio Benito
- d IBSAL, IBMCC, CIC, University of Salamanca-CSIC , Salamanca , Spain
| | - Nuria Bermejo
- e Department of Hematology , Hospital of San Pedro de Alcantara , Cáceres , Spain
| | - Mutlu Karkucak
- f Department of Medical Genetics , Sakarya University Training and Research Hospital , Sakarya , Turkey
| | - Maria Trapero-Marugan
- g Department of Hematology , University Hospital of Puerta de Hierro , Majadahonda , Spain
| | - Natalia Bohdan
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Mónica Pereira
- b Department of Hematology, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Ana Marin-Quilez
- d IBSAL, IBMCC, CIC, University of Salamanca-CSIC , Salamanca , Spain
| | - Jorge Oliveira
- h Department of Molecular Genetics, Medical Center of Genetics Dr. Jacinto Magalhães, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Yusuf Yucel
- f Department of Medical Genetics , Sakarya University Training and Research Hospital , Sakarya , Turkey
| | - Rosario Santos
- h Department of Molecular Genetics, Medical Center of Genetics Dr. Jacinto Magalhães, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Jose Padilla
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Kamila Janusz
- d IBSAL, IBMCC, CIC, University of Salamanca-CSIC , Salamanca , Spain
| | - Catarina Lau
- b Department of Hematology, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | | | - Eduarda Couto
- b Department of Hematology, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Juan Francisco Ruiz-Pividal
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Vicente Vicente
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Jesus Maria Hernández-Rivas
- a Department of Hematology , University Hospital of Salamanca-IBSAL , Salamanca , Spain.,d IBSAL, IBMCC, CIC, University of Salamanca-CSIC , Salamanca , Spain
| | | | - Maria Luisa Lozano
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
| | - Margarida Lima
- b Department of Hematology, University Hospital of Porto-UMIB/ICBAS/UP , Porto , Portugal
| | - Jose Rivera
- c Department of Hematology and Oncology, University Hospital of Morales Meseguer, Centro Regional de Hemodonación, University of Murcia , Murcia , Spain
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Aguila S, Navarro-Fernández J, Bohdan N, Gutiérrez-Gallego R, de la Morena-Barrio ME, Vicente V, Corral J, Martínez-Martínez I. Role of the C-sheet in the maturation of N-glycans on antithrombin: functional relevance of pleiotropic mutations. J Thromb Haemost 2014; 12:1131-40. [PMID: 24824609 DOI: 10.1111/jth.12606] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 04/15/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND The characterization of natural mutants identified in patients with antithrombin deficiency has helped to identify functional domains or regions of this key anticoagulant and the mechanisms involved in the deficiency, as well as to define the clinical prognosis. Recently, we described an abnormal glycosylation in a pleiotropic mutant (K241E) that explained the impaired heparin affinity and the mild risk of thrombosis in carriers. OBJECTIVES To evaluate the effects of different natural pleiotropic mutations on the glycosylation of antithrombin and their functional effects. METHODS Five pleiotropic mutations identified in patients with antithrombin deficiency and located at each one of the strands of the C-sheet were selected (K241E, M251I, M315K, F402L, and P429L). Recombinant mutants were generated and purified. Glycoform heterogeneity and conformational sensitivity were studied with electrophoresis, proteomic analysis, and glycomic analysis. Heparin affinity was evaluated from intrinsic fluorescence. Reactivity assays with factor Xa, thrombin and neutrophil elastase in the presence or absence of heparin were also performed. RESULTS AND CONCLUSIONS Pleiotropic mutants, except for that with the M315K mutation, which affects a non-exposed residue, showed two glycoforms. Variant 1, with abnormal glycosylation, had reduced heparin affinity and severely affected reactivity with the target proteases. In contrast, variant 2, with similar electrophoretic mobility and heparin affinity to wild-type antithrombin, had impaired inhibitory activity that was partially compensated for by activation with heparin. Our results suggest the C-sheet of antithrombin as a new region that is relevant for proper maturation of the N-glycans. Therefore, pleiotropic mutations lead to glycosylation defects that are responsible for the reduced heparin affinity.
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Affiliation(s)
- S Aguila
- Centro Regional de Hemodonación, Servicio de Hematología y Oncología Médica HU Morales Meseguer, University of Murcia, IMIB, Murcia, Spain
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Aguila S, Martínez-Martínez I, Bohdan N, de la Morena-Barrio M, Vicente V, Corral J. C0229: Mutations Creating New Glycosylation Sites Cause Different Types of Antithrombin Deficiency. Role of an N-Glycan at the Reactive Centre Loop. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50072-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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