首页|15例遗传性凝血因子Ⅴ缺陷症先证者的临床特征与基因突变分析

15例遗传性凝血因子Ⅴ缺陷症先证者的临床特征与基因突变分析

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目的 分析15个遗传性凝血因子Ⅴ(FⅤ)缺陷症先证者的临床特征与基因突变类型,初步探讨其可能的分子致病机制.方法 采用一期凝固法和ELISA法分别检测FⅤ活性(FⅤ∶C)和FⅤ抗原(FⅤ∶Ag).用PCR扩增患者F5基因的25个外显子及其侧翼序列,并直接测序.利用蛋白质模型分析其可能的分子机制.结果 在5例FⅤ∶C大于10%的先证者中,仅有1例出现轻微出血症状;在10例FⅤ∶C小于10%的先证者中,7例表现出各种出血症状.15例先证者共检出12个基因突变位点(其中8个为新的突变,1个为致病的多态性).蛋白质模型分析表明,所有6种错义突变都会导致FⅤ蛋白的构象改变,其中2种(p.Ser1781Arg和p.Asp96His)会减少氢键数量,从而导致局部蛋白质结构不稳定.结论 这些遗传性FⅤ缺陷症先证者的FⅤ水平与各自的F5基因突变有关,其FⅤ水平与出血症状具有较强的相关性.
Clinical features and gene mutation analysis of fifteen probands with hereditary coagulation factor Ⅴ deficiency
Objective To analyze the clinical features and gene mutations types of 15 unrelated probands with coagulation factor Ⅴ(FⅤ)deficiency,and explore the possible molecular pathogenesis.Methods FⅤ activity(FⅤ∶C)and FⅤ antigen(FⅤ∶Ag)were detected by one-stage clotting and ELISA,respectively.All 25 exons of the F5 gene in the patients were amplified by PCR,and se-quenced directly.Haplotype analysis was performed with different polymorphisms on FⅤ.Protein modeling was applied to analyze the potential molecular mechanisms.Results Of the 5 probands with an FⅤ∶C greater than 10%,only 1 had minor bleeding symptoms.In the 10 probands with FⅤ∶C less than 10%,seven showed various bleeding manifestations.A total of 12 gene mutations locus were de-tected from 15 probands(8 gene mutations locus were novel mutations,and 1 was pathogenic polymorphism).An in silico analysis pre-liminarily investigated the potential pathogenic mechanism of the mutation.Modeling analysis showed that all the six missense mutations would lead to conformational alterations in the FⅤ protein.Among them,two(p.Ser1781 Arg and p.Asp96His)would decrease hydro-gen bonds.Conclusion The level of FⅤ in these probands with inherited FⅤ deficiency were associated with mutations in the respec-tive F5 gene,and the FⅤ levels strongly correlated with the probability of hemorrhage.

factor Ⅴ deficiencyclinical featurescompound heterozygous mutation

林双女、叶银才、陈碧乐、谢作听、王明山

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温州医科大学附属第一医院输血科,浙江温州 325015

温州医科大学附属第一医院医学检验中心,浙江温州 325015

凝血因子Ⅴ缺陷症 临床特征 复合杂合突变

温州市科学技术局

Y2023508

2024

临床检验杂志
江苏省医学会

临床检验杂志

CSTPCD
影响因子:0.746
ISSN:1001-764X
年,卷(期):2024.42(6)
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