Irani-Hakime N, Tamim H, Kreidy R, Almawi W Y
Department of Laboratory Medicine, St. Georges Hospital, Beirut, Lebanon.
Am J Hematol. 2000 Sep;65(1):45-9. doi: 10.1002/1096-8652(200009)65:1<45::aid-ajh8>3.0.co;2-v.
Resistance to activated protein C (APC) degradation caused by a specific point mutation in the factor V (FV) gene, FV:R506Q or FV-Leiden, which replaces Arg506 with Gln at the APC cleavage site within the FV gene, is the most prevalent inherited caused of venous thrombosis. Recent reports suggested that the prevalence of FV-Leiden is high among Caucasians, and very low among non-Caucasians, thereby suggesting that FV-Leiden has originated as a single event in a primary focus. Insofar as FV-Leiden is associated with increased risk of thromboembolic diseases, coupled with its selective worldwide distribution, the aim of this study was to determine the prevalence of FV-Leiden in Lebanon and compare it with those of other countries of Caucasian and non-Caucasian origin. FV-Leiden was determined by PCR, followed by hybridization with specific wild-type and mutant DNA probes. By screening 174 healthy Lebanese subjects, 25 were shown to carry the FV-Leiden mutation, giving an allele frequency of 7.4% and an overall prevalence rate of 14.4%. Of the 25 FV-Leiden carriers, 24 were in the heterozygous state while one was in the homozygous states. No statistical difference in the FV-Leiden prevalence was noted with respect to age, gender, or sect. In addition to Lebanon, which had the highest prevalence rate reported thus far (14.4%), a high prevalence of FV-Leiden was reported for Syria (13.6%), Greece-Cyprus (13.4%), and Jordan (12.3%), an indication that the Eastern Mediterranean is the primary focus of FV-Leiden mutation. The high prevalence of FV-Leiden in Lebanon suggests that screening for this mutation must be considered for those with a family history, and/or those with additional risk factors for venous thrombosis.
凝血因子V(FV)基因中的特定点突变,即FV:R506Q或FV-莱顿突变,导致对活化蛋白C(APC)降解产生抗性,该突变在FV基因的APC裂解位点处将精氨酸506替换为谷氨酰胺,是静脉血栓形成最常见的遗传性病因。最近的报告表明,FV-莱顿突变在白种人中的患病率很高,而在非白种人中非常低,这表明FV-莱顿突变最初是在一个主要区域作为单一事件出现的。鉴于FV-莱顿突变与血栓栓塞性疾病风险增加相关,再加上其在全球的选择性分布,本研究的目的是确定黎巴嫩FV-莱顿突变的患病率,并将其与其他白种人和非白种人国家的患病率进行比较。通过聚合酶链反应(PCR)测定FV-莱顿突变,随后与特定的野生型和突变型DNA探针杂交。通过对174名健康黎巴嫩受试者进行筛查,发现25人携带FV-莱顿突变,等位基因频率为7.4%,总体患病率为14.4%。在这25名FV-莱顿突变携带者中,24人为杂合状态,1人为纯合状态。在年龄、性别或教派方面,FV-莱顿突变的患病率没有统计学差异。除黎巴嫩(迄今为止报告的患病率最高,为14.4%)外,叙利亚(13.6%)、希腊-塞浦路斯(13.4%)和约旦(12.3%)也报告了FV-莱顿突变的高患病率,这表明东地中海地区是FV-莱顿突变的主要区域。黎巴嫩FV-莱顿突变的高患病率表明,对于有家族病史和/或有静脉血栓形成其他危险因素的人群,必须考虑进行该突变的筛查。