Identification of haemophilia B patients with mutations in the two calcium binding domains of factor IX: importance of a beta-OH Asp 64----Asn change.

The polymerase chain reaction procedure (PCR) coupled with direct sequencing has been used to screen a panel of haemophilia B patients. This analysis has identified, amongst others, several mutations in the functionally important gla and type B EGF domains of factor IX, both of which are known to bind calcium. Type B EGF domains are widely distributed in proteins; located within these domains are highly conserved amino acid residues important for the formation of a high-affinity calcium binding site. One prominent feature of these domains is a highly conserved beta-hydroxylated Asp or Asn residue. Of particular interest is the identification of one patient, with a substitution of the beta-hydroxy Asp-64 residue normally present in factor IX for Asn. This change results in a functionally defective factor IX molecule with altered calcium binding properties. To explain the functional abnormality caused by this substitution of one amino acid residue for another which is commonly found at the equivalent position in other proteins with type B EGF domains, we propose the existence of additional conserved residues within this domain, which are important for calcium binding, and which correlate with whether the beta-hydroxylated residue is Asp or Asn.