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血小板无力症中 GPIIb 和 GPIIIa 基因的新型突变

Novel Mutations in the GPIIb and GPIIIa Genes in Glanzmann Thrombasthenia.

作者信息

Pillitteri Daniele, Pilgrimm Ann-Kathrin, Kirchmaier Carl Maximilian

机构信息

Deutsche Klinik für Diagnostik, Sektion Innere Medizin I, Arbeitsgruppe: «Thrombose, Hämostase und vaskuläre Medizin», Wiesbaden, Germany.

出版信息

Transfus Med Hemother. 2010;37(5):268-277. doi: 10.1159/000320258. Epub 2010 Sep 15.

Abstract

BACKGROUND

Glanzmann thrombasthenia (GT) is an inherited autosomal recessive platelet disorder characterized by a complete or partial lack, or mutation, of the GPIIb/IIIa complex (integrin α(IIb)β(3)) on the thrombocytes' surface, leading to a severe bleeding syndrome. MATERIAL AND METHODS: Molecular genetic analysis was performed in patients with suspected GT. The aim of the present study was the identification of new natural variants, their impact on platelet function, and their relation to the risk of bleeding. RESULTS: Expression of the platelet integrin α(IIb)β(3) was determined by flow cytometry. Mutations were identified through sequencing of cDNA and genomic DNA. In addition, platelet function studies (PAC-binding, aggregations) were implemented. The study included 25 patients revealing 13 mutations (GPIIb: n = 9; GPIIIa: n = 4). Two of the 13 mutations were previously described (T207I; L214P). The remaining mutations have not been published yet, whereas 1 mutation in 2 unrelated families was identical (3062 T→C). CONCLUSION: All patients with less than 25% of present α(IIb)β(3) have a medical history of bleeding.

摘要

背景

Glanzmann血小板无力症(GT)是一种遗传性常染色体隐性血小板疾病,其特征是血小板表面的糖蛋白IIb/IIIa复合物(整合素α(IIb)β(3))完全或部分缺失、或发生突变,导致严重的出血综合征。

材料与方法

对疑似GT的患者进行分子遗传学分析。本研究的目的是鉴定新的自然变异体、它们对血小板功能的影响以及它们与出血风险的关系。

结果

通过流式细胞术测定血小板整合素α(IIb)β(3)的表达。通过对cDNA和基因组DNA进行测序来鉴定突变。此外,还进行了血小板功能研究(血小板聚集功能检测、聚集试验)。该研究纳入了25例患者,发现了13种突变(糖蛋白IIb:n = 9;糖蛋白IIIa:n = 4)。13种突变中有2种先前已有描述(T207I;L214P)。其余突变尚未发表,而在2个无亲缘关系的家族中发现1种相同的突变(3062 T→C)。

结论

所有α(IIb)β(3)表达低于25%的患者都有出血病史。

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