Liang Wei-ling, Wei Hong-ying, Lin Fa-quan, Zhou Jun-li
Department of Pediatrics, the First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China.
Zhonghua Er Ke Za Zhi. 2012 Nov;50(11):817-20.
To analyze the gene mutation in two pedigrees of inherited coagulation factor VII (FVII) deficiency, and investigate the relationship between the genotype and phenotype.
The coagulation function and coagulation factors activity of probands were detected for phenotype diagnosis, all exons and junctions of FVII gene from the family members' genomic DNA were amplified using polymerase chain reaction (PCR), and detected the gene mutation by direct sequencing. Mutations were confirmed by reverse sequencing.
The prothrombin time (PT) of proband 1 was 265.2 s, FVII:C was 22% and the PT of proband 2 was > 120 s, FVII:C was 1%. Homozygous 17844G→A mutation in No. 8 exon of FVII gene was identified in the proband 1 resulting in Gly343Ser, and heterozygosity for the same mutations were confirmed in his parents and a sister. The proband 2 was compound heterozygous, one mutation was the same as the proband 1 but was a heterozygosity that can also found in his mother and brother; the other heterozygosity mutation was located on No. 8 exon 18055G→A that resulted in Gln413Arg which was inherited from his father.
No. 8 exon of FVII gene encodes catalytic domain. Mutation found in those domain could change the FVII catalytic domain spatial structure, affected FVII function and stability, and the sufferer of homozygote and compound heterozygous may have clinical bleeding tendency. Almost no clinical findings in simple heterozygotes, however, a few of heterozygotes could have a tendency of bleeding because of genetic polymorphism which would reduce the FVII:C.
分析两个遗传性凝血因子 VII(FVII)缺乏家系的基因突变情况,探讨基因型与表型之间的关系。
检测先证者的凝血功能及凝血因子活性以进行表型诊断,采用聚合酶链反应(PCR)扩增家系成员基因组 DNA 中 FVII 基因的所有外显子及接头,并通过直接测序检测基因突变。通过反向测序确认突变。
先证者 1 的凝血酶原时间(PT)为 265.2 秒,FVII:C 为 22%,先证者 2 的 PT>120 秒,FVII:C 为 1%。在先证者 1 中鉴定出 FVII 基因第 8 外显子纯合的 17844G→A 突变,导致 Gly343Ser,其父母及一个妹妹被证实为相同突变的杂合子。先证者 2 为复合杂合子,一个突变与先证者 1 相同但为杂合子,其母亲和兄弟也存在该突变;另一个杂合子突变位于第 8 外显子 18055G→A,导致 Gln413Arg,遗传自其父亲。
FVII 基因第 8 外显子编码催化结构域。该结构域中发现的突变可改变 FVII 催化结构域的空间结构,影响 FVII 的功能和稳定性,纯合子和复合杂合子患者可能有临床出血倾向。单纯杂合子几乎无临床症状,但少数杂合子可能因基因多态性导致 FVII:C 降低而有出血倾向。