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遗传性凝血因子XII缺乏症家系的基因分析

Genetic analysis of a pedigree with hereditary coagulation factor XII deficiency.

作者信息

Fang Weiwei, Chen Bile, Zou Anqing, Xu Fei, Qin Langyi, Yang Lihong, Wang Mingshan, Zhou Xingxing

机构信息

Wenzhou TCM Hospital of Zhejiang Chinese Medical University Wenzhou, Wenzhou, Zhejiang, China.

Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Ann Hematol. 2025 Feb;104(2):1281-1289. doi: 10.1007/s00277-025-06205-4. Epub 2025 Jan 22.

Abstract

Analyze the clinical phenotype and gene mutations of a family with hereditary FXII deficiency, and preliminarily explore its phenotypic manifestations. The routine coagulation indicators and related coagulation factors were measured.Thromboelastography and thrombin generation tests simulated coagulation and anticoagulation states in vitro and in vivo. PCR direct sequencing was utilized to analyze all exons and flanking sequences of the F12 gene in the proband, confirming suspected mutations through reverse sequencing, and identifying corresponding mutation sites in family members. Using ClustalX-2.1-win to analyze the conservation of the variant, and employing online software to predict the pathogenicity of mutations. The proband exhibited significantly prolonged APTT (169.1 s) and a pronounced decrease in FXII: C to 1.0%. Thromboelastography testing indicated a diminished function of the endogenous coagulation system, while thrombin generation testing revealed a normal ability for thrombin production in the proband. Gene sequencing revealed that the proband harbored a deletion mutation c.303_304delCA in exon 5 and a substitution mutation c.800 + 1G > A in intron 8. All three bioinformatics software indicated that the mutations were pathogenic and could lead to the production of a terminator, potentially altering the structure and function of the protein. The deletion mutation c.303_304delCA and substitution mutation c.800 + 1G > A are associated with a decreased in FXII levels in this family, with the c.800 + 1G > A mutation being the first reported mutation worldwide.

摘要

分析一个遗传性FXII缺乏症家系的临床表型和基因突变情况,并初步探讨其临床表现。检测常规凝血指标及相关凝血因子。通过血栓弹力图和凝血酶生成试验模拟体内外凝血和抗凝状态。利用PCR直接测序法分析先证者F12基因的所有外显子及侧翼序列,通过反向测序确认可疑突变,并在家族成员中鉴定相应突变位点。使用ClustalX-2.1-win分析变异的保守性,采用在线软件预测突变的致病性。先证者的活化部分凝血活酶时间(APTT)显著延长(169.1秒),FXII:C显著降低至1.0%。血栓弹力图检测表明内源性凝血系统功能减弱,而凝血酶生成试验显示先证者凝血酶产生能力正常。基因测序显示先证者在外显子5存在缺失突变c.303_304delCA,在内含子8存在替换突变c.800+1G>A。所有三个生物信息学软件均表明这些突变具有致病性,可导致产生终止密码子,可能改变蛋白质的结构和功能。缺失突变c.303_304delCA和替换突变c.800+1G>A与该家系中FXII水平降低有关,其中c.800+1G>A突变是全球首次报道的突变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81a5/11971214/d6819d13ae06/277_2025_6205_Fig1_HTML.jpg

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