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VR Arruda, WC Pieneman, PH Reitsma, PP Deutz-Terlouw, JM Annichino-Bizzacchi, E Briet and FF Costa
Department of Internal Medicine, State University of Campinas, UNICAMP, SP,
Brazil.
The molecular characterization of the mutations in hemophilia A patients is
hampered by the large size of the factor VIII gene and the great
heterogeneity of mutations. In this study, we have performed a protocol
involving multiplex polymerase chain reaction in which 19 exons were
amplified in four different combinations followed by nonradioactive
single-strand conformational polymorphism (SSCP) to screen for mutations.
Southern blotting was used to detect inversion of the factor VIII gene
resulting from recombination between copies of the gene A (F8A) located in
intron 22 of the factor VIII gene and two copies close telomeric region of
X chromosome. Forty-two hemophilia A patients (21 with severe and 21 with
mild-to-moderate disease) were studied. The inversion of factor VIII
occurred in 13 of 21 patients affected by severe hemophilia A. One patient
showed a large extra band in addition to the three bands observed after
Southern blotting with the F8A probe. An abnormal electrophoretic pattern
of SSCP was detected in 85% and 50% of the patients affected by
mild-to-moderate and severe disease, respectively. Sixteen different
mutations were identified. Eleven mutations were novel and comprised 9
point mutations and 2 small deletions. This study shows that the
methodology used is safe and rapid and has potential for detecting almost
all of the genetic defects of the studied hemophilia A patients.
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| Copyright © 1995 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||