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Blood, 1 June 2001, Vol. 97, No. 11, pp. 3327-3332

PLENARY PAPER

Genetic basis of hemolytic anemia caused by pyrimidine 5' nucleotidase deficiency

Anthony M. Marinaki, Emilia Escuredo, John A. Duley, H. Anne Simmonds, Adolfo Amici, Valeria Naponelli, Giulio Magni, Martin Seip, Isaac Ben-Bassat, Eric H. Harley, Swee Lay Thein, and David C. Rees

From the Purine Research Unit, Guy's Hospital; the Department of Haematology, King's College Hospital, London; the Department of Haematology, Royal Hallamshire Hospital, Sheffield, United Kingdom; the Istituto di Biochimica, Facolta di Medicina, Universita di Ancona, Italy; the Department of Pediatrics, The National Hospital, Oslo, Norway; the Institute of Hematology, Chaim Sheba Medical Center, Tel Hashomer, Israel; and the Department of Chemical Pathology, University of Cape Town, South Africa.

Pyrimidine 5' nucleotidase (P5'N-1) deficiency is an autosomal recessive condition causing hemolytic anemia characterized by marked basophilic stippling and the accumulation of high concentrations of pyrimidine nucleotides within the erythrocyte. It is implicated in the anemia of lead poisoning and is possibly associated with learning difficulties. Recently, a protein with P5'N-1 activity was analyzed and a provisional complementary DNA (cDNA) sequence published. This sequence was used to study 3 families with P5'N-1 deficiency. This approach generated a genomic DNA sequence that was used to search GenBank and identify the gene for P5'N-1. It is found on chromosome 7, consists of 10 exons with alternative splicing of exon 2, and produces proteins 286 and 297 amino acids long. Three homozygous mutations were identified in this gene in 4 subjects with P5'N-1 deficiency: codon 98 GATright-arrowGTT, Aspright-arrowVal (linked to a silent polymorphism codon 92, TACright-arrowTAT), codon 177, CAAright-arrowTAA, Glnright-arrowtermination, and IVS9-1, Gright-arrowT. The latter mutation results in the loss of exon 9 (201 bp) from the cDNA. None of these mutations was found in 100 normal controls. The DNA analysis was complicated by P5'N-1 pseudogenes found on chromosomes 4 and 7. This study is the first description of the structure and location of the P5'N-1 gene, and 3 mutations have been identified in affected patients from separate kindreds.

© 2001 by The American Society of Hematology.
 

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