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Blood, 15 February 2002, Vol. 99, No. 4, pp. 1495-1497
BRIEF REPORT
Residual factor VII activity and different hemorrhagic phenotypes
in CRM+ factor VII deficiencies (Gly331Ser and
Gly283Ser)
Mirko Pinotti,
Daniela Etro,
Debora Bindini,
Maria Luisa Papa,
Giuseppina Rodorigo,
Angiola Rocino,
Guglielmo Mariani,
Nicola Ciavarella, and
Francesco Bernardi
From the Dipartimento di Biochimica e Biologia
Molecolare-CIBF, University of Ferrara, Italy; Centro Emofilia e
Trombosi, Ospedale Nuovo Pellegrini, Naples, Italy; Divisione di
Angiologia, Azienda Ospedaliera, Policlinico S Orsola-Malpighi,
Bologna, Italy; Divisione di Ematologia, University of Palermo, Italy;
Centro Emofilia e Trombosi, Ospedale Consorziale, Policlinico, Bari,
Italy.
Two cross-reacting material-positive (CRM+) factor VII
(FVII) mutations, associated with similar reductions in coagulant
activity (2.5%) but with mild to asymptomatic (Gly331Ser, c184
[in chymotrypsin numbering]) or severe (Gly283Ser, c140) hemorrhagic
phenotypes, were investigated. The affected glycines belong to
structurally conserved regions in the c184 through c193 and c140s
activation domain loops, respectively. The natural mutants 331Ser-FVII
and 283Ser-FVII were expressed, and in addition 331Ala-FVII and
283Ala-FVII were expressed because 3 functional serine-proteases
bear alanine at these positions. The
331Ser-FVII, present in several asymptomatic subjects, showed
detectable factor Xa generation activity in patient plasma (0.7% ±
0.2%) and in reconstituted system with the recombinant molecules
(2.7% ± 1.1%). The reduced activity of recombinant 283Ala-FVII (7.2% ± 2.2%) indicates that the full function of FVII requires glycine at this position, and the undetectable activity of 283Ser-FVII suggests that the oxydrile group of Ser283 participates in causing severe CRM+ deficiency. Furthermore, in a plasma system
with limiting thromboplastin concentration, 283Ser-FVII inhibited
wild-type FVIIa activity in a dose-dependent manner.

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