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Prepublished online as a Blood First Edition Paper on August 8, 2002; DOI 10.1182/blood-2002-06-1851.
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Blood, 1 January 2003, Vol. 101, No. 1, pp. 345-347
RED CELLS
Brief report
HK Utrecht: missense mutation in the active site of human
hexokinase associated with hexokinase deficiency and severe
nonspherocytic hemolytic anemia
Richard van Wijk,
Gert Rijksen,
Eric G. Huizinga,
Hendrik K. Nieuwenhuis, and
Wouter W. van
Solinge
From the Department of Clinical Chemistry and the
Department of Hematology, University Medical Center Utrecht; Department
of Crystal & Structural Chemistry, Bijvoet Center for Biomolecular
Research, Utrecht University, Utrecht, The
Netherlands.
Hexokinase deficiency is a rare autosomal recessive disease with a
clinical phenotype of severe hemolysis. We report a novel homozygous missense mutation in exon 15 (c.2039C>G, HK
[hexokinase] Utrecht) of HK1, the gene that
encodes red blood cell-specific hexokinase-R, in a patient previously
diagnosed with hexokinase deficiency. The Thr680Ser substitution
predicted by this mutation affects a highly conserved residue in the
enzyme's active site that interacts with phosphate moieties of
adenosine diphosphate, adenosine triphosphate (ATP), and inhibitor
glucose-6-phosphate. We correlated the molecular data
to the severe clinical phenotype of the patient by means of altered
enzymatic properties of partially purified hexokinase from the patient,
notably with respect to Mg2+-ATP binding. These kinetic
properties contradict those obtained from a recombinant mutant brain
hexokinase-I with the same Thr680Ser substitution. This contradiction
thereby stresses the valuable contribution of studying patients with
hexokinase deficiency to achieve a better understanding of
hexokinase's key role in glycolysis.

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