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Prepublished online as a Blood First Edition Paper on August 8, 2002; DOI 10.1182/blood-2002-06-1851.

Submitted June 24, 2002
Accepted July 29, 2002
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*
Department of Clinical Chemistry, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Crystal & Structural Chemistry, Bijvoet Center for Biomolecular Research, Utrecht University, Utrecht, The Netherlands
* Corresponding author; email: wsolinge{at}lab.azu.nl.
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 Utrecht) of HK1, the gene that encodes red blood cell specific hexokinase-R, in a patient previously diagnosed with hexokinase deficiency. The T680S substitution predicted by this mutation affects a highly conserved residue in the enzyme's active site that interacts with phosphate moieties of ADP, 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 with those obtained from a recombinant mutant brain hexokinase-I with the same T680S substitution. It thereby stresses the valuable contribution of studying patients with hexokinase deficiency towards a better understanding of its key role in glycolysis.

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