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Blood, 15 April 2005, Vol. 105, No. 8, pp. 3149-3154.
Prepublished online as a Blood First Edition Paper on December 30, 2004; DOI 10.1182/blood-2004-06-2250.


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Submitted June 28, 2004
Accepted November 1, 2004

A naturally occurring E30Q mutation in the Gla domain of protein Z caused its impaired secretion and subsequent deficiency

Masayoshi Souri, Shiori Koseki-Kuno, Hiroki Iwata, Bettina Kemkes-Matthes, and Akitada Ichinose*

Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan
Zentrum Innere Medizin, Giessen University, Giessen, Germany

* Corresponding author; email: aichinos{at}med.id.yamagata-u.ac.jp.

Protein Z is a vitamin K-dependent glycoprotein that plays a role in the regulation of coagulation. A nucleotide substitution of G by C in exon II of the protein Z gene, resulting in the replacement of Glu-30 with Gln (E30Q), and a G to A transition at the 79th nucleotide in intron F (IntF79 G/A) were heterozygously identified in a patient with a severe thrombotic tendency, whose plasma protein Z level was about 15% of normal. Other vitamin K-dependent coagulation factors were within normal ranges. The IntF79 A allele is reported to be associated with lowered PZ levels. Glu-30 is one of 13 {gamma}carboxylation sites in protein Z and is well conserved among vitamin K-dependent proteins. Expression studies revealed that the E30Q mutant was not released from synthesizing cells, although wild type protein Z was readily secreted in a vitamin K-dependent fashion. The E30Q mutant was N-glycosylated, {gamma}carboxylated, and translocated from the ER to the Golgi in the presence of vitamin K, as was the wild type. Co-expression of E30Q with wild type protein Z interfered with the secretion of the wild type, while only a minor or no effect was observed on the secretion of factor X and plasminogen. The IntF79A allele has been reported to be also associated with lowered PZ levels.


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