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A Leu117 Trp Mutation Within the RGD-Peptide Cross-Linking Region of 3 Results in Glanzmann Thrombasthenia by Preventing IIb 3 Export to the Platelet Surface
Ramesh B. Basani,
Deborah L. Brown,
Gaston Vilaire,
Joel S. Bennett, and
Mortimer Poncz
From the Departments of Pediatrics and Medicine, The University of Pennsylvania School of Medicine, Philadelphia, PA.
We report a case of Glanzmann thrombasthenia in a Pakistani child whose platelets express less than 10% of the normal amount of IIb 3 on their surface. Single-stranded conformation polymorphism analysis of the exons of the patient's IIb and 3 genes showed an abnormality in exon 4 of the 3 gene. Direct sequence analysis showed that the patient was homozygous for a T G nucleotide substitution in this exon, resulting in the replacement of a highly conserved Leu at position 117 with Trp. Heterologous expression of IIb 3 containing the 3 mutation in COS-1 cells confirmed the pathogenicity of the Leu117 Trp substitution and showed that it resulted in the intracellular retention of malfolded IIb 3 heterodimers. Additional site-directed mutagenesis at position 117 indicated that, although the smaller hydrophobic amino acid Val could be substituted for the wild-type Leu, the larger hydrophobic amino acids Trp and Phe or the charged amino acids Asp and Lys were not tolerated. These studies indicate that Leu117 in 3 plays a critical role in attaining the correct folded conformation of IIb 3. These studies also suggest that the hydrophobic side chain of Leu117 is likely folded into the interior of 3, where it serves to stabilize internal packing of the protein and determines its overall shape.
Blood, Vol. 90 No. 8 (July 15), 1997:
pp. 3082-3088
© 1997 by The American Society of Hematology.

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