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A Leu117 right-arrow  Trp Mutation Within the RGD-Peptide Cross-Linking Region of beta 3 Results in Glanzmann Thrombasthenia by Preventing alpha IIbbeta 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 alpha IIbbeta 3 on their surface. Single-stranded conformation polymorphism analysis of the exons of the patient's alpha IIb and beta 3 genes showed an abnormality in exon 4 of the beta 3 gene. Direct sequence analysis showed that the patient was homozygous for a T right-arrow G nucleotide substitution in this exon, resulting in the replacement of a highly conserved Leu at position 117 with Trp. Heterologous expression of alpha IIbbeta 3 containing the beta 3 mutation in COS-1 cells confirmed the pathogenicity of the Leu117 right-arrow Trp substitution and showed that it resulted in the intracellular retention of malfolded alpha IIbbeta 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 beta 3 plays a critical role in attaining the correct folded conformation of alpha IIbbeta 3. These studies also suggest that the hydrophobic side chain of Leu117 is likely folded into the interior of beta 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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