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Blood, Vol. 92 No. 5 (September 1), 1998:
pp. 1646-1651
Molecular Mechanisms of FVII Deficiency: Expression of Mutations
Clustered in the IVS7 Donor Splice Site of Factor VII Gene
M. Pinotti,
R. Toso,
R. Redaelli,
M. Berrettini,
G. Marchetti, and
F. Bernardi
From the Dipartimento di Biochimica e Biologia Molecolare - CIBF,
Sezione SBPGU, Università di Ferrara, Ferrara; the Divisione di
Ematologia, Ospedale Niguarda, Milano; and the Istituto di Medicina
Interna e di Medicina Vascolare, Università di Perugia, Perugia,
Italy.
In three Italian patients, two point mutations and a short deletion
were found in the intron 7 of factor VII gene, clustered in the donor
splice site and located in the first of several repeats. The mutation
9726+5G A, the most frequent cause of symptomatic factor VII
deficiency in Italy, as well as the deletion (9729del4) gave rise in
expression studies to abnormally spliced transcripts, which were
exclusively produced from the cryptic site in the second repeat. The
insertion in the mature mRNA of the first intronic repeat caused
(9726+5G A) a reading frameshift, abolishing most of the
factor VII catalytic domain, or produced (9729del4), an altered factor
with 11 additional residues, the activity of which was not detectable
in the cell medium after mutagenesis and expression studies. Studies of
factor VII ectopic mRNA from leukocytes and expression studies
indicated that the deleted gene produced 30% of normally spliced
transcript. Differently, the 9726+5G A mutation permitted a
very low level (0.2% to 1%) of correct splicing to occur, which could
be of great importance to prevent the onset, in the homozygous
patients, of most of the life-threatening bleeding symptoms. The
9726+7A G mutation was found to be a rare and functionally silent polymorphism. These findings, which provide further evidence of
the interplay of sequence and position in the 5 splice site selection, throw light on the heterogeneous molecular bases and clinical phenotypes of FVII deficiency.
© 1998 by The American Society of Hematology.

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