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Blood, 1 May 2007, Vol. 109, No. 9, pp. 3713-3724.
Prepublished online as a Blood First Edition Paper on January 5, 2007; DOI 10.1182/blood-2006-06-026104.


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Submitted June 9, 2006
Accepted November 3, 2006

A sequence variation scan of the coagulation factor (F)VIII structural gene and associations with plasma FVIII activity (FVIII:C) levels

Kevin R. Viel, Deepa K. Machiah, Diane M. Warren, Manana Khachidze, Alfonso Buil, Karl Fernstrom, Juan C. Souto, Jaun M Peralta, Todd Smith, John Blangero, Sandra Porter, Stephen T. Warren, Jordi Fontcuberta, Jose M. Soria, William Dana Flanders, Laura Almasy, and Tom E. Howard*

Dept of Pathology & Laboratory Medicine, Emory University, Atlanta, GA, United States
Dept of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX, United States
Unitat d Hemostasia i Trombosi, Dept d Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Centro de Investigacion en Biologia Celular y Molecular, Universidad de Costa Rica, San Pedro, Costa Rica
Geospiza Inc., Seattle, WA, United States
Dept of Human Genetics, Emory University, Atlanta, GA, United States
Dept of Epidemiology, Emory University, Atlanta, GA, United States

* Corresponding author; email: thoward{at}emory.edu.

Plasma FVIII:C is a highly heritable quantitative-trait that is strongly correlated with thrombosis risk. Polymorphisms within only one gene, the ABO blood-group locus, have been unequivocally demonstrated to contribute to the broad population variability observed for this trait. Because less than 2.5% of the structural FVIII gene (F8) has been examined previously, we resequenced all known functional regions in 222 potentially distinct alleles from 137 unrelated non-hemophilic individuals representing seven racial groups. Eighteen of the 47 variants identified, including 17 single-nucleotide polymorphisms (SNPs), were previously unknown. As the degree of linkage disequilibrium across F8 was weak overall, we used measured-genotype association analysis to evaluate the influence of each polymorphism on the FVIII:C levels in 398 subjects from 21 pedigrees known as the Genetic Analysis of Idiopathic Thrombophilia project (GAIT). Our results suggested that C92714G, a nonsynonymous-SNP encoding the B-domain substitution D1241E, was significantly associated with FVIII:C. After accounting for important covariates, including age and ABO-genotype, the association persisted with each C-allele additively increasing the FVIII:C level by 14.3 IU dL-1 (P = 0.016). Nevertheless, because the alleles of G56010A, a SNP within the 3'-splice-junction of intron-7, are strongly associated with C92714G in GAIT, additional studies are required to determine whether D1241E is itself a functional variant.


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