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Blood, 1 February 2008, Vol. 111, No. 3, pp. 1299-1301.
Prepublished online as a Blood First Edition Paper on October 30, 2007; DOI 10.1182/blood-2007-09-112854.
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Submitted September 19, 2007
Accepted October 29, 2007
Deletion of three residues from the C-terminus of MCFD2 affects binding to ERGIC-53 and causes combined factor V and factor VIII deficiency
Beat Nyfeler, Yukiko Kamiya, Francoise Boehlen, Kazuo Yamamoto, Koichi Kato, Philippe de Moerloose, Hans-Peter Hauri, and Marguerite Neerman-Arbez*
Biozentrum, University of Basel, Basel, Switzerland
Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
Division of Angiology and Hemostasis, University Hospitals, Geneva, Switzerland
Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan
Institute for Molecular Science, National Institute of Natural Sciences, Okazaki, Japan
Department of Genetic Medicine and Development, University Medical School, Geneva, Switzerland
* Corresponding author; email: marguerite.arbez{at}medecine.unige.ch.
Combined factor V and factor VIII deficiency (F5F8D) is a rare, autosomal recessive coagulation disorder. F5F8D is genetically linked to mutations in the transmembrane lectin ERGIC-53 and its soluble interaction partner MCFD2. The ERGIC-53/MCFD2 protein complex functions as transport receptor of coagulation factors V and VIII by mediating their export from the endoplasmic reticulum (ER). Here, we studied a F5F8D patient who was found to be a compound heterozygote for two novel mutations in MCFD2: a large deletion of 8.4 kb eliminating the 5'UTR of the gene and a nonsense mutation resulting in the deletion of only three amino acids ( SLQ) from the C-terminus of MCFD2. Biochemical and structural analysis of the SLQ mutant demonstrated impaired binding to ERGIC-53 due to modification of the three-dimensional structure of MCFD2. Our results highlight the importance of the ERGIC-53/MCFD2 protein interaction for the efficient secretion of coagulation factors V and VIII.

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