R255h amino acid substitution of protein Z identified in patients with factor V Leiden mutation |
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Authors: | Kemkes-Matthes Bettina Matthes Karl J Souri Masayoshi Koseki-Kuno Shiori Ichinose Akitada |
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Institution: | Department of Internal Medicine, Justus Liebig University Giessen, Giessen, Germany. bettina.kemkes-matthes@innere.med.uni-giessen.de |
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Abstract: | The clinical significance of diminished protein Z in plasma is controversial. Studies in mice demonstrated that deficiency of protein Z dramatically increases the prothrombotic tendency of factor V Leiden mutation. This finding was confirmed by initial results in humans, indicating that thromboembolism in factor V Leiden patients with lowered protein Z level occurs earlier than in patients with normal protein Z levels. Consequently, the aim of our present study was to find out whether genetic alterations of protein Z were demonstrated in patients with factor V Leiden mutation and early onset of thromboembolic disease. DNA-sequencing of the protein Z gene was performed in two patients with factor V Leiden mutation, early onset of thromboembolism, and lowered protein Z levels. In both patients, R255H substitution of the protein Z gene was identified. Subsequently, the R255H substitution was also found in 12 of 132 additional patients. Patients presenting with the R255H substitution in addition to factor V Leiden mutation showed thromboembolic events more frequently than factor V Leiden patients without R255H substitution of the protein Z gene. In conclusion, R255H substitution of the protein Z gene seems to influence clinical symptoms of thromboembolism in factor V Leiden patients. |
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Keywords: | protein Z R255H substitution factor V Leiden mutation thrombosis thrombophilia |
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