Factor V,tissue factor pathway inhibitor,and east Texas bleeding disorder |
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Authors: | George J. Broze Jr. Thomas J. Girard |
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Affiliation: | Division of Hematology, Washington University School of Medicine, St. Louis, Missouri, USA. |
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Abstract: | In a report reading like a fascinating detective story, Vincent and colleagues crack the mysterious case of east Texas bleeding disorder. They show that affected individuals have a mutation in exon 13 of the coagulation F5 gene that causes increased expression of an alternatively spliced transcript, which encodes a previously unrecognized factor V (FV) isoform they call FV-short. This FV isoform lacks a large portion of the B domain of FV, which is normally released upon the proteolytic activation of FV by thrombin and binds tightly to the coagulation regulator tissue factor pathway inhibitor-α (TFPIα). This interaction leads to an approximately 10-fold increase in the level of TFPIα circulating in plasma and a resultant anticoagulant effect that produces a hemorrhagic diathesis. |
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