Subscribe to RSS
DOI: 10.1055/s-0037-1613866
The HR2 Haplotype of Factor V: Effects on Factor V Levels, Normalized Activated Protein C Sensitivity Ratios and the Risk of Venous Thrombosis
This study was supported by grant no. 95.001 from the Trombosestichting Nederland. The LETS study was originally supported by a grant from the Netherlands Heart Foundation (89.063). Dr. T. Koster, Mrs T. Visser and Mrs A. Schreijer are acknowledged for their work in contacting the patients and processing the bloodsamples. We are grateful to Dr. F. J. M. van der Meer (Anticoagulation Clinic Leiden), Mrs Dr. L. P. Colly (Anticoagulation Clinic Amsterdam) and Dr. P. H. Trienekens (Anticoagulation Clinic Rotterdam) for their assistence.Publication History
Received
13 September 1999
Accepted after revision
14 December 1999
Publication Date:
08 December 2017 (online)
Summary
We studied the HR2 haplotype of the factor V gene in a case-control study for venous thrombosis including 474 patients with a first deep-vein thrombosis and 474 age- and sex-matched healthy controls (Leiden Thrombophilia Study, LETS). We investigated both the original His1299Arg (A4070G) polymorphism and the Met385Thr (T1328C) polymorphism. This latter polymorphism, located in exon 8 (heavy chain), is always present in the HR2 haplotype, but also occurs on its own in a His1299 (wt) background. The HR2 haplotype was not associated with an increased risk of venous thrombosis (OR = 1.2, 95% confidence interval: 0.8-2.0). We did not find an association between the HR2 haplotype and a reduced sensitivity for activated protein C (APC) in non-carriers of factor V Leiden (FVL). However, in compound heterozygous FVL/HR2 carriers the sensitivity for APC was reduced. The HR2 haplotype was also associated with reduced factor V antigen levels in both patients and controls. Sequence analysis of the promoter region of factor V in HR2 homozygotes did not reveal any sequence variations that could explain the reduced FV levels. Our results show that the HR2 haplotype is not associated with an increased risk of venous thrombosis or with a reduced sensitivity for APC in non-FVL carriers. However, the HR2 haplotype is associated with a reduced sensitivity for APC in carriers of FVL and with reduced factor V antigen levels.
-
References
- 1 Jenny RJ, Pittman DD, Toole JJ, Kriz RW, Aldape RA, Hewick RM, Kaufman RJ, Mann KG. Complete cDNA and derived amino acid sequence of human factor V. Proc Natl Acad Sci USA 1987; 84: 4846-50.
- 2 Rosing J, Tans G. Coagulation factor V: An old star shines again. Thromb Haemost 1997; 78: 427-33.
- 3 Mann KG, Jenny RJ, Krishnaswamy S. Cofactor proteins in the assembly and expression of blood clotting enzyme complexes. Annu Rev Biochem 1988; 57: 915-56.
- 4 Kalafatis M, Rand MD, Mann KG. The mechanism of inactivation of human factor V and human factor Va by activated protein C. J Biol Chem 1994; 269: 31869-80.
- 5 Shen L, Dahlbäck B. Factor V and protein S as synergistic cofactors to activated protein C in degradation of factor VIIIa. J Biol Chem 1994; 269: 18735-8.
- 6 Lu D, Kalafatis M, Mann KG, Long GL. Comparison of activated protein C/protein S-mediated inactivation of human factor VIII and factor V. Blood 1996; 87: 4708-17.
- 7 Varadi K, Rosing J, Tans G, Pabinger I, Keil B, Schwarz HP. Factor V enhances the cofactor function of protein S in the APC-mediated inactivation of factor VIII: Influence of the factor V R506Q mutation. Thromb Haemost 1996; 76: 208-14.
- 8 Dahlbäck B, Carlsson M, Svensson PJ. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: Prediction of a cofactor to activated protein C. Proc Natl Acad Sci USA 1993; 90: 1004-8.
- 9 Bertina RM, Koeleman BPC, Koster T, Rosendaal FR, Dirven RJ, de Ronde H, van der Velden PA, Reitsma PH. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature 1994; 369: 64-7.
- 10 Kalafatis M, Bertina RM, Rand MD, Mann KG. Characterization of the molecular defect in factor VR506Q. J Biol Chem 1995; 270: 4053-7.
- 11 Heeb MJ, Kojima Y, Greengard JS, Griffin JH. Activated protein C resistance: molecular mechanisms based on studies using purified Gln506-factor V. Blood 1995; 85: 3405-11.
- 12 Nicolaes GAF, Tans G, Thomassen MCLGD, Hemker HC, Pabinger I, Varadi K, Schwarz HP, Rosing J. Peptide bond cleavages and loss of functional activity during inactivation of factor Va and factor VaR506Q by activated protein C. J Biol Chem 1995; 270: 21158-66.
- 13 Aparicio C, Dahlbäck B. Molecular mechanisms of activated protein C resistance. Properties of factor V isolated from an individual with homozygosity for the Arg506 to Gln mutation in the factor V gene. Biochem J 1996; 313: 467-72.
- 14 Ridker PM, Hennekens CH, Lindpaintner K, Stampfer MJ, Eisenberg PR, Miletich JP. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. N Engl J Med 1995; 332: 912-7.
- 15 Rosendaal FR, Koster T, Vandenbroucke JP, Reitsma PH. High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance). Blood 1995; 85: 1504-8.
- 16 de Visser MCH, Rosendaal FR, Bertina RM. A reduced sensitivity for activated protein C in the absence of factor V Leiden increases the risk of venous thrombosis. Blood 1999; 93: 1271-6.
- 17 Cripe DC, Moore KD, Kane WH. Structure of the gene for human coagulation factor V. Biochemistry 1992; 31: 3777-85.
- 18 Lunghi B, Iacoviello L, Gemmati D, Dilasio MG, Castoldi E, Pinotti M, Castaman G, Redaelli R, Mariani G, Marchetti G, Bernardi F. Detection of new polymorphic markers in the factor V gene: Association with factor V levels in plasma. Thromb Haemost 1996; 75: 45-8.
- 19 Bernardi F, Faioni EM, Castoldi E, Lunghi B, Castaman G, Sacchi E, Mannucci PM. A factor V genetic component differing from factor V R506Q contributes to the activated protein C resistance phenotype. Blood 1997; 90: 1552-7.
- 20 Alhenc-Gelas M, Nicaud V, Gandrille S, Van Dreden P, Amiral J, Aubry ML, Fiessinger JN, Emmerich J, Aiach M. The factor V gene A4070G mutation and the risk of venous thrombosis. Thromb Haemost 1999; 81: 193-7.
- 21 Castaman G, Lunghi B, Missiaglia E, Bernardi F, Rodeghiero F. Phenotypic homozygous activated protein C resistance associated with compound heterozygosity for Arg506Gln (factor V Leiden) and His1299Arg substitutions in factor V. Br J Haematol 1997; 99: 257-61.
- 22 Koster T, Rosendaal FR, de Ronde H, Briët E, Vandenbroucke JP, Bertina RM. Venous thrombosis due to poor anticoagulant response to activated protein C: Leiden Thrombophilia Study. Lancet 1993; 342: 1503-6.
- 23 Kamphuisen PW, Rosendaal FR, Eikenboom JCJ, Bos R, Bertina RM. Factor V antigen levels and venous thrombosis: Risk profile, interaction with factor V Leiden and relation with factor VIII antigen levels. Arterioscler Thromb Vasc Biol. 2000 in press.
- 24 Koster T, Blann AD, Briët E, Vandenbroucke JP, Rosendaal FR. Role of clotting factor VIII in effect of von Willebrand factor on occurrence of deep-vein thrombosis. Lancet 1995; 345: 152-5.
- 25 Bertina RM, Van der Marel-van Nieuwkoop W, Loeliger EA. Spectrophotometric assays of prothrombin in plasma of patients using oral anticoagulants. Thromb Haemost 1979; 42: 1296-305.
- 26 Koster T, Rosendaal FR, Reitsma PH, van der Velden PA, Briët E, Vandenbroucke JP. Factor VII and fibrinogen levels as risk factors for venous thrombosis: a case control study of plasma levels and DNA polymorphisms – Leiden Thrombophilia Study (LETS). Thromb Haemost 1994; 71: 719-22.
- 27 Deutz-Terlouw PP, Ballering L, van Wijngaarden A, Bertina RM. Two ELISA’s for measurement of protein S, and their use in the laboratory diagnosis of protein S deficiency. Clin Chim Acta 1989; 186: 321-34.
- 28 Amiral J, Grosley B, Boyer-Neumann C, Marfaing-Koka A, Peynaud-Debayle E, Wolf M, Meyer D. New direct assay of free protein S antigen using two distinct monoclonal antibodies specific for the free form. Blood Coagul Fibrinolysis 1994; 05: 179-86.
- 29 Wolf M, Boyer-Neumann C, Peynaud-Debayle E, Marfaing-Koka A, Amiral J, Meyer D. Clinical applications of a direct assay of free protein S antigen using monoclonal antibodies. A study of 59 cases. Blood Coagul Fibrinolysis 1994; 05: 187-92.
- 30 Koster T, Rosendaal FR, Briët E, van der Meer FJ, Colly LP, Trienekens PH, Poort SR, Reitsma PH, Vandenbroucke JP. Protein C deficiency in a controlled series of unselected outpatients: An infrequent but clear risk factor for venous thrombosis (Leiden Thrombophilia Study). Blood 1995; 85: 2756-61.
- 31 Guasch JF, Cannegieter S, Reitsma PH, Van ’t Veer-Korthof ET, Bertina RM. Severe coagulation factor V deficiency caused by a 4 bp deletion in the factor V gene. Br J Haematol 1998; 101: 32-9.
- 32 Woolf B. On estimating the relation between blood group and disease. Am J Hum Genet 1955; 19: 251-3.
- 33 de Ronde H, Bertina RM. Laboratory diagnosis of APC-resistance: A critical evaluation of the test and the development of diagnostic criteria. Thromb Haemost 1994; 72: 880-6.
- 34 Zöller B, Dahlbäck B. Linkage between inherited resistance to activated protein C and factor V gene mutation in venous thrombosis. Lancet 1994; 343: 1536-8.
- 35 Cox MJ, Rees DC, Martinson JJ, Clegg JB. Evidence for a single origin of factor V Leiden. Br J Haematol 1996; 92: 1022-5.
- 36 Zöller B, Hillarp A, Dahlbäck B. Activated protein C resistance caused by a common factor V mutation has a single origin. Thromb Res 1997; 85: 237-43.
- 37 Castoldi E, Lunghi B, Mingozzi F, Ioannou P, Marchetti G, Bernardi F. New coagulation factor V gene polymorphisms define a single and infrequent haplotype underlying the factor V Leiden mutation in Mediterranean populations and Indians. Thromb Haemost 1997; 78: 1037-41.
- 38 Lunghi B, Castoldi E, Mingozzi F, Bernardi F. A new factor V gene polymorphism (His 1254 Arg) present in subjects of African origin mimics the R2 polymorphism (His 1299 Arg). Blood 1998; 91: 364-5.
- 39 Castoldi E, Rosing J, Lunghi B, Hoekema L, Girelli D, Mingozzi F, Ferraresi P, Friso S, Corrocher R, Tans G, Bernardi F. Factor V gene mutations (R2 gene) are associated with coronary artery disease in elderly people. Thromb Haemost. 1999 Suppl: 509.
- 40 Luddington R, Jackson A, Pannerselvam S, Brown K, Baglin T. The factor V HR2 haplotype: Risk of venous thromboembolism, factor V levels and resistance to activated protein C. Thromb Haemost 1999; Suppl: 266.
- 41 Poort SR, Rosendaal FR, Reitsma PH, Bertina RM. A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 1996; 88: 3698-703.
- 42 Faioni EM, Franchi F, Bucciarelli P, Margaglione M, De Stefano V, Castaman G, Finazzi G, Casorelli I, Mannucci PM. The HR2 haplotype in the factor V gene confers an increased risk of venous thromboembolism to carriers of factor R506Q. Thromb Haemost. 1999 Suppl: 418.
- 43 Hoekema L, Nicolaes GAF, Hemker HC, Tans G, Rosing J. Human factor Va1 and factor Va2: Properties in the procoagulant and anticoagulant pathways. Biochemistry 1997; 36: 3331-5.
- 44 Hoekema L, Castoldi E, Tans G, Manzato F, Bernardi F, Rosing J. Characterization of blood coagulation factor V (a) encoded by the R2 gene. Thromb Haemost 1999; Suppl: 684.
- 45 Henkens CMA, Bom VJJ, van der Meer J. Lowered APC-sensitivity ratio related to increased factor VIII-clotting activity. Thromb Haemost 1995; 74: 1198-9.
- 46 Laffan MA, Manning R. The influence of factor VIII on measurement of activated protein C resistance. Blood Coagul Fibrinolysis 1996; 07: 761-5.
- 47 Greengard JS, Alhenc-Gelas M, Gandrille S, Emmerich J, Aiach M, Griffin JH. Pseudo-homozygous activated protein C resistance due to coinheritance of heterozygous factor V-R506Q and type I factor V deficiency associated with thrombosis. Thromb Haemost 1995; 73: 1361.
- 48 Simioni P, Scudeller A, Radossi P, Gavasso S, Girolami B, Tormene D, Girolami A. “Pseudo homozygous” activated protein C resistance due to double heterozygous factor V defects (factor V Leiden mutation and type I quantitative factor V defect) associated with thrombosis: Report of two cases belonging to two unrelated kindreds. Thromb Haemost 1996; 75: 422-6.
- 49 Zehnder JL, Jain M. Recurrent thrombosis due to compound heterozygosity for factor V Leiden and Factor V deficiency. Blood Coagul Fibrinolysis 1996; 07: 361-2.
- 50 Guasch JF, Lensen RPM, Bertina RM. Molecular characterization of a type I quantitative factor V deficiency in a thrombosis patient that is “pseudo homozygous” for activated protein C resistance. Thromb Haemost 1997; 77: 252-7.