Thromb Haemost 1988; 59(03): 468-473
DOI: 10.1055/s-0038-1647517
Original Article
Schattauer GmbH Stuttgart

Antithrombin Oslo: Type Ib Classification of the First Reported Antithrombin-Deficient Family, with a Review of Hereditary Antithrombin Variants

Mae B Hultin
*   The Division of Hematology, Dept. of Medicine, State University of New York at Stony Brook, the Veterans Administration Medical Center, Northport, NY, USA
,
John McKay
**   The Immunology Dept., Aukland Hospital Aukland, New Zealand
,
Ulrich Abildgaard
***   The Medicine Dept. A, Aker Hospital, Oslo, Norway
› Author Affiliations
Further Information

Publication History

Received 15 June 1987

Accepted after revision 19 February 1988

Publication Date:
29 June 2018 (online)

Summary

Patients with classical antithrombin deficiency (Type I) from seven unrelated kindreds were studied by crossed immunoelectrophoresis of plasma in the presence and absence of heparin. The only abnormal pattern was found in the kindred first reported by Egeberg in 1965. An abnormal cathodal peak of antithrombin antigen was found in the presence, but not the absence, of heparin in the first dimension gel. We have named this variant antithrombin Oslo. Such evidence of an abnormal protein, despite equivalent low levels of antithrombin antigen and activity, has been denoted previously by Sas as Type Ib deficiency. In the context of this new report, we review the literature to date on 33 other variants of the Types Ib, II and III subclassifications with a discussion of the value of the classification scheme.

 
  • References

  • 1 Egeberg O. Inherited antithrombin deficiency causing thrombophilia. Thromb Diathes Haemorrh 1965; 13: 516-530
  • 2 Abildgaard U, Fagerhold MK, Egeberg O. Comparison of progressive antithrombin activity and the concentrations of three thrombin inhibitors in human plasma. Scand J Clin Lab Invest 1970; 26: 349-354
  • 3 Nagy I, Losonczy H, Szaksz I, Temesi C, Hergert K. An analysis of clinical and laboratory data in patients with congenital antithrombin III (ATIII) deficiency. Acta Med Hung 1979; 36: 53-60
  • 4 Sas G, Blaskó G, Bánhegyi D, Jákó J, Pálos LA. Abnormal antithrombin III (Antithrombin III “Budapest”) as a cause of a familial thrombophilia. Thromb Diathes Haemorrh 1974; 32: 105-115
  • 5 Sas G, Köves A, Petö I, Domján G. On the inheritance of the abnormal antithrombin III (“AT-III Budapest”). Thromb Haemostas 1978; 39: 530-532
  • 6 SØrensen PJ, Sas G, Petö I, Blaskó G, Kremmer T, Samu A. Distinction of two pathologic antithrombin III molecules: antithrombin III “Aalborg” and antithrombin III “Budapest”. Thromb Res 1982; 26: 211-212
  • 7 SØrensen PJ, Dyerberg J, Stoffersen E, Krogh JensenM. Familial functional antithrombin III deficiency. Scand J Haematol 1980; 24: 105-109
  • 8 Barbui T, Rodeghiero F. Hereditary dysfunctional antithrombin III (AT-III Vicenza). Thromb Haemostas 1981; 45: 97
  • 9 Barbui T, Finazzi G, Rodeghiero F, Dini E. Immunoelectrophoretic evidence of a thrombin-induced abnormality in a new variant of hereditary dysfunctional antithrombin III (AT III “Vicenza”). Br J Haematol 1983; 54: 561-565
  • 10 Finazzi G, Tran TH, Barbui T, Duckert F. Purification of antithrombin “Vicenza”: a molecule with normal heparin affinity and impaired reactivity to thrombin. Br J Haematol 1985; 59: 259-263
  • 11 Girolami A, Marafioti F, Rubertelli M, Vicarioto MA, Cappellato G, Mazzuccato M. A “new” congenital AT III abnormality with a peculiar crossed-immunoelectrophoretic pattern in the absence of heparin. Acta Haematol 1984; 72: 73-82
  • 12 Brozović M, Stirling Y, Hamlyn AN. Thrombotic tendency and probable antithrombin III deficiency. Thromb Haemostas 1978; 39: 778-779
  • 13 Samson D, Stirling Y, Woolf L, Howarth D, Seghatchian MJ, de Chazal R. Management of planned pregnancy in a patient with congenital antithrombin III deficiency. Br J Haematol 1984; 56: 243-249
  • 14 Howarth DJ, Samson D, Stirling Y, Seghatchian MJ. Antithrombin III “Northwick Park”: a variant antithrombin with normal affinity for heparin but reduced heparin cofactor activity. Thromb Haemostas 1985; 53: 314-319
  • 15 Lane DA, Flynn A, Ireland H, Erdjument H, Samson D, Howarth D, Thompson E. Antithrombin III Northwick Park: demonstration of an inactive high MW complex with increased affinity for heparin. Br J Haematol 1987; 65: 451-456
  • 16 Stephens AW, Thalley BS, Hirs CH W. Antithrombin-III Denver, a reactive site variant. J Biol Chem 1987; 262: 1044-1048
  • 17 Sambrano JE, Jacobson LJ, Reeve EB, Manco-Johnson MJ, Hathaway WE. Abnormal antithrombin III with defective serine protease binding (Antithrombin III “Denver”). J Clin Invest 1986; 77: 887-893
  • 18 Murayama H, Matsuda M. Abnormal antithrombin III with defective biological and immunological functions found in a thrombophilic patient-“Antithrombin III Tokyo”. Thromb Haemostas 1983; 50: 358 (Abstr)
  • 19 Mortensen JZ. Inherited AT-III deficiency: fast and slow inactivation of thrombin and factor Xa. Thromb Res 1984; 33: 511-515
  • 20 JØrgensen M, Petersen LC, Thorsen S. Purification and characterization of hereditary abnormal antithrombin III with impaired thrombin binding. J Lab Clin Med 1984; 104: 245-256
  • 21 Boyer C, Tripodi A, Wolf M, Mannucci PM, Larrieu MJ. A new familial variant of antithrombin III: “Antithrombin III Milano”. Thromb Haemostas 1983; 50: 51 (Abstr)
  • 22 Wolf M, Boyer C, Tripodi A, Meyer D, Larrieu MJ, Mannucci PM. Antithrombin Milano: A new variant with monomeric and dimeric inactive antithrombin III. Blood 1985; 65: 496-500
  • 23 Bauer KA, Ashenhurst JB, Chediak J, Rosenberg RD. Antithrombin “Chicago”: A functionally abnormal molecule with increased heparin affinity causing familial thrombophilia. Blood 1983; 62: 1242-1250
  • 24 Tengborn L, Frohm B, Nilsson LE, Nilsson IM. A Swedish family with abnormal antithrombin III. Scand J Haematol 1985; 34: 412-416
  • 25 Aiach M, Nora M, Fiessinger JN, Roncato M, Francois D, Gelas MA. A functional abnormal antithrombin III (AT III) deficiency: AT III Charleville. Thromb Res 1985; 39: 559-570
  • 26 Tripodi A, Krachmalnicoff A, Mannucci PM. Characterization of an abnormal antithrombin (Milano 2) with defective thrombin binding. Thromb Haemostas 1986; 56: 349-352
  • 27 Carter CJ, Johnston M, Brain MC, Glynn MF X. A new antithrombin-III variant presenting as familial thrombophilia. Blood 1981; 58: 231 (Abstr)
  • 28 Devra-Kizuk R, Prochownik EV, Chui DH K, Blajchman MA. Molecular pathology of a mutant antithrombin III gene, AT III Hamilton. Blood 1986; 68: 345 (Abstr)
  • 29 Leone G, de Stefano V, Di Donfrancesco A, Ferrelli R, Traisci G, Bizzi B. Antithrombin III Pescara: a defective AT III variant with no alterations of plasma crossed Immunoelectrophoresis, but with an abnormal crossed immunoelectrofocusing pattern. Br J Haematol 1987; 65: 187-191
  • 30 Lane DA, Lowe GD O, Flynn A, Thompson E, Ireland H, Erdjument H. Antithrombin III Glasgow: a variant with increased heparin affinity and reduced ability to inactivate thrombin, associated with familial thrombosis. Br J Haematol 1987; 66: 523-527
  • 31 Penner JA, Hassouna H, Hunter MJ, Chockley M. A clinically silent antithrombin III defect in an Ann Arbor family. Thromb Haemostas 1979; 42: 186 (Abstr)
  • 32 Tran TH, Bounameaux H, Bondeli C, Honkanen H, Marbet GA, Duckert F. Purification and partial characterization of a hereditary abnormal antithrombin III fraction of a patient with recurrent thrombophlebitis. Thromb Haemostas 1980; 44: 87-91
  • 33 Tran TH, Bondeli C, Marbet GA, Duckert F. Reactivity of a hereditary abnormal antithrombin III fraction in the inhibition of thrombin and factor Xa. Thromb Haemostas 1980; 44: 92-95
  • 34 Chang JY, Tran TH. Identification of a pro-leu substitution in a hereditary abnormal antithrombin with impaired heparin cofactor activity. J Biol Chem 1986; 261: 1174-1176
  • 35 Wolf M, Boyer C, Lavergne JM, Larrieu MJ. A new familial variant of antithrombin III: “Antithrombin III Paris”. Br J Haematol 1982; 51: 285-295
  • 36 Girolami A, Pengo V, Cappellato G, Vianello C, Procidano M, Cartei C. Antithrombin III Padua: A “new” congenital antithrombin III abnormality with normal or near normal activity, normal antigen, abnormal migration and no thrombotic disease. Folia Haematol 1983; 110: 98-111
  • 37 Girolami A, Fabris F, Cappellato G, Sainati L, Boeri G. Antithrombin III (AT III) Padua2: a “new” congenital abnormality with defective heparin co-factor activities but no thrombotic disease. Blut 1983; 47: 93-103
  • 38 Koide T, Takahashi K, Odani S, Ono T, Sakuragawa N. Isolation and characterization of a hereditary abnormal antithrombin III “Antithrombin III Toyama”. Thromb Res 1983; 31: 319-328
  • 39 Koide T, Odani S, Takahashi K, Ono T, Sakuragawa N. Antithrombin III Toyama: replacement of arginine-47 by cysteine in hereditary abnormal antithrombin III that lacks heparin-binding ability. Proc Natl Acad Sci USA 1984; 81: 289-293
  • 40 Fischer AM, Gazengel C, Dautzenberg MD, Benhammo J, Béguin S, Vergoz D. A new case of abnormal antithrombin III (AT III): biological characteristics and thromboembolic accidents management. Thromb Haemostas 1983; 50: 358 (Abstr)
  • 41 Duchange N, Chasse J-F, Cohen GN, Zakin MM. Molecular characterization of the antithrombin III Tours deficiency. Thromb Res 1987; 45: 115-121
  • 42 Duchange N, Chasse J-F, Cohen GN, Zakin MM. Antithrombin III Tours gene: identification of a point mutation leading to an arginine- cysteine replacement in a silent deficiency. Nucleic Acids Res 1986; 14: 2408
  • 43 Fischer AM, Sternberg C, Dautzenberg MD, Mériane F, Béguin S, Cornu P. Comparative effect of heparin and heparan sulfate on a new abnormal antithrombin III. Thromb Haemostas 1985; 54: 49 (Abstr)
  • 44 Fischer AM, Cornu P, Sternberg C, Mériane F, Dautzenberg MD, Chafa O, Béguin S, Desnos M. Antithrombin III Alger: a new homozygous AT III variant. Thromb Haemostas 1986; 55: 218-221
  • 45 Brunei F, Duchange N, Fischer A-M, Cohen GN, Zakin MM. Antithrombin III Alger: a new case of arg 47→cys mutation. Am J Hematol 1987; 25: 223-224
  • 46 Boyer C, Wolf M, Vedrenne J, Meyer D, Larrieu MJ. Homozygous variant of antithrombin III: AT III Fontainebleau. Thromb Haemostas 1986; 56: 18-22
  • 47 de Moerloose PA, Reber G, Vernet Ph, Minazio Ph, Bouvier CA. Antithrombin III Geneva: a hereditary abnormal AT III with defective heparin cofactor activity. Thromb Haemostas 1987; 57: 154-157
  • 48 Aiach M, Francois D, Priollet P, Capron L, Roncato M, Alhene-Gelas M, Fiessinger J-N. An abnormal antithrombin III (AT III) with low heparin affinity: AT III Clichy. Br J Haematol 1987; 66: 515-522
  • 49 Owen MC, Borg JY, Soria C, Soria J, Caen J, Carrell RW. Heparin binding defect in a new antithrombin III variant: Rouen, 47 arg to his. Blood 1987; 69: 1275-1279
  • 50 Sas G, Petö I, Bánhegyi D, Blaskó G, Domján G. Heterogeneity of the “classical” antithrombin III deficiency. Thromb Haemostas 1980; 43: 133-136
  • 51 Leone G, Cotumaccio R, DeStefano V, Zannetti L. Antithrombin III Roma: a familial quantitative-qualitative AT-III deficiency identifiable by crossed immunoelectrofocusing and by crossed Immunoelectrophoresis. Haematologica (Pavia) 1983; 68: 765-774
  • 52 Leone G, DeStefano V, DeMartini D, Bizzi B. Antithrombin III Roma: further evidence that defective binding to heparin is related to a pH 4.65–4.8 isoantithrombin. Thromb Haemostas 1985; 54: 25 (Abstr)
  • 53 Gomperts ED, Feesey M, Van der Walt JD. Two dimensional immunoelectrophoretic studies in anti-thrombin III deficiency. Thromb Res 1976; 8: 713-718
  • 54 Cosgriff TM, Bishop DT, Hershgold EJ, Skolnick MH, Martin BA, Baty BJ, Carlson KS. Familial antithrombin III deficiency: its natural history, genetics, diagnosis and treatment. Medicine 1983; 62: 209-220
  • 55 Bock SC, Harris JF, Schwartz CE, Ward JH, Hershgold EJ, Skolnick MH. Hereditary Thrombosis in a Utah kindred is caused by a dysfunctional antithrombin III gene. Am J Hum Genet 1985; 37: 32-41
  • 56 Bock SC, Marrinan JA. Antithrombin III-Utah: identification of a pro to leu mutation in a highly conserved region near the thrombin reactive site. Am J Hum Genet 1985; 37: 145
  • 57 Hultin MB. Studies of factor IX concentrate therapy in hemophilia. Blood 1983; 62: 677-684
  • 58 Hultin MB, Abildgaard U. Antithrombin antigen of high molecular weight associated with neoantigen in hemophilic plasma after factor IX concentrate therapy. Thromb Res 1987; 45: 175-182
  • 59 Sas G. Hereditary antithrombin III deficiency: biochemical aspects. Haematologia 1984; 7: 81-86
  • 60 Girolami A. The incidence of thrombotic manifestations in AT III abnormalities. Thromb Haemostas 1987; 57: 123
  • 61 Finazzi G, Caccia R, Barbui T. Different prevalence of thromboembolism in the subtypes of congenital antithrombin III deficiency: review of 404 cases. Thromb Haemostas 1987; 58: 1094