Identification and functional characterization of a novel splicing variant in the F8 coagulation gene causing severe hemophilia A.


Journal

Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508

Informations de publication

Date de publication:
05 2020
Historique:
received: 25 06 2019
revised: 30 01 2020
accepted: 10 02 2020
pubmed: 23 2 2020
medline: 15 5 2021
entrez: 21 2 2020
Statut: ppublish

Résumé

We have identified a synonymous F8 variation in a severe hemophilia A (HA) patient who developed inhibitors following factor VIII (FVIII) prophylaxis. The unreported c.6273 G > A variant targets the consensus splicing site of exon 21. To determine the impact of c.6273 G > A nucleotide substitution on F8 splicing and its translated protein. Patient peripheral blood mononuclear cells were isolated and differentiated into monocyte-derived macrophages (MDMs). FVIII distribution in cell compartments was evaluated by immunofluorescence. The splicing of mutated exon 21 was assessed by exon trapping. Identified FVIII splicing variants were generated by site-directed mutagenesis, inserted into a lentiviral vector (LV) to transduce Chinese hamster ovary (CHO) cells, and inject into B6/129 HA-mice. FVIII activity was assessed by activated partial thromboplastin time, whereas anti-FVIII antibodies and FVIII antigen, by ELISA. HA-MDMs demonstrated a predominant retention of FVIII around the endoplasmic reticulum. Exon trapping revealed the production of two isoforms: one retaining part of intron 21 and the other skipping exon 21. These variants, predicted to truncate FVIII in the C1 domain, were detected in the patient. CHO cells transduced with the two FVIII transcripts confirmed protein retention and absence of the C2 domain. HA mice injected with LV carrying FVIII mutants, partially recovered FVIII activity without the appearance of anti-FVIII antibodies. Herein, we demonstrate the aberrant impact of a FVIII synonymous mutation on its transcription, activity, and pathological outcomes. Our data underline the importance of increasing the knowledge regarding the functional consequences of F8 mutations and their link to inhibitor development and an effective replacement therapy.

Sections du résumé

BACKGROUND
We have identified a synonymous F8 variation in a severe hemophilia A (HA) patient who developed inhibitors following factor VIII (FVIII) prophylaxis. The unreported c.6273 G > A variant targets the consensus splicing site of exon 21.
OBJECTIVES
To determine the impact of c.6273 G > A nucleotide substitution on F8 splicing and its translated protein.
METHODS
Patient peripheral blood mononuclear cells were isolated and differentiated into monocyte-derived macrophages (MDMs). FVIII distribution in cell compartments was evaluated by immunofluorescence. The splicing of mutated exon 21 was assessed by exon trapping. Identified FVIII splicing variants were generated by site-directed mutagenesis, inserted into a lentiviral vector (LV) to transduce Chinese hamster ovary (CHO) cells, and inject into B6/129 HA-mice. FVIII activity was assessed by activated partial thromboplastin time, whereas anti-FVIII antibodies and FVIII antigen, by ELISA.
RESULTS
HA-MDMs demonstrated a predominant retention of FVIII around the endoplasmic reticulum. Exon trapping revealed the production of two isoforms: one retaining part of intron 21 and the other skipping exon 21. These variants, predicted to truncate FVIII in the C1 domain, were detected in the patient. CHO cells transduced with the two FVIII transcripts confirmed protein retention and absence of the C2 domain. HA mice injected with LV carrying FVIII mutants, partially recovered FVIII activity without the appearance of anti-FVIII antibodies.
CONCLUSIONS
Herein, we demonstrate the aberrant impact of a FVIII synonymous mutation on its transcription, activity, and pathological outcomes. Our data underline the importance of increasing the knowledge regarding the functional consequences of F8 mutations and their link to inhibitor development and an effective replacement therapy.

Identifiants

pubmed: 32078252
doi: 10.1111/jth.14779
pii: S1538-7836(22)00322-1
doi:

Substances chimiques

Factor VIII 9001-27-8

Banques de données

GENBANK
['NM_000132.3']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1050-1064

Informations de copyright

© 2020 International Society on Thrombosis and Haemostasis.

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Auteurs

Rosella Famà (R)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Ester Borroni (E)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Diego Zanolini (D)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Simone Merlin (S)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Valentina Bruscaggin (V)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Gillian E Walker (GE)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Cristina Olgasi (C)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Deepak Babu (D)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Jacopo Agnelli Giacchello (J)

Hemostasis and Thrombosis Unit, Città Della Salute e Della Scienza, Molinette, Turin, Italy.

Federica Valeri (F)

Hemostasis and Thrombosis Unit, Città Della Salute e Della Scienza, Molinette, Turin, Italy.

Mara Giordano (M)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

Alessandra Borchiellini (A)

Hemostasis and Thrombosis Unit, Città Della Salute e Della Scienza, Molinette, Turin, Italy.

Antonia Follenzi (A)

Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.

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