A novel deletion mutation is recurrent in von Willebrand disease types 1 and 3

Author:

Sutherland Megan S.1,Cumming Anthony M.1,Bowman Mackenzie2,Bolton-Maggs Paula H. B.1,Bowen Derrick J.3,Collins Peter W.3,Hay Charles R. M.1,Will Andrew M.4,Keeney Stephen1

Affiliation:

1. University Department of Haematology, Manchester Royal Infirmary, Manchester, United Kingdom;

2. Pathology and Molecular Medicine, Queen's University, Kingston, ON;

3. Department of Haematology, School of Medicine, Cardiff University, Cardiff, United Kingdom; and

4. Department of Haematology, Royal Manchester Children's Hospital, Manchester, United Kingdom

Abstract

Direct sequencing of VWF genomic DNA in 21 patients with type 3 von Willebrand disease (VWD) failed to reveal a causative homozygous or compound heterozygous VWF genotype in 5 cases. Subsequent analysis of VWF mRNA led to the discovery of a deletion (c.221-977_532 + 7059del [p.Asp75_Gly178del]) of VWF in 7 of 12 white type 3 VWD patients from 6 unrelated families. This deletion of VWF exons 4 and 5 was absent in 9 patients of Asian origin. We developed a genomic DNA-based assay for the deletion, which also revealed its presence in 2 of 34 type 1 VWD families, segregating with VWD in an autosomal dominant fashion. The deletion was associated with a specific VWF haplotype, indicating a possible founder origin. Expression studies indicated markedly decreased secretion and defective multimerization of the mutant VWF protein. Further studies have found the mutation in additional type 1 VWD patients and in a family expressing both type 3 and type 1 VWD. The c.221-977_532 + 7059del mutation represents a previously unreported cause of both types 1 and 3 VWD. Screening for this mutation in other type 1 and type 3 VWD patient populations is required to elucidate further its overall contribution to VWD arising from quantitative deficiencies of VWF.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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