Caracterização molecular da deficiencia de proteina S

AUTOR(ES)
DATA DE PUBLICAÇÃO

1998

RESUMO

Human protein S is a plasmatic vitamin-K dependent glicoprotein that acts as a non-enzimatic cofactor of activated protein C in the protein C anticoagulant pathway. In addition to this protein S has an independent role that activated protein C, which is to inactivate factors Va and Xa. The plasmatic concentration of protein S is regulated by a C4b binding protein that acts on the Complement Classical Pathway. C4b protein forms inactive complexes with approximately 60% of total protein S, and only the free form of protein S its can act as a cofactor of activated protein C. The hereditary deficiency of protein S is a common cause of recurrent venous thrombosis, and occurs due to the decrease of the anticoagulant activity of protein S. It is a relatively rare disease and it has a dominant autossomic hereditary patteFI1. The gene which controls the production of protein S (PROS1) is Ipcated in chromosome 3, near the centromer region at position 3p11.1 - 3q11.2. It is formed by 15 exons and 14 introns comprising a region of over 80kb, which originates a mRNA of 3,5 to 4,0 kb. In this same region of chromosome 3 there is a pseudogene (PROS2) which is 97% homologous to the codifying region of the active gene. According to the protein S gene mutation database published by GANDRILLE et aI., 71 different point mutations were described, 19.8% were nonsense mutations, 65,3% were missense mutations, 12,8% were splice site mutations, and 2% abolished the natural codon termination of the protein. Sixteen different insertions/deletions and two large deletions were also described. A total of twelve rare polymorphisms were described including the Heerlen polymorphism and a frequent polymorphism, the neutral dimorphism CCA/CCG. The SSCP and CSGE analysis permit the quick and efficient screening of the mutations. Direct DNA sequencing permit the precise determination of the molecular alteration responsible for the disease. In this study these methods were used in the study of protein S gene (PROS1) of eight patients with protein S deficiency which presented spontaneous thrombosis. Other deficiencies which predispose to thrombosis were evaluated but were not detected. With the use of this methodology it was possible to detect and identify seven point mutations in four of the eight patients studied, including a silent mutation in addition to a polymorphism in another patient. Of the mutation found only one was detected by the SSCP method. Considering the clinical and laboratory data of the patients studied, together with the analysis of the family, the results of this study suggest that the mutations identified are responsible for the hereditary protein S deficiency. The identification of the mutations and its correlation to the clinical data of the patients studied contribute to the comprehension of the structural-functional relation of this protein. The frequencies of the Heerlen polymorphism and the neutral dimorphism CCA/CCG, in different groups of the Brazilian population (newborns, caucasoides, Black population, Indians and patients with thrombosis) were also determined. The results obtained in the different groups studied, for Heerlen polymorphism, did not differ significantly from those described previously in the literature by BERTINA et al, 1990. This polymorphism was not identified in any of the patients studied. The allelic frequencies of the neutral dismorphism CCA/CCG do not differ significantly from those described in literature by DIEPSTRATEN, et aI., 1991 and GANDRILLE et aI., 1995. Our results revealed that the miscigenation may have occurred in the Black population, in spite of being considered as a genetic isolate, showed a predomination of the heterozygous genotype. The CCA/CCG polymorphism was also used to analyze the segregation in families with protein S deficiency and was informative in three families that were analyzed

ASSUNTO(S)

mutação (biologia) doenças hereditarias genetica humana trombose

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