2. Academic Validation
  3. Mutation Ter462GlnextTer17 introduces a tail to C-terminus of protein C and causes venous thrombosis

Mutation Ter462GlnextTer17 introduces a tail to C-terminus of protein C and causes venous thrombosis

  • Thromb Res. 2024 May 29:240:109044. doi: 10.1016/j.thromres.2024.109044.
Zhe Lai 1,  Jiaming Li 2,  Shijie Zhou 1,  Xi Wu 1,  Junwei Yuan 1,  Fang Li 3,  Wenman Wu 1,  Qiulan Ding 1,  Jing Dai 1,  Xuefeng Wang 4,  Yeling Lu 5,  Xiaohong Cai 6
Affiliations

Affiliations

  • 1 Department of Laboratory Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
  • 2 Department of Laboratory Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Transfusion Department, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
  • 3 State Key Laboratory of Microbial Metabolism & Joint International Research Laboratory of Metabolic and Developmental Sciences, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.
  • 4 Department of Laboratory Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Electronic address: wxf63@shsmu.edu.cn.
  • 5 Department of Laboratory Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Electronic address: yeling-lu@shsmu.edu.cn.
  • 6 Department of Laboratory Medicine, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; Transfusion Department, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Electronic address: cxh8407@shsmu.edu.cn.
PMID: 38824799 DOI: 10.1016/j.thromres.2024.109044
Abstract

Protein C (PC), a vitamin K-dependent serine Protease zymogen in plasma, can be activated by thrombin-thrombomodulin(TM) complex, resulting in the formation of activated protein C (APC). APC functions to downregulate Thrombin generation by inactivating active coagulation factors V(FVa) and VIII(FVIIIa). Deficiency in PC increases the risk of venous thromboembolism (VTE). We have identified two unrelated VTE patients with the same heterozygous mutation (c.1384 T > C, p.Ter462GlnextTer17) in PROC. To comprehend the role of this mutation in VTE development, we expressed recombinant PC-Ter462GlnextTer17 in mammalian cells and evaluated its characteristics using established coagulation assay systems. Functional studies revealed a significant impairment in the activation of the mutant by Thrombin or thrombin-TM complex. Furthermore, APC-Ter462GlnextTer17 demonstrated diminished hydrolytic activity towards the chromogenic substrate S2366. APTT and FVa degradation assays showed that both the anticoagulant activity of the mutant protein was markedly impaired, regardless of whether protein S was present or absent. These results were further supported by a Thrombin generation assay conducted using purified and plasma-based systems. In conclusion, the Ter462GlnextTer17 mutation introduces a novel tail at the C-terminus of PC, leading to impaired activity in both PC zymogen activation and APC's anticoagulant function. This impairment contributes to thrombosis in individuals carrying this heterozygous mutation and represents a genetic risk factor for VTE.

Keywords

Anticoagulant; Mutation; Protein C; Thrombosis.

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