Molecular defects in CRM+ factor VII deficiencies: modelling of missense mutations in the catalytic domain of FVII

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<jats:p><jats:bold>Summary. </jats:bold> The molecular defects causing CRM+ factor VII deficiency were investigated in seven unrelated subjects and several members of their families.</jats:p><jats:p>Four missense mutations located in the catalytic domain of factor VII were found. The previously reported <jats:sup>304</jats:sup>ArgGln substitution was present in the homozygous and heterozygous forms, with different polymorphic haplotypes, thus demonstrating that it is recurrent and frequent in the Italian population. The <jats:sup>310</jats:sup>Cys Phe substitution was found in the homozygous form and in the compound heterozygous condition with the nonsense mutation <jats:sup>356</jats:sup>Trpstop. Two missense mutations, <jats:sup>298</jats:sup>MetIle and <jats:sup>342</jats:sup>GlyArg, were found in the homozygous and in the heterozygous condition respectively.</jats:p><jats:p>Molecular heterogeneity was further increased by finding of the <jats:sup>353</jats:sup>ArgGln polymorphism in the doubly heterozygous condition with the 304 and 342 mutations.</jats:p><jats:p>Plausible explanations for loss of FVII function were found by inspecting a model of the serine protease domain of factor VIIa. Inefficient activation of the catalytic site is predicted for <jats:sup>298</jats:sup>MetIle. <jats:sup>342</jats:sup>GlyArg would directly distort the geometry of the ‘oxyanion hole’preventing formation of a substrate enzyme intermediate. <jats:sup>310</jats:sup>Cyshe is predicted to have an adverse effect on tissue factor interaction. These mutations point to important regions of the factor VII molecule.</jats:p>

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