Molecular detection of a common mutation in coagulation factor v causing thrombosis via hereditary resistance to activated protein c

Xiao Yuan Liu, Diana Nelson, Chris Grant, Virginia Morthland, Scott H. Goodnight, Richard D. Press

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

More than half of all patients with familial or recurring venous thrombosis have hereditary resistance to activated protein C (HRAPC) as the result of a specific mis- sense mutation in the gene for coagulation factor V Because the mutant factor Va (with an Arg to Gin substitution at codon 506) cannot be cleaved and inactivated by activated protein C. carriers of this mutation are at significantly increased risk of venous thrombosis. We have recently introduced a direct polymerase chain reaction (PCR)-based clinical diagnostic test for the factor V codon 506 mutation based on the destruction of an Mnl I restriction site by the causative nucleotide substitution. To assess the accuracy of this PCR-based assay, we compared a functional clotting time test for HRAPC with the direct mutation test. Of 47 patients dually tested, only five had discrepant values for the functional test versus the DNA test. Either of these two complementary assays is useful for the accurate diagnosis of HRAPC. The DNA- based test is, however, specifically recommended for evaluation of anticoagulated patients or patients with borderline functional tests and confirmation of genotype in HRAPC families. In an additional analysis of 287 normal individuals, we found an extremely high prevalence of the mutated codon 506 allele—-4% in each of two different populations. The absence of disease in the majority of heterozygous carriers suggests that symptomatic thrombosis requires the simultaneous presence of both a mutated factor V protein and additional synergistic factors.

Original languageEnglish (US)
Pages (from-to)191-197
Number of pages7
JournalDiagnostic Molecular Pathology
Volume4
Issue number3
DOIs
StatePublished - Sep 1995

Keywords

  • Activated protein C resistance
  • Factor V
  • Mutation
  • Polymerase chain reaction
  • Protein C
  • Thrombosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Molecular Biology
  • Cell Biology

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