Structural Conformation and the Binding of Factor VIII R2159C (FVIII-Ise) Mutated in the C1 Domain to Phospholipid

Kuniyoshi Mizumachi1, Masahiro Takeyama1,2, Kaoru Horiuchi1

  • 1Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan.

PubMed

Insights

The R2159C mutation in Factor VIII (FVIII) affects its binding to phospholipids and antibodies, despite normal interactions with other clotting factors. This suggests subtle conformational changes influence FVIII function in hemophilia A.

Area of Science:

  • Biochemistry
  • Molecular Biology
  • Hematology

Background:

  • A previously identified Factor VIII (FVIII) mutation (R2159C) in the C1 domain was associated with undetectable FVIII antigen (FVIII:Ag).
  • This mutation, termed FVIII-Ise, presented with mild hemophilia A, where FVIII:C correlated with FVIII:Ag measured by specific monoclonal antibodies (mAbs).
  • The findings suggested the R2159C mutation altered the antigenicity of the FVIII C2 domain.

Purpose of the Study:

  • To investigate the functional and structural characteristics of the FVIII-R2159C mutant.
  • To understand how the R2159C mutation impacts FVIII's interactions and overall function.

Main Methods:

  • Recombinant FVIII-R2159C mutant was prepared and analyzed using enzyme-linked immunosorbent assays (ELISAs) with specific antibodies.
  • Kinetic parameters (Km) for interactions with Factor IXa (FIXa) and Factor X (FX) were determined.
  • Cleavage reactions by thrombin and FXa were assessed.
  • Binding affinity to phospholipids and von Willebrand factor (vWF) was measured.
  • In silico molecular dynamic simulations were performed.

Main Results:

  • ELISAs confirmed a 56% lower antigen level for FVIII-R2159C compared to wild-type (WT) using an anti-C2 domain alloantibody.
  • The anti-C2 alloantibody binding was competitively inhibited by FVIII and an anti-C1 domain mAb, indicating shared epitopes.
  • FVIII-R2159C exhibited similar Km values for FIXa and FX, and comparable cleavage patterns to FVIII-WT.
  • A moderately increased dissociation constant (Kd) for phospholipid binding was observed for FVIII-R2159C, while vWF binding remained unchanged.
  • Molecular dynamic simulations revealed subtle structural differences between FVIII-WT and FVIII-R2159C.

Conclusions:

  • The R2159C mutation does not alter FVIII's interactions with FIXa, FX, or thrombin.
  • Reduced binding to phospholipids and a specific anti-C1/C2 domain alloantibody is associated with the R2159C mutation.
  • These functional alterations are likely due to subtle changes in the conformational structure of FVIII.

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