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von Willebrand factor mutation enhancing interaction with platelets in patients with normal multimeric structure

L Holmberg1, J A Dent, R Schneppenheim

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|May 1, 1993
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Summary

Researchers identified a specific mutation (Pro503Leu) in the von Willebrand factor gene responsible for a variant form of von Willebrand disease, leading to enhanced platelet aggregation. This finding clarifies the molecular basis of this bleeding disorder.

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Area of Science:

  • Hematology
  • Molecular Biology
  • Genetics

Background:

  • Variant von Willebrand disease (vWD) types I New York/Malmö exhibit increased ristocetin-induced platelet agglutination.
  • Normal von Willebrand factor (vWF) multimeric distribution in plasma is observed in these variants.
  • The underlying molecular defect in these vWD variants was previously uncharacterized.

Purpose of the Study:

  • To elucidate the molecular basis of variant von Willebrand disease characterized by enhanced platelet agglutination.
  • To identify the specific genetic mutation responsible for the Pro503Leu alteration in the von Willebrand factor.

Main Methods:

  • Genetic analysis of four patients from three families with variant vWD.
  • DNA sequencing to identify nucleotide changes in the von Willebrand factor gene and pseudogene.
  • Analysis of platelet mRNA-derived cDNA.
  • Recombinant expression of the von Willebrand factor glycoprotein Ib-binding domain.

Main Results:

  • A consistent cytosine-to-thymine transition (Pro503Leu) was identified in the von Willebrand factor gene of all patients.
  • A silent mutation (Ser500) was present in three of the four patients.
  • Recombinant expression confirmed that the Pro503Leu mutation enhances platelet reactivity to ristocetin.

Conclusions:

  • The Pro503Leu mutation in the von Willebrand factor gene is the molecular cause of this variant vWD.
  • This mutation alters a structural element affecting von Willebrand factor's affinity for glycoprotein Ib.
  • Establishes the molecular basis for enhanced platelet aggregation in this specific vWD type.