Severe Factor VII Deficiency Due to a Mutation Disrupting a Hepatocyte Nuclear Factor 4 Binding Site in the Factor VII Promoter

DOI PDF 3 Citations
  • Arnaldo A. Arbini
    From the Hematology-Oncology Section, Department of Medicine, Brockton-West Roxbury Department of Veterans Affairs Medical Center, and Beth Israel Hospital, Harvard Medical School, Boston, MA; the Departments of Pediatrics and Pathology and Laboratory Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, PA; and the Genetics Program, Eastern Maine Medical Center, Bangor, ME.
  • Eleanor S. Pollak
    From the Hematology-Oncology Section, Department of Medicine, Brockton-West Roxbury Department of Veterans Affairs Medical Center, and Beth Israel Hospital, Harvard Medical School, Boston, MA; the Departments of Pediatrics and Pathology and Laboratory Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, PA; and the Genetics Program, Eastern Maine Medical Center, Bangor, ME.
  • Janet K. Bayleran
    From the Hematology-Oncology Section, Department of Medicine, Brockton-West Roxbury Department of Veterans Affairs Medical Center, and Beth Israel Hospital, Harvard Medical School, Boston, MA; the Departments of Pediatrics and Pathology and Laboratory Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, PA; and the Genetics Program, Eastern Maine Medical Center, Bangor, ME.
  • Katherine A. High
    From the Hematology-Oncology Section, Department of Medicine, Brockton-West Roxbury Department of Veterans Affairs Medical Center, and Beth Israel Hospital, Harvard Medical School, Boston, MA; the Departments of Pediatrics and Pathology and Laboratory Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, PA; and the Genetics Program, Eastern Maine Medical Center, Bangor, ME.
  • Kenneth A. Bauer
    From the Hematology-Oncology Section, Department of Medicine, Brockton-West Roxbury Department of Veterans Affairs Medical Center, and Beth Israel Hospital, Harvard Medical School, Boston, MA; the Departments of Pediatrics and Pathology and Laboratory Medicine, University of Pennsylvania and The Children's Hospital of Philadelphia, PA; and the Genetics Program, Eastern Maine Medical Center, Bangor, ME.

Description

<jats:title>Abstract</jats:title><jats:p>Although small deletions, splice site abnormalities, missense, and nonsense mutations have been identified in patients with factor VII deficiency, there have been no reports of mutations in the factor VII promoter. We investigated a girl with factor VII levels that were less than 1% of normal in association with a severe bleeding diathesis. The patient is homozygous for a T to G transversion that occurs 61 bp before the translation start site. This nucleotide is in a sequence that is an hepatocyte nuclear factor 4 (HNF-4) binding site within the factor VII promoter (ACTTTG Æ → ACGTTG). Using gel mobility shift assays, we show that the mutation disrupts the binding of HNF-4 to its cognate binding site. In growth hormone reporter gene assays, the activity of a plasmid containing the mutant promoter was 6.7% of the wild-type promoter plasmid. Although HNF-4 was able to transactivate the wild-type factor VII promoter 5.4-fold in HeLa cells, no transactivation could be shown with the mutant promoter. These findings indicate that HNF-4 exerts a major positive regulatory effect on factor VII expression and provides in vivo evidence that binding of this transcription factor is critical for normal factor VII expression.</jats:p>

Journal

  • Blood

    Blood 89 (1), 176-182, 1997-01-01

    American Society of Hematology

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