|
|
Screening for inherited thrombophilia and genome sequencing |
YIN Li1( ),LI Ge2,SHEN Jian3,LIU Zhenjie1,*( ) |
1. Department of Vascular Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China 2. Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China 3. Institute of Cardiovascular Diseases, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China |
|
|
Abstract Objective: To screening coagulation and anticoagulation genes and mutations in Chinese patients with venous thromboembolism suspected of inhered thrombophilia. Methods: Patients with venous thromboembolism caused by inherited thrombophilia were collected from the second Affiliated Hospital, Zhejiang University School of Medicine during June 2015 and December 2017. Gene sequencing was conducted to screen the anticoagulant-related genes PROC, PROS1, SERPINC1 and coagulation-related genes F5, F2, F8, CBS, MTHFR. The thousands of human genome database, ESP6500 database, Genoma database, HGMD mutation database were used to compare the mutation sites, and the pathogenic mutation sites were predicted according to SIFT, Polyphen, MutationTaster and CADD databases. Results: Among 25 patients screened, eight patients with PROC mutations, two patients with PROS1 mutations, three patients with SERPINC1 mutations; one patient with F5 mutation, one patient with F2 mutation, one patient with F8 mutation, two patient with CBS mutations, and one patient with MTHFR mutation. Conclusion: The second generation gene sequencing helps to diagnose inherited thrombophilia and guide the decision of anticoagulation duration.
|
Received: 14 August 2018
Published: 15 March 2019
|
|
Corresponding Authors:
LIU Zhenjie
E-mail: yinli18c@zju.edu.cn;lawson4001@zju.edu.cn
|
遗传性易栓症筛查及相关基因检测分析
目的: 检测和分析遗传性易栓症的相关基因及其突变位点,为中国人群遗传性易栓症患者的基因突变特点积累资料。方法: 对2015年6月至2017年12月在浙江大学医学院附属第二医院就诊的遗传性易栓症疑似患者25例进行血清蛋白C、蛋白S,抗凝因子相关基因蛋白C(基因名PROC)、蛋白S(基因名PROS1)和抗凝血酶Ⅲ(基因名SERPINC1),凝血因子相关基因凝血因子Ⅴ(基因名F5)、凝血因子Ⅱ(基因名F2)、凝血因子Ⅷ(基因名F8)、高型半胱氨酸血症相关因子(CBS、MTHFR)第二代测序分析。利用千人基因组数据库、ESP6500数据库、Genoma数据库、HGMD突变数据库比对突变位点,根据SIFT、Polyphen、MutationTaster、CADD数据库预测突变位点的致病性。结果: 25例患者中,发现抗凝因子相关基因PROC突变患者8例,PROS1突变患者2例,SERPINC1突变患者3例;凝血相关基因F5突变1例,F2突变1例,F8突变1例,CBS突变2例,MTHFR突变1例。结论: 应用第二代基因测序分析有助于诊断遗传性易栓症相关静脉血栓,指导精准治疗。
关键词:
静脉血栓形成/遗传学,
血栓形成倾向/遗传学,
血液凝固,
抗凝血酶类,
基因,
突变
|
|
[1] |
LIJFERING W M , ROSENDAAL F R , CANNEGIETER S C . Risk factors for venous thrombosis-current understanding from an epidemiological point of view[J]. Br J Haematol, 149 (6): 824- 833
doi: 10.1111/bjh.2010.149.issue-6
|
|
|
[2] |
BAGOT C N , ARYA R . Virchow and his triad:a question of attribution[J]. Br J Haematol, 2008, 143 (2): 180- 190
doi: 10.1111/bjh.2008.143.issue-2
|
|
|
[3] |
MATEO J , OLIVER A , BORRELL M et al. Increased risk of venous thrombosis in carriers of natural anticoagulant deficiencies. Results of the family studies of the Spanish Multicenter Study on Thrombophilia (EMET study)[J]. Blood Coagul Fibrinolysis, 1998, 9 (1): 71- 78
doi: 10.1097/00001721-199801000-00009
|
|
|
[4] |
MATEO J , OLIVER A , BORRELL M et al. Laboratory evaluation and clinical characteristics of 2, 132 consecutive unselected patients with venous thromboembolism——results of the Spanish Multicentric Study on Thrombophilia (EMET-Study)[J]. Thromb Haemost, 1997, 77 (3): 444- 451
doi: 10.1055/s-0038-1655986
|
|
|
[5] |
BERTINA R M . Genetic approach to thrombophilia[J]. Thromb Haemost, 2001, 86 (1): 92- 103
|
|
|
[6] |
DOUKETIS J , AGENO W , CARRIER M et al. Managing challenging patients with venous thromboembolism:a practical, case-based approach[J]. Pol Arch Intern Med, 2017, 127 (1): 41- 46
|
|
|
[7] |
WEITZ J I , JAFFER I H . Optimizing the safety of treatment for venous thromboembolism in the era of direct oral anticoagulants[J]. Pol Arch Med Wewn, 2016, 126 (9): 688- 696
|
|
|
[8] |
CROWTHER M A , KELTON J G . Congenital thrombophilic states associated with venous thrombosis:a qualitative overview and proposed classification system[J]. Ann Intern Med, 2003, 138 (2): 128- 134
doi: 10.7326/0003-4819-138-2-200301210-00014
|
|
|
[9] |
TAIT R C , WALKER I D , PERRY D J et al. Prevalence of antithrombin deficiency in the healthy population[J]. Br J Haematol, 1994, 87 (1): 106- 112
doi: 10.1111/j.1365-2141.1994.tb04878.x
|
|
|
[10] |
WHITLATCH N L , ORTEL T L . Thrombophilias:when should we test and how does it help?[J]. Semin Respir Crit Care Med, 2008, 29 (1): 25- 39
|
|
|
[11] |
GARCíA DE FRUTOS P , FUENTES-PRIOR P , HURTADO B et al. Molecular basis of protein S deficiency[J]. Thromb Haemost, 2007, 98 (3): 543- 556
|
|
|
[12] |
MARGAGLIONE M , BRANCACCIO V , GIULIANI N et al. Increased risk for venous thrombosis in carriers of the prothrombin G-->A 20210 gene variant[J]. Ann Intern Med, 1998, 129 (2): 89- 93
doi: 10.7326/0003-4819-129-2-199807150-00003
|
|
|
[13] |
GU Y , SHEN W , ZHANG L et al. Deficiency of antithrombin and protein C gene in 202 Chinese venous thromboembolism patients[J]. Int J Lab Hematol, 2014, 36 (2): 151- 155
doi: 10.1111/ijlh.12146
|
|
|
[14] |
WANG D , CUI G , HU S et al. Subtypes of SERPINC1 mutations and the thrombotic phenotype of inherited antithrombin deficient individuals in Chinese Han population[J]. Blood Cells Mol Dis, 2016, 62:38- 41
doi: 10.1016/j.bcmd.2016.10.029
|
|
|
[15] |
MILLAR D S , JOHANSEN B , BERNTORP E et al. Molecular genetic analysis of severe protein C deficiency[J]. Hum Genet, 2000, 106 (6): 646- 653
|
|
|
[16] |
BROEKMANS A W . Hereditary protein C deficiency[J]. Haemostasis, 1985, 15 (4): 233- 240
|
|
|
[17] |
COOPER P C , HILL M , MACLEAN R M . The phenotypic and genetic assessment of protein C deficiency[J]. Int J Lab Hematol, 2012, 34 (4): 336- 346
doi: 10.1111/ijlh.2012.34.issue-4
|
|
|
[18] |
WYPASEK E , UNDAS A . Protein C and protein S deficiency-practical diagnostic issues[J]. Adv Clin Exp Med, 2013, 22 (4): 459- 467
|
|
|
[19] |
WYPASEK E , CORRAL J , ALHENC-GELAS M et al. Genetic characterization of antithrombin, protein C, and protein S deficiencies in Polish patients[J]. Pol Arch Intern Med, 2017, 127 (7-8): 512- 523
|
|
|
[20] |
CAMPBELL I A , BENTLEY D P , PRESCOTT R J et al. Anticoagulation for three versus six months in patients with deep vein thrombosis or pulmonary embolism, or both:randomised trial[J]. BMJ, 2007, 334 (7595): 674
doi: 10.1136/bmj.39098.583356.55
|
|
|
[21] |
RIDKER P M , MILETICH J P , HENNEKENS C H et al. Ethnic distribution of factor V Leiden in 4047 men and women. Implications for venous thromboembolism screening[J]. JAMA, 1997, 277 (16): 1305- 1307
doi: 10.1001/jama.1997.03540400055031
|
|
|
[22] |
CONNORS J M . Thrombophilia testing and venous thrombosis[J]. N Engl J Med, 2017, 377 (23): 2297- 2298
doi: 10.1056/NEJMc1713797
|
|
|
[23] |
COUTURAUD F , LEROYER C , TROMEUR C et al. Factors that predict thrombosis in relatives of patients with venous thromboembolism[J]. Blood, 2014, 124 (13): 2124- 2130
doi: 10.1182/blood-2014-03-559757
|
|
|
[24] |
VAN VLIJMEN E F , WIEWEL-VERSCHUEREN S , MONSTER T B et al. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism:a systematic review and meta-analysis[J]. J Thromb Haemost, 2016, 14 (7): 1393- 1403
doi: 10.1111/jth.13349
|
|
|
[25] |
GERHARDT A , SCHARF R E , GREER I A et al. Hereditary risk factors for thrombophilia and probability of venous thromboembolism during pregnancy and the puerperium[J]. Blood, 2016, 128 (19): 2343- 2349
doi: 10.1182/blood-2016-03-703728
|
|
|
[26] |
KEARON C , AKL E A , ORNELAS J et al. Antithrombotic therapy for VTE disease:CHEST guideline and expert panel report[J]. Chest, 2016, 149 (2): 315- 352
doi: 10.1016/j.chest.2015.11.026
|
|
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|