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  • 1
    In: Experimental Hematology, Elsevier BV, Vol. 35, No. 8 ( 2007-08), p. 1182-1189
    Type of Medium: Online Resource
    ISSN: 0301-472X
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2007
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  • 2
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2017-05-11)
    Abstract: The Gardos channel is a Ca 2+ sensitive, K + selective channel present in several tissues including RBCs, where it is involved in cell volume regulation. Recently, mutations at two different aminoacid residues in KCNN4 have been reported in patients with hereditary xerocytosis. We identified by whole exome sequencing a new family with two members affected by chronic hemolytic anemia carrying mutation R352H in the KCNN4 gene. No additional mutations in genes encoding for RBCs cytoskeletal, membrane or channel proteins were detected. We performed functional studies on patients’ RBCs to evaluate the effects of R352H mutation on the cellular properties and eventually on the clinical phenotype. Gardos channel hyperactivation was demonstrated in circulating erythrocytes and erythroblasts differentiated ex - vivo from peripheral CD34+ cells. Pathological alterations in the function of multiple ion transport systems were observed, suggesting the presence of compensatory effects ultimately preventing cellular dehydration in patient’s RBCs; moreover, flow cytometry and confocal fluorescence live-cell imaging showed Ca 2+ overload in the RBCs of both patients and hypersensitivity of Ca 2+ uptake by RBCs to swelling. Altogether these findings suggest that the ‘Gardos channelopathy’ is a complex pathology, to some extent different from the common hereditary xerocytosis.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
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  • 3
    In: Blood, American Society of Hematology, Vol. 131, No. 20 ( 2018-05-17), p. 2183-2192
    Abstract: PK deficiency manifests a broad spectrum in anemia severity that moderately improves after splenectomy. Close attention to monitoring for iron overload, gallstones, and other complications is recommended in all patients with PK deficiency.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
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  • 4
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 3016-3016
    Abstract: Abstract 3016 Poster Board II-992 Phosphoglycerate kinase (PGK) is a key glycolytic enzyme that catalyzes the reversible phosphotransfer reaction from 1,3-bisphosphoglycerate (1,3-BPG) to ADP to form 3-phosphoglycerate (3-PG) and ATP. It is a relatively small monomeric molecule characterized by two hinge-bent domains, with a highly conserved structure. The N-terminal domain binds 1,3-BPG or 3-PG, whereas the C-terminal domain binds Mg-ADP or Mg-ATP. During the catalytic cycle, the enzyme undergoes large conformational rearrangements, proceeding from an open form to a closed form. Two isozymes, PGK1 and PGK2, are present in humans, encoded by two distinct genes. Whereas PGK2 is a testis-specific enzyme, PGK1 is expressed in all the somatic cells. The PGK1 gene is located on the X-chromosome q-13.1, and encodes a protein of 416 amino acids. Mutations of the PGK1 gene result in an enzyme deficiency, that is characterized by mild to severe hemolytic anemia, neurological dysfunctions and myopathy. Patients rarely exhibit all three clinical features. To date, 20 different mutations with worldwide distribution have been described. To investigate the genotype-phenotype relationship of PGK deficiency, recently we have undertaken a characterization of the all PGK mutant enzymes so far reported. In this study we describe the molecular abnormalities of the G158V, R206P, V266M and D285V variants obtained from E.coli as recombinant proteins. All patients were affected by moderate to severe hemolytic anemia. Moreover, patients bearing GI58V, R206P, and D285V variants displayed muscular disorders. Neurological dysfunctions were present in patients with R206P and V266M. The desired mutations were introduced into the PGK cDNA by site directed mutagenesis. All mutant enzymes were expressed and purified to homogeneity as previously indicated (Morera et al., Blood, ASH, Annual Meeting Abstracts, 2008;112:2875). Each variant was subjected to kinetic analysis and to different heat treatments in the absence and in the presence of specific ligands. The enzyme activity was determined following the backward reaction. Variants G158V and D285V turned out to be affected in their catalytic activities, displaying kcat values towards ATP and 3-PG 7-fold and 19-fold, respectively, lower than that of the wild type enzyme previously characterized. Variant R206P displayed reduced affinity vs 3-PG, the Km value being 8-fold higher than that of the wild type. Variant V266M showed kinetic properties similar to those of the wild type. The mutant enzymes subjected to heat treatments exhibited different protein stability. Whereas the wild type enzyme preserved 70% of its activity after one hour-incubation at 45°C, mutants G158V and D285V at the same temperature halved their activities after only 5 min and 2 min, respectively. Mutants R206P and V266M turned to be quite heat stable, their T50 (the temperature to which an enzyme halves its activity in 10 min) being 2°C lower than that of the wild type enzyme (47°C vs 49°C). Moreover, at a temperature 3-4 °C higher than its own T50, no one mutant was properly protected by the presence of Mg-ATP. In addition, variants G158V and D285V were not even protected by 3-PG. Therefore, these studies suggest that G158V and D285V substitutions affect amino acid residues located in key positions for allowing the enzyme to preserve its protein stability, especially during the red cell life span, and to adopt its proper conformations in fulfilling the catalytic cycle. The reduced RBC concentration of PGK and the energy pathway deficiency would account for the dysfunctions displayed by patients with G158V and D285V. With regard to R206P variant, the mutation affects an amino acid residue located in the hinge of the enzyme, far away from the 3-PG binding site. Owing to the fact that the variant displayed a reduced affinity versus 3-PG, it is likely that Arg206 plays an important role in the structuring of the 3-PG binding site, via long-distance interactions. Thus mutation R206P would lead to a distortion of the 3-PG binding site, impairing the PGK activity under physiological 3-PG concentrations. Consequently, the reduced energy supply would be the cause of the hemolysis displayed by the PGK deficient patient. Finally, with regard to V266M mutant, no acceptable explanation of the enzyme deficiency can be drawn by the present biochemical studies, the mutant behaving as the wild type enzyme. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 5
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 272-272
    Abstract: Congenital dyserythropoietic anemia (CDA) type II is the most frequent type of congenital dyserythropoietic anemia; it is transmitted in an autosomal recessive fashion and is characterized by ineffective erythropoiesis, peripheral hemolysis, bi-multinuclearity in the erythroblasts, and hypoglycosylation of red blood cell (RBC) membrane proteins such as band 3. The disease is generally caused by biallelic mutations in the SEC23B gene. However, there are a small portion of patients with clinical and hematologic features of CDA II that are negative for mutations in SEC23B, suggesting that alternative etiologies for such disturbed erythropoiesis exist. We identified two siblings of Italian origin who had dyserythropoiesis with a chronic macrocytic anemia. Their parents were healthy with normal hematologic parameters. No history of consanguinity for at least three generations was noted. The affected siblings had anisopoikylocytosis on peripheral blood smear with stomatocytes (8-9%), spherocytes (4-5%), rare ovalocytes, and dacryocytes. RBCs osmotic fragility was increased but the red cells had normal eosin-5-maleimide (EMA)-binding. Serum ferritin and transferrin saturation were increased in only one sibling. Bone marrow morphology revealed erythroid hyperplasia (myeloid: erythroid ratio = 0.6) with binuclearity and megaloblastic changes, as well as occasional cytoplasmic bridging between cells at different stage of maturation; electron microscopy of bone marrow erythroblasts showed multiple membranes that ran parallel to the plasma membrane or that were grouped in stacked segments, possibly attributable to residual endoplasmic reticulum (ER) cisternae. SDS-PAGE analysis of RBC ghosts from both siblings demonstrated hypoglycosylation of band 3 and GLUT1, as well as residual residual Protein Disulphide Isomerase (PDI) positive ER remnants, as observed in classical CDA II cases. However, in contrast to CDAII, the Ham's test performed with 15 normal serum samples was negative, and no mutations were detected in the SEC23B gene. To uncover the underlying etiologies, whole-exome sequencing was conducted on all available family members. After filtering for common variants, only a single gene had biallelic mutations in the affected siblings, which were transmitted from the unaffected heterozygous parents. The identified mutations resided in the PARP4 gene, which encodes a poly-ADP ribose polymerase enzyme, and were predicted to be deleterious. We demonstrate that knockdown of PARP4 using shRNA in primary human erythroid progenitors results in impaired erythroid differentiation and increased apoptosis. In addition, morpholino-mediated knockdown of the PARP4 orthologue in the zebrafish resulted in dyserythropoiesis and anemia in developing embryos. Sequencing of PARP4 in additional rare cases of CDA II without an identified molecular basis will help to uncover the frequency and spectrum of PARP4 mutations leading to dyserythropoiesis. The finding of a new gene implicated in a similar type of CDA with features such as redundant ER membranes offers the potential for more mechanistic dissection of the role of both SEC23B and PARP4 in erythroid development and suggests that new insight can be gained into the underlying pathophysiology of both normal and disordered erythropoiesis through the study of such rare cases. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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  • 6
    In: Blood, American Society of Hematology, Vol. 104, No. 11 ( 2004-11-16), p. 1592-1592
    Abstract: Pyrimidine 5′-nucleotidase type-I (P5′N-1) catalyzes the dephosphorylation of UMP and CMP to their respective nucleosides. In red blood cells, the enzyme has a major role in the catabolism of nucleotides formed from RNA degradation. P5′N-1 possesses also phospho-transferase activity suggesting an additional role of the enzyme in nucleotide metabolism. P5′N-1 deficiency is an autosomal recessive disorder characterized by hemolytic nonspherocytic anemia, heavy basophilic stippling in the peripheral blood smear, and accumulation of pyrimidine nucleotides within the erythrocytes. P5′N-1 deficiency is the third most common RBC enzymopathy causing hemolysis after G6PD and PK deficiency. Fourteen different mutations have been identified at the DNA level to date including four missense mutations. To increase our understanding on molecular basis of the P5′N-1 deficiency, after mutants N190S and G241R (Chiarelli et al, Blood 2003, abstract; Chiarelli et al, The Hematology Journal 2004, abstract), we have undertaken the biochemical characterization of D98V and L142P enzymes, identified respectively in a Norwegian family and in Japanese patients. The proteins were produced in E. coli cells as recombinant forms, and purified to homogeneity. The L142P protein showed a drastic reduction in the thermal stability (t1/2 at 37°C about 6 min compared to a fully stable wild-type), and kinetic properties slightly altered (kcat values nearly halved and Km 3–5 times higher). D98V exhibited reduced heat stability (t1/2 at 37° about 25 min) and catalytic efficiency turned especially versus UMP (about 25 times) owing the increased Km values. Thus, the decreased activity observed in Japanese patients homozygous for the L142P mutation is essentially due to lowered enzyme levels caused by protein instability, whereas the D98V mutation of Norwegian patients alters both stability and catalytic efficiency. We suggest that substitution D98V affects an amino acid residue involved in substrates binding site.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2004
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  • 7
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 3628-3628
    Abstract: According to the recently published WHO classification, two well-defined stages of PV, known as polycythemic phase and post-polycythemic myelofibrosis, are clearly recognizable. A few years ago, it has been reported that erythrocytosis may develop in the course of ET, and that PV may present in the early stage of the disease with an elevated platelet count, mimicking ET. Recently, it has been suggested that PV could be preceded by an “early” phase of the disease (Thiele et al, 2005), in which the increase in the red cell mass or hemoglobin level are lower than requested for the diagnosis either by the updated diagnostic criteria of the Polycythemia Vera Study Group (PVSG) or by the WHO classification. Very recently, the European Clinical and Pathological (ECP) criteria for the diagnosis of the “early” PV have been published (Michiels et al, 2006). The aim of this study is to examine the clinical features, the bone marrow biopsies (BMBs) and the JAK2V617F mutational status of 17 e-PV patients. All presented, at diagnosis, the clinical and morphological features of ET, and manifested a well-developed polycythemic phase of PV during the course of the follow-up (median 8.6 yrs; range 2–17 yrs). We compared the study group with 19 cases of PV and 14 cases of ET (according to WHO) as controls. Clinically, e-PV patients revealed at diagnosis increased levels of Hb (e-PV: 15.5g/dl; ET: 13.8g/dl; PV: 16.9g/dl), Hct (e-PV: 45.9%; ET: 41%; PV: 51.8%) and Ptl count (e-PV: 854×109/l; ET: 877×109/l; PV: 691×109/l), splenomegaly (e-PV: 43%; ET: 0%; PV: 61%) and hepatomegaly (e-PV: 53%; ET: 14%; PV: 61%). Morphological examination of the BMBs in e-PV patients demonstrated moderate to marked increase of the BM cellularity (e-PV: 65%; ET: 0%; PV: 73%) and pleiomorphic (i.e. clusters of small to giant) megakaryocytes (e-PV: 83%; ET: 20%; PV: 100%). Moreover, increased (e-PV: 100%; ET: 14%; PV: 100%) and left shifted erythropoiesis (e-PV: 82%; ET: 0%; PV: 79%), and increased (e-PV: 65%; ET: 14%; PV: 100%) and left-shifted granulopoiesis (e-PV: 65%; ET: 0%; PV: 58%) were also found. Mutational status analysis revealed that 15/15 e-PV cases (100%) carried the JAK2V617F mutation (6 homozygous and 9 heterozygous), in comparison to 7/13 (54%) ET (1 homozygous, 6 heterozygous) and to 17/19 (89%) PV (5 homozygous, 12 heterozygous). In conclusion, the results of our study confirm the existence of a “early” phase of PV that may mimic ET. A diagnostic algorithm, useful to differentiate e-PV from ET, may be obtained considering altogether the clinical, morphological and molecular characteristics of each patient.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
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  • 8
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 1981-1981
    Abstract: Abstract 1981 Poster Board I-1003 Congenital dyserythropoietic anemias (CDAs) are a heterogeneous group of disorders characterized by ineffective erythropoiesis with prominent dysplastic features of the erythroid precursors in the bone marrow. Three main subtypes (I, II and III) have been identified, but several variants or atypical forms have been reported over the years. CDA are rarely associated with hydrops foetalis. In the past we described two cases presenting with hydrops foetalis and very severe anemia that were classified as atypical CDAs since they presented CDAII-like erythroblastic morphological features lacking other diagnostic CDAII markers. Very recently we and others (Bianchi et al, Human Mutat 2009, in press; Schwarz et al, Nat Genet 2009, in press) demonstrated that mutations in SEC23B gene, coding for a protein involved in the coat protein complex responsible for vesicle budding from the endoplasmic reticulum, cause CDA II. The aim of this work was to ascertain whether atypical CDAII-like forms presenting as hydrops foetalis could be caused by mutations in SEC23B gene and reclassified as CDAII. Two patients (Cantù-Rajnoldi et al, Br J Haematol 1997, 96: 530-3; Bianchi et al, Blood 1999, 94, suppl 1, 8b) from unrelated families with a history of intrauterine death of hydropic foetuses in previous pregnancies were referred at 20th week gestation following ultrasonic diagnosis of foetal hydrops and severe anemia (2.0 and 1.3 g/dL Hb respectively). In both cases intrauterine transfusions enabled the delivery of the babies. At birth both of them underwent extensive laboratory evaluation (including red cell metabolism and membrane proteins analysis) that was not informative on the causes of anemia. Ham test was repeatedly normal as for Western blotting analysis for GRP78 and glycoslylation pattern of red cell band 3. The bone marrow examination revealed the presence of 30 and 48% of bi- or multinucleated erythroblasts, some of whom presenting typical double outer membranes at transmission electron microscopy. Both babies became transfusion dependent. The 20 exons and intronic flanking regions of SEC23B gene were analyzed by direct sequencing. Both patients displayed mutations in SEC23B gene, in particular mutations c.325 G 〉 A/ c.2101 C 〉 T in patient 1 and c.325 G 〉 A/ c.197G 〉 A in patient 2 (Glu109Lys/ Arg701Cys and Glu109Lys/ Cys66Tyr respectively). c.325 G 〉 A is the most frequent mutation so far described in CDAII and at homozygous level is usually associated with mild anemia. When found in compound heterozygosity with a second missense mutation as in these cases it may result in a very severe clinical pattern, although we cannot exclude that factors other than SEC23B mutations may contribute to worsening the clinical picture. In conclusion, SEC23B gene analysis allowed the correct classification of two very severe CDA cases associated with hydrops foetalis. This finding indicates that CDAII may result in intrauterine death and its frequency may therefore be underestimated. These cases may present as “atypical” for the lack of band3 hypoglycosylation likely due to the early sequestration of the more severely affected cells. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 9
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 2875-2875
    Abstract: Phosphoglycerate kinase (PGK) is a key glycolytic enzyme that catalyzes the reversible transfer of a phoshoryl-group from 1,3-bisphosphoglycerate (1,3-BPG) to ADP forming 3-phosphoglycerate (3-PG) and ATP. PGK is a typical two-domain hinge-bending enzyme, with a highly conserved structure. The N-terminal domain binds 1,3-BPG/3-PG, whereas the C-terminal domain binds Mg-ADP/Mg-ATP.Humans have two PGK isozymes, PGK1 and PGK2, where PGK1 is an ubiquitous enzyme that is expressed in all somatic cells and PGK2 is a testis-specific enzyme. The PGK1 gene is located on the X-chromosome q-13.1, contains 11 exons and encodes a protein of 416 amino acids. Mutations of the PGK1 gene result in an enzyme deficiency that is for the most clinically characterized by mild-to severe hemolytic anemia and various defects in the central nervous system. To date, 19 different mutations with worldwide distribution have been reported. No correlation between the residual PGK activity and the severity of the clinical manifestations have been documented so far. To analyze the mutations at protein level and possibly to correlate the genotype to clinical phenotype, we started with the molecular characterization of the wild-type PGK1 enzyme and three mutants (I47N, D164 and S320N) obtained from E.coli as recombinant proteins. The corresponding mutations, i.e., c.140T & gt;A, c.491A & gt;T and c.959G & gt;A, have been identified in patients with PGK deficiency and affected by severe hemolytic anemia and progressive mental retardation. The cDNA encoding the PGK1 was prepared starting from a blood sample of a healthy donor, with normal PGK1 activity. Site-directed mutagenesis was used to introduce the desired mutations into the PGK1 cDNA. The wild type enzyme was expressed to its maximum level (about 80–100 mg of enzyme per liter of culture) after 5 hours of induction with 0.5 mM IPTG at 37 °C. For mutant enzymes the induction temperature was lowered to 25°C. All recombinant enzymes were purified to homogeneity after a single chromatographic step on DEAE Sepharose column. The wild-type enzyme was crystallized in both free form or complexed with 3-PG. The corresponding structures were solved to high resolution (1.8 and 1.6 A, respectively) and compared. Essentially, binding 3-PG caused a 6° rotation of the N-domain in respect to the C-domain. The recombinant enzyme exhibited kinetic properties similar to those of the authentic enzyme, displaying vs 3-PG and ATP alike specific activities (about 1000 U/mg) and alike Km values (about 1mM). I47N and S320N mutant enzymes showed kcat values 3-fold lower than the wild-type enzyme. The D164V was characterized by a Km value vs 3-PG 15 times higher than that of the other enzymes studied and a catalytic efficiency 70 times lower. Finally, all mutant enzymes turned out to be highly heat unstable with respect to the wildtype enzyme, losing half of their activity after approximately 10 minutes of incubation at 37 °C. At higher temperatures, the wild-type enzyme was protected from heat inactivation by Mg-ATP or 3-PG. On the contrary, no one mutant was protect by Mg-ATP and the D164V and S320N mutants were not even protected by 3-PG. Therefore, these preliminary studies indicate that all mutations target amino acid residues located in positions primarily important for preserving the protein stability during the red cell life span.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
    In: British Journal of Haematology, Wiley, Vol. 105, No. 1 ( 1999-04), p. 75-79
    Type of Medium: Online Resource
    ISSN: 0007-1048 , 1365-2141
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    Language: English
    Publisher: Wiley
    Publication Date: 1999
    detail.hit.zdb_id: 1475751-5
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