Phenotypic and genotypic analysis of a pedigree affected with hereditary protein C deficiency due to heterozygous deletional mutation of PROC gene.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.cn511374-20190625-00312
   		
        
        	
        		- VernacularTitle:一个杂合缺失变异致遗传性蛋白C缺陷症家系的表型和基因型分析
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Siqi LIU
			        		
			        		
			        		
			        			1
			        			,
			        		
			        			2
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Fang YU
			        		
			        		;
		        		
		        		
		        		
			        		Shasha LUO
			        		
			        		;
		        		
		        		
		        		
			        		Xiaolong LI
			        		
			        		;
		        		
		        		
		        		
			        		Yanhui JIN
			        		
			        		;
		        		
		        		
		        		
			        		Lihong YANG
			        		
			        		;
		        		
		        		
		        		
			        		Xingxing ZHOU
			        		
			        		;
		        		
		        		
		        		
			        		Haiyue ZHANG
			        		
			        		;
		        		
		        		
		        		
			        		Mingshan WANG
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Zhejiang 325000, China. wywms@
			        		
			        			2. com.
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Medical Genetics
	            		
	            		 2020;37(10):1108-1112
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	OBJECTIVE:To analyze the phenotype and genetic variants of a pedigree affected with hereditary protein C (PC) deficiency.
				        	
				        
				        	METHODS:The protein C activity (PC:A) of the proband and her family members (a four-generation pedigree including 11 individuals) were tested by chromogenic substrate method, and the protein C antigen (PC:Ag) was detected with an enzyme-linked immunosorbent assay(ELISA). The 9 exons and flanking sequences of the protein C (PROC) gene were amplified by PCR and directly sequenced. Suspected mutation was validated by clone sequencing and in other members of the family. MutationTaster and ClustalX-2.1-win was used to analyze the pathogenicity and conservation of the mutation site,respectively. Three-dimentional protein model and amino acids interaction were analyzed with Swiss-PdbViewer software.
				        	
				        
				        	RESULTS:The PC: A and PC: Ag of the proband were decreased to 46% (reference range: 70%-130%) and 50% (referencerange:70%-140%), respectively. Her grandmother,aunt, cousin and younger brother also showed declined PC:A and PC:Ag by approximately 50%. Genetic analysis revealed that the above individuals have all carried a deletional mutation c.1212-1212delG (p.Met364TrpfsX15) in exon 9 of the PROC gene which can cause replacement of Methionine at position 364 by Tryptophan and alteration of 15 downstream amino acids, and produce a premature stop codon at position 378. The score of MutationTaster was 1.000, indicating that the variant is pathogenic. Conservative analysis showed that the 15 altered amino acids are located in a conserved region across nine homologous species. Protein model analysis showed that the mutation has disrupted a catalytic domain of protein C thereby affected its function.
				        	
				        
				        	CONCLUSION:The heterozygous c.1212-1212delG deletional mutation in exon 9 of the PROC gene, which was unreported previously,probably accounts for the decrease of PC:A and PC:Ag in this pedigree.