title: The mutation Arg (53)----Trp causes von Willebrand disease Normandy by abolishing binding to factor VIII. Studies with recombinant von Willebrand factor.
abstract: von Willebrand factor (vWF) and factor VIII (FVIII) circulate in plasma as a noncovalently linked protein complex. The FVIII/vWF interaction is required for the stabilization of procoagulant FVIII activity. Recently, we reported a new variant of von Willebrand disease (vWD) tentatively named "Normandy," characterized by plasma vWF that appears to be structurally and functionally normal except that it does not bind FVIII. Three patients from one family were found to be homozygous for a C----T transition at codon 816 converting Arg 53 to Trp in the mature vWF subunit. To firmly establish a causal relationship between this missense mutation and vWD Normandy phenotype, we have characterized the corresponding recombinant mutant vWF(R53W). Expressed in COS-7 cells or CHO cell lines, normal vWF and vWF(R53W) were processed and formed multimers with equal efficiency. However, vWF(R53W) exhibited the same defect in FVIII binding as did plasma vWF from patients with vWD Normandy, confirming that this mutation is responsible for the vWD Normandy phenotype. These results illustrate the importance of Arg 53 of the mature vWF subunit for the binding of FVIII to vWF, and identify an amino acid residue within a disulfide loop not previously known to be involved in this interaction.
authors.affiliation: Howard Hughes Medical Institute, Department of Medicine, Washington University School of Medicine, St Louis, MO 63110.
authors.forename: S
authors.initials: S
authors.lastname: Jorieux
authors.forename: E A
authors.initials: EA
authors.lastname: Tuley
authors.forename: C
authors.initials: C
authors.lastname: Gaucher
authors.forename: C
authors.initials: C
authors.lastname: Mazurier
authors.forename: J E
authors.initials: JE
authors.lastname: Sadler
mesh_terms: D001483:Base Sequence; D001665:Binding Sites; D004252:DNA Mutational Analysis; D005169:Factor VIII / Q000378:metabolism*; D006801:Humans; D046911:Macromolecular Substances; D008969:Molecular Sequence Data; D009154:Mutation; D009838:Oligodeoxyribonucleotides / Q000737:chemistry; D011994:Recombinant Proteins / Q000378:metabolism; D013329:Structure-Activity Relationship; D014842:von Willebrand Diseases / Q000235:genetics* / Q000378:metabolism; D014841:von Willebrand Factor / Q000737:chemistry / Q000235:genetics* / Q000378:metabolism
chemical_list: D046911:Macromolecular Substances; D009838:Oligodeoxyribonucleotides; D011994:Recombinant Proteins; D014841:von Willebrand Factor; D005169:Factor VIII