title: Familial multiple coagulation factor deficiencies: new biologic insight from rare genetic bleeding disorders.
abstract: Combined deficiency of factor (F)V and FVIII (F5F8D) and combined deficiency of vitamin K-dependent clotting factors (VKCFD) comprise the vast majority of reported cases of familial multiple coagulation factor deficiencies. Recently, significant progress has been made in understanding the molecular mechanisms underlying these disorders. F5F8D is caused by mutations in two different genes (LMAN1 and MCFD2) that encode components of a stable protein complex. This complex is localized to the secretory pathway of the cell and likely functions in transporting newly synthesized FV and FVIII, and perhaps other proteins, from the ER to the Golgi. VKCFD is either caused by mutations in the gamma-carboxylase gene or in a recently identified gene encoding the vitamin K epoxide reductase. These two proteins are essential components of the vitamin K dependent carboxylation reaction. Deficiency in either protein leads to under-carboxylation and reduced activities of all the vitamin K-dependent coagulation factors, as well as several other proteins. The multiple coagulation factor deficiencies provide a notable example of important basic biological insight gained through the study of rare human diseases.
authors.affiliation: Department of Internal Medicine and Human Genetics, University of Michigan, Ann Arbor, MI 48109-0650, USA.
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.forename: D
authors.initials: D
authors.lastname: Ginsburg
mesh_terms: D019735:Carbon-Carbon Ligases / Q000378:metabolism; D020147:Coagulation Protein Disorders / Q000097:blood / Q000150:complications / Q000235:genetics*; D005165:Factor V / Q000235:genetics / Q000378:metabolism; D005166:Factor V Deficiency / Q000097:blood / Q000150:complications / Q000235:genetics; D005169:Factor VIII / Q000235:genetics / Q000378:metabolism; D005260:Female; D006467:Hemophilia A / Q000097:blood / Q000150:complications / Q000235:genetics; D006801:Humans; D008297:Male; D037241:Mannose-Binding Lectins / Q000235:genetics; D008565:Membrane Proteins / Q000235:genetics; D008954:Models, Biological; D009154:Mutation; D014812:Vitamin K / Q000378:metabolism
chemical_list: C084004:LMAN1 protein, human; D037241:Mannose-Binding Lectins; D008565:Membrane Proteins; D014812:Vitamin K; D005165:Factor V; D005169:Factor VIII; D019735:Carbon-Carbon Ligases; C020660:glutamyl carboxylase