Mutations within the protein Z-dependent protease inhibitor gene are associated with venous thromboembolic disease: a new form of thrombophilia.
Protein Z-dependent protease inhibitor (ZPI) is a serpin that inhibits the activated coagulation factors X and XI. The precise physiological significance of ZPI in the control of haemostasis is unknown although a deficiency of ZPI may be predicted to alter this balance. The coding region of the ZPI gene was screened for mutations using denaturing high-performance liquid chromatography. 16 mutations/polymorphisms within the coding region of ZPI were identified including two mutations, which generated stop codons at residues R67 and W303. We observed nonsense mutations within the ZPI gene in 4.4% of thrombosis patients (n = 250) compared with 0.8% of controls (n = 250). The difference in distribution of stop codon mutations between thrombosis patients and controls was significant (P = 0.02) with an odds ratio of 5.7 (95% confidence interval, 1.25-26.0). Our results suggest an association between ZPI deficiency and venous thrombosis and we propose that ZPI deficiency is potentially a new form of thrombophilia.
Van de Water
Neil
N
Department of Haematology, Auckland Hospital, Auckland, New Zealand.
Tan
Tina
T
Ashton
Fern
F
O'Grady
Anna
A
Day
Tony
T
Browett
Peter
P
Ockelford
Paul
P
Harper
Paul
P
D000328:Adult; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D018388:Codon, Terminator; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011655:Pulmonary Embolism / Q000097:blood / Q000235:genetics; D015843:Serpins / Q000172:deficiency / Q000235:genetics*; D019851:Thrombophilia / Q000235:genetics; D020246:Venous Thrombosis / Q000097:blood / Q000235:genetics*
D018388:Codon, Terminator; C416370:SERPINA10 protein, human; D015843:Serpins