title: Kallikrein-kinin system and fibrinolysis in hereditary angioedema due to factor XII gene mutation Thr309Lys.
abstract: In a subgroup of hereditary angioedema (HAE) patients with normal C1-esterase inhibitor levels, HAE is caused by a Thr309Lys mutation in the coagulation factor XII (F12) gene. The aim of this study was to examine elements of the kallikrein-kinin system ('contact system') and the downstream-linked coagulation, complement and fibrinolytic systems in the plasma of six patients with HAE caused by the Thr309Lys mutation and healthy probands. Blood samples were taken from participants during the symptom-free interval between attacks. Samples were analyzed for activity and concentrations of components of the kallikrein-kinin system and linked enzyme systems. The mean FXII clotting activity was 90% in patients with the FXII mutation, and the concentration of FXIIa was 4.1 ng/ml; this did not differ from healthy probands. Mean prekallikrein amidolytic activity and high-molecular-weight kininogen clotting activity were 130 and 144%, respectively, both higher than in healthy probands. The mean kallikrein-like activity of the HAE patients was 11.4 U/l and did not differ from healthy probands. There was no difference in FXII surface activation by silicon dioxide or in kallikrein-like activity with and without activation by dextran sulfate. Contrary to the results of a recently published study, no indication that the Thr309Lys mutation causes a 'gain-of-function' of FXIIa was observed in this investigation.
authors.affiliation: Department of Dermatology, Johannes Gutenberg University, Mainz, Germany. bork@hautklinik.klinik.uni-mainz.de
authors.forename: Konrad
authors.initials: K
authors.lastname: Bork
authors.forename: Rouven
authors.initials: R
authors.lastname: Kleist
authors.forename: Jochen
authors.initials: J
authors.lastname: Hardt
authors.forename: Günther
authors.initials: G
authors.lastname: Witzke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019943:Amino Acid Substitution; D054179:Angioedemas, Hereditary / Q000097:blood / Q000235:genetics*; D001798:Blood Proteins / Q000032:analysis; D002863:Chromogenic Compounds / Q000378:metabolism; D003171:Complement Pathway, Classical / Q000235:genetics; D016264:Dextran Sulfate / Q000494:pharmacology; D004789:Enzyme Activation; D015956:Factor XIIa / Q000235:genetics* / Q000502:physiology; D005260:Female; D005342:Fibrinolysis / Q000235:genetics*; D006801:Humans; D007610:Kallikreins / Q000037:antagonists & inhibitors / Q000097:blood*; D007705:Kinins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D017354:Point Mutation; D011288:Prekallikrein / Q000032:analysis; D012822:Silicon Dioxide / Q000494:pharmacology; D010959:Tissue Plasminogen Activator / Q000097:blood; D055815:Young Adult
chemical_list: D001798:Blood Proteins; D002863:Chromogenic Compounds; D007705:Kinins; D012822:Silicon Dioxide; D016264:Dextran Sulfate; D011288:Prekallikrein; D007610:Kallikreins; D015956:Factor XIIa; D010959:Tissue Plasminogen Activator