title: The Thr224Asn mutation in the VPS45 gene is associated with the congenital neutropenia and primary myelofibrosis of infancy.
abstract: Severe congenital neutropenia as well as primary myelofibrosis are rare in infancy. Elucidation of the underlying mechanism is important because it extends our understanding of the more common adult forms of these disorders. Using homozygosity mapping followed by exome sequencing, we identified a Thr224Asn mutation in the VPS45 gene in infants from consanguineous families who suffered from life-threatening neutropenia, which was refractory to granulocyte CSF, from defective platelet aggregation and myelofibrosis. The mutation segregated in the families, was not present in controls, affected a highly conserved codon, and apparently destabilized the Vps45 protein, which was reduced in the patients' leukocytes. Introduction of the corresponding mutation into yeast resulted in reduced cellular levels of Vps45 and also of the cognate syntaxin Tlg2, which is required for membrane traffic through the endosomal system. A defect in the endosomal-lysosomal pathway, the homologous system in humans, was suggested by the absence of lysosomes in the patients' fibroblasts and by the depletion of α granules in their platelets. Importantly, accelerated apoptosis was observed in the patients' neutrophils and bone marrow. This is the first report of a Vps45-related disease in humans, manifesting by neutropenia, thrombasthenia, myelofibrosis, and progressive bone marrow failure.
authors.affiliation: Department of Pediatric Hematology-Oncology, Hadassah, Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Polina
authors.initials: P
authors.lastname: Stepensky
authors.forename: Ann
authors.initials: A
authors.lastname: Saada
authors.forename: Marianne
authors.initials: M
authors.lastname: Cowan
authors.forename: Adi
authors.initials: A
authors.lastname: Tabib
authors.forename: Ute
authors.initials: U
authors.lastname: Fischer
authors.forename: Yackov
authors.initials: Y
authors.lastname: Berkun
authors.forename: Hani
authors.initials: H
authors.lastname: Saleh
authors.forename: Natalia
authors.initials: N
authors.lastname: Simanovsky
authors.forename: Aviram
authors.initials: A
authors.lastname: Kogot-Levin
authors.forename: Michael
authors.initials: M
authors.lastname: Weintraub
authors.forename: Hamam
authors.initials: H
authors.lastname: Ganaiem
authors.forename: Avraham
authors.initials: A
authors.lastname: Shaag
authors.forename: Shamir
authors.initials: S
authors.lastname: Zenvirt
authors.forename: Arndt
authors.initials: A
authors.lastname: Borkhardt
authors.forename: Orly
authors.initials: O
authors.lastname: Elpeleg
authors.forename: Nia J
authors.initials: NJ
authors.lastname: Bryant
authors.forename: Dror
authors.initials: D
authors.lastname: Mevorach
mesh_terms: D001483:Base Sequence; D015153:Blotting, Western; D000080984:Congenital Bone Marrow Failure Syndromes; D003241:Consanguinity; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D009154:Mutation; D009503:Neutropenia / Q000151:congenital* / Q000235:genetics; D010375:Pedigree; D055728:Primary Myelofibrosis / Q000235:genetics*; D033921:Vesicular Transport Proteins / Q000235:genetics*
chemical_list: C498421:VPS45 protein, human; D033921:Vesicular Transport Proteins