title: Hereditary protein S deficiency leads to ischemic stroke.
abstract: Hereditary protein S (PS) deficiency is an independent risk factor for venous thromboembolism. However, the correlation between PS and arterial thrombotic disease, such as cerebral thrombosis, is not clear. The present study focused on the molecular mechanisms underlying ischemic stroke caused by a PS gene mutation in one family. The activity of antithrombin, protein C and PS in the plasma of the proband was measured, and the genes encoding PS were amplified and sequenced. The cellular localization and expression of PS were analyzed in HEK‑293 cells. The proband was a 50‑year‑old male. Plasma PS activity of the proband was 38.9%, which was significantly decreased compared with normal levels. Sequencing analysis revealed a PROS1 c.1486_1490delGATTA mutation on exon 12. This frameshift mutation converts Asp496 in the precursor PS into the termination codon. In addition, the PROS1 mutation was correlated with low PS activity in the family. Functional tests revealed that the mutant protein aggregated in the cytoplasm and its secretion and expression decreased. In conclusion, protein S mutation appeared to be the primary cause of thrombosis in the family of the present study. However, the correlation between PS deficiency and ischemic stroke requires further investigation.
authors.affiliation: Department of Neurology, Hanyang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei 430050. P.R. China.
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: Wang
authors.affiliation: Department of Ultrasonic Diagnosis and Interventional Therapy, The First Hospital Affiliated to Henan University, Kaifeng, Henan 475001, P.R. China.
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Xinhua Hospital of Hubei, Wuhan, Hubei 430015, P.R. China.
authors.forename: Kang
authors.initials: K
authors.lastname: Xu
authors.affiliation: Department of Neurology, Xinhua Hospital of Hubei, Wuhan, Hubei 430015, P.R. China.
authors.forename: Guo-Bing
authors.initials: GB
authors.lastname: Sun
authors.affiliation: Department of Neurology, Xinhua Hospital of Hubei, Wuhan, Hubei 430015, P.R. China.
authors.forename: Lin
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Neurology, Xinhua Hospital of Hubei, Wuhan, Hubei 430015, P.R. China.
authors.forename: Hong-Xiang
authors.initials: HX
authors.lastname: Yin
authors.affiliation: Department of Neurology, Xinhua Hospital of Hubei, Wuhan, Hubei 430015, P.R. China.
authors.forename: Xiao-Qi
authors.initials: XQ
authors.lastname: Chen
mesh_terms: D001483:Base Sequence; D005260:Female; D016368:Frameshift Mutation; D057809:HEK293 Cells; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D011498:Protein Precursors / Q000235:genetics*; D017293:Protein S / Q000235:genetics*; D018455:Protein S Deficiency / Q000150:complications* / Q000235:genetics; D020521:Stroke / Q000209:etiology* / Q000235:genetics; D013927:Thrombosis / Q000209:etiology* / Q000235:genetics
chemical_list: D011498:Protein Precursors; D017293:Protein S; C050930:protein S precursor