Skip to main content
Log in

The molecular genetic analysis of haemophilia A; characterization of six partial deletions in the factor VIII gene

  • Original Investigations
  • Published:
Human Genetics Aims and scope Submit manuscript

Summary

In a survey of 528 unrelated haemophilia A patients, six partial deletions of the factor VIII (FVIII) gene were detected by Southern blotting. These deletions were further mapped by a combination of Southern blotting and polymerase chain reaction amplification and found to vary in length between 4.7kb and 57kb. The frequency of detectable FVIII gene deletions (about 1%) is thus considerably lower than previously reported. Statistical analysis of currently available data did not provide any evidence for a deletion “hotspot”. Four of the six deletion patients reported here possessed inhibitors. Taken together with previous data, deletion of the FVIII gene was found to be associated with an approximately fivefold higher risk of developing inhibitors compared with other severe haemophiliacs without gene deletions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Antonarakis SE, Waber PG, Kittur SD, Patel AS, Kazazian HH Jr, Mellis MA, Counts RB, Stamatoyannopoulos G, Bowie EJW, Fass DN, Pittman DD, Wozney JM, Toole JJ (1985) Hemophilia A: molecular defects and carrier detection by DNA analysis. N Engl J Med 313:842–848

    Google Scholar 

  • Antonarakis SE, Youssoufian H, Kazazian HH Jr (1987) Molecular genetics of hemophilia A in man. Mol Biol Med 4:81–94

    Google Scholar 

  • Bardoni B, Sampietro M, Romano M, Crapanzano C, Mannucci PM, Camerino G (1988) Characterization of a partial deletion of the factor VIII gene in a haemophiliac with inhibitor. Hum Genet 79:68–88

    Google Scholar 

  • Barrowcliffe TW (1984) Comparison of one-stage and two-stage assays of factor VIII:C. Scand J Haematol [Suppl] 41:39–54

    Google Scholar 

  • Bernardi F, Legnani C, Volinia S, Patracchini P, Roderigo G, DeRosa V, Marchetti G (1988) A HindIII RFLP and a gene lesion in the coagulation factor VIII gene. Hum Genet 78:359–362

    Google Scholar 

  • Bernardi F, Volinia S, Patracchini P, Gemmati D, Boninsegna S, Schwienbacher C, Marchetti G (1989) A recurrent missense mutation (Arg-Gln) and a partial deletion in factor VIII gene causing severe haemophilia A. Br J Haematol 71:271–276

    Google Scholar 

  • Casarino L, Pecorara M, Mori PG, Morfini M, Mancuso G, Scrivano L, Molinari AC, Lanza T, Giavarella G, Loi A, Perseu L, Cao A, Pirastu M (1986) Molecular basis for haemophilia A in Italians. Ric Clin Lab 16:227

    Google Scholar 

  • Casula L, Murru S, Pecorara M, Ristaldi MS, Restagno G, Mancuso G, Morfini M, DeBiasi R, Baudo F, Carbonara A, Mori PG, Cao A, Pirastu M (1990) Recurrent mutations and three novel rearrangements in the factor VIII gene of hemophilia A patients of Italian descent. Blood 75:662–670

    Google Scholar 

  • Cooper DN, Krawczak M (1990) The mutational spectrum of single base-pair substitutions causing human genetic disease: patterns and predictions. Hum Genet 85:55–74

    CAS  PubMed  Google Scholar 

  • Cooper DN, Schmidtke J (1989) Diagnosis of genetic disease using recombinant DNA. Second edition. Hum Genet 83:307–334

    Google Scholar 

  • Cooper DN, Tuddenham EGD (1991) The molecular genetics of coagulation disorders. Oxford University Press, Oxford (in press)

    Google Scholar 

  • Cooper DN, Smith BA, Cooke HJ, Niemann S, Schmidtke J (1985) An estimate of unique DNA sequence heterozygosity in the human genome. Hum Genet 69:201–205

    Google Scholar 

  • Cutting GR, Antonarakis SE, Youssoufian H, Kazazian HH Jr (1988) Accuracy and limitations of pulsed field gel electrophoresis in sizing partial deletions of the factor VIII gene. Mol Biol Med 5:173–184

    Google Scholar 

  • Frommel D, Muller JY, Prou-Warbelle O, Allain JP (1977) Possible linkage between the major histocompatibility complex and the immune response to factor VIII in classic haemophilia. Vox Sang 33:270–272

    Google Scholar 

  • Frydecka I, Kowalewska B, Lesiecki A, Kuliczkowski K, Palakowska A, Polkowski A (1986) Immunologic studies in asymptomatic hemophiliac patients. Folia Haematol (Leipz) 5:708–715

    Google Scholar 

  • Giannelli F, Choo KH, Rees DJG, Boyd Y, Rizza CR, Brownlee GG (1983) Gene deletions in patients with haemophilia B and antifactor IX antibodies. Nature 303:181–182

    Google Scholar 

  • Gitschier J, Wood WI, Goralka TM, Wion KL, Chen EY, Eaton DH, Vehar GA, Capon DJ, Lawn RM (1984) Characterization of the human factor VIII gene. Nature 312:326–330

    Google Scholar 

  • Gitschier J, Wood WI, Tuddenham EGD, Shuman MA, Goralka TM, Chen EY, Lawn RM (1985) Detection and sequence of mutations in the factor VIII gene of haemophiliacs. Nature 315:427–430

    Google Scholar 

  • Haldane JBS (1935) The rate of spontaneous mutation of a human gene. J Genet 31:317–326

    Google Scholar 

  • Hassan HJ, Leonardi A, Guerriero R, Chelucci C, Cianetti L, Ciavarella N, Ramieri P, Pilolli D, Peschle C (1985) Hemophilia B with inhibitor: molecular analysis of the subtotal deletion of the factor IX gene. Blood 66:728–730

    Google Scholar 

  • Hentemann M, Reiss J, Wagner M, Cooper DN (1990) Rapid detection of deletions in the DMD gene by PCR amplification of deletion-prone exon sequences. Hum Genet 84:228–232

    Google Scholar 

  • Higuchi M, Kochan L, Schwaab R, Egli H, Brackmann H-H, Horst J, Olek K (1989) Molecular defects in hemophilia A: identification and characterization of mutations in the factor VIII gene and family analysis. Blood 74:1045–1051

    Google Scholar 

  • Higuchi M, Wong C, Kochhan L, Olek K, Aronis S, Kasper CK, Kazazian HH, Antonarakis SE (1990) Characterization of mutations in the factor VIII gene by direct sequencing of amplified genomic DNA. Genomics 6:65–71

    Google Scholar 

  • Hoyer LW (1987) Molecular pathology and immunology of factor VIII (hemophilia A and factor VIII inhibitors). Hum Pathol 18:153–161

    Google Scholar 

  • Kasper CK, Aldort L, Aronson D, Counts RB, Edson JR, Fratantoni J, Green D, Hampton JW, Hilgartner MW, Levine PH, McMillan CW, Pool JG, Shapiro SS, Shulamn NR, Van Eyes J (1975) A more uniform measurement of factor VIII inhibitor. Thromb Diath Haemorrh 34:869–872

    Google Scholar 

  • Kazazian HH, Wong C, Youssoufian H, Scott AF, Phillips DG, Antonarakis SE (1988) Haemophilia A resulting from de novo insertion of L1 sequences represents a novel mechanism for mutation in man. Nature 332:164–166

    Google Scholar 

  • Koenig M, Hoffman EP, Bertelson CJ, Monaco AP, Feeder C, Kunkel LM (1987) Complete cloning of the Duchenne muscular dystrophy cDNA and primary genomic organization of the DMD gene in normal and affected individuals. Cell 50:509–517

    Google Scholar 

  • Kogan SC, Doherty M, Gitschier J (1987) An improved method for prenatal diagnosis of genetic diseases by analysis of amplified DNA sequences. N Engl J Med 317:985–990

    Google Scholar 

  • Lehrman MA, Goldstein JL, Russell DW, Brown MS (1987) Duplication of seven exons in LDL receptor gene caused by AluAlu recombination in a subject with familial hypercholesterolaemia. Cell 48:827–835

    Google Scholar 

  • Levinson B, Lehesjoki A-E, Chapelle A de la, Gitschier J (1990) Molecular analysis of haemophilia A mutations in the Finnish population. Am J Hum Genet 46:53–62

    Google Scholar 

  • McKee PA (1983) Hemostasis and disorders of blood coagulation. In: Stanbury JB, Wyngaarden JB, Fredrickson DS, Goldstein JL, Brown MS (eds) The metabolic basis of inherited disease. McGraw-Hill, New York, pp 1301–1384

    Google Scholar 

  • McMillan CW, Shapiro SS, Whitehurst D, Hoyer LW, Rao AV, Lazerson J (1988) The natural history of factor VIII:C inhibitors in patients with hemophilia A: a national cooperative study. II. Observations on the initial development of factor VIII: C inhibitors. Blood 71:344–348

    Google Scholar 

  • Mikami S, Nishimura T, Naka H, Kuze K, Fukui H (1988) A deletion involving intron 13 and exon 14 of factor VIII gene in a haemophiliac with anti-factor VIII antibody. Jpn J Hum Genet 33:401–407

    Google Scholar 

  • Myerowitz R, Hogikyan ND (1986) Different mutations in Ashkenazi Jewish and non-Jewish French Canadians with Tay-Sachs disease. Science 232:1646–1648

    Google Scholar 

  • Nicholls RD, Fischel-Ghodsian N, Higgs DR (1987) Recombination of the human α-globin gene cluster: sequence features and topological constraints. Cell 49:369–378

    Google Scholar 

  • Rizza CR, Jones P (1987) Management of patients with inherited blood coagulation defects. In: Bloom AL, Thomas DP (eds) Haemostasis and thrombosis. Churchill Livingstone, Edinburgh, pp 465–493

    Google Scholar 

  • Rizza CR, Spooner JRD (1983) Treatment of haemophilia and related disorders in Britain and Northern Ireland during 1976–80: report on behalf of the directors of haemophilia centres in the United Kingdom. Br Med J 286:929

    Google Scholar 

  • Saiki RK, Chang CA, Levenson CH, Warren TC, Boehm CD, Kazazian HH, Erlich HA (1988) Diagnosis of sickle cell anemia and beta-thalassemia with enzymatically amplified DNA and non-radioactive allele-specific oligonucleotide probes. N Engl J Med 319:537–541

    Google Scholar 

  • Schwartz C, Fitch N, Phelan MC, Richer C-L, Stevenson R (1987) Two sisters with a distal deletion at the Xq26/Xq27 interface: DNA studies indicate that the gene locus for factor IX is present. Hum Genet 76:54–57

    Google Scholar 

  • Schwarzinger I, Pabinger I, Korninger C, Haschke F, Kundi M, Niessner H, Lechner K (1987) Incidence of inhibitors in patients with severe and moderate hemophilia A treated with factor VIII concentrates. Am J Hematol 24:241–245

    Google Scholar 

  • Shapiro SS (1984) Genetic predisposition to inhibitor formation. In: Hoyer LW (eds) Factor VIII inhibitors. Liss, New York, pp 45–55

    Google Scholar 

  • Toole JJ, Knopf JF, Wozney JM, Sultzman LA, Buecker JL, Pittman DD, Kaufman RJ, Brown E, Shoemaker C, Orr EC, Amphlett GW, Foster WB, Coe ML, Knutson GJ, Fass DN, Hewick RM (1984) Molecular cloning of a cDNA encoding human anti-haemophilic factor. Nature 312:342–347

    Google Scholar 

  • Tuddenham EGD (1989) Factor VIII and haemophilia A. Baillieres Clin Haematol 2:849–877

    Google Scholar 

  • Wion KL, Tuddenham EGD, Lawn RM (1986) A new polymorphism in the factor VIII gene for prenatal diagnosis of hemophilia A. Nucleic Acids Res 14:4535–4542

    Google Scholar 

  • Woods-Samuels P, Kazazian HH Jr, Antonarakis SE (1989) Molecular characterization of four deletions in the human factor VIII gene in patients with hemophilia A. Am J Hum Genet 45 [Suppl]:A230

    Google Scholar 

  • Youssoufian H, Antonarakis SE, Phillips DG, Aronis S, Tsiftis G, Kazazian HH Jr (1987a) Characterization of five partial deletions of the factor VIII gene. Proc Natl Acad Sci USA 84:3772–3776

    Google Scholar 

  • Youssoufian H, Phillips DG, Kazazian HH Jr, Antonarakis SE (1987b) MspI polymorphism in the 3′ flanking region of the factor VIII gene. Nucleic Acids Res 15:6312

    Google Scholar 

  • Youssoufian H, Patel A, Phillips D, Kazazian HH Jr, Antonarakis SE (1987c) Recurrent mutations and an unusual deletion in haemophilia A. Thromb Haemost 58:336

    Google Scholar 

  • Youssoufian H, Kaspar CK, Phillips DG, Kazazian HH Jr, Antonarakis SE (1988) Restriction endonuclease mapping of six novel deletions of the factor VIII gene in hemophilia A. Hum Genet 80:143–148

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Millar, D.S., Steinbrecher, R.A., Wieland, K. et al. The molecular genetic analysis of haemophilia A; characterization of six partial deletions in the factor VIII gene. Hum Genet 86, 219–227 (1990). https://doi.org/10.1007/BF00197709

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00197709

Keywords

Navigation