Summary
Factor VII (FVII) requires the cleavage of an internal peptide bond and the association
with tissue factor (TF) to attain its fully active FVIIa conformation. This event
alone leaves FVIIa in a zymogen-like state of relatively low specific activity. The
TF-induced allosteric enhancement of FVIIa’s activity contributes to the procoagulant
activity of the complex. We have characterized two naturally occurring mutations (S363I
W364C) on FVII gene. Both homozygous patients for each mutation have a normal FVII:Ag
level associated to an undetectable FVII coagulant activity. The patient carrying
the allele 364C had a more severe hemorrhagic diathesis than the S363I mutant. To
understand the mechanism of these deficiency, in vitro expression analysis with further
biochemical characterization of recombinant proteins of both mutants FVII-363I, FVII-364C
and wild type (WTFVII) FVII constructs were done. The results recapitulated the patients’
plasma data with normal Ag level and no detectable coagulant activity. The D-F-Pip-R-pNA
and CH3SO2-D-CHA-A-But-R chromogenic substrates were used to evaluate the amidolytic
activity of WT and mutant FVII in presence and absence of recombinant tissue factor
(rTF). Binding of FVII to rTF by a solid phase binding assay was done using recombinant
human rTF. The results of amidolytic assays showed that rTF enhances 28 fold the value
of the specificity of constant (kcat/Km) in WT but no activity was detectable in either
mutant constructs under any condition. The equilibrium dissociation constant of rTF-FVIIa
interaction showed Kd equal to 4.4 ± 0.2nM, 4.9 ± 0.5nM and 6 ± 0.9 of WT, 363I and
364C FVII forms, respectively. The Kd values of the non activated forms were equal
to 24.7 ± 3.3, 24.4 ± 3.1 and 20.6 ± 4nM, respectively. These data demonstrate that,
compared to the WT form, FVII-363I and FVII-364C have no significant affinity change
for TF and that the detrimental effect of these two mutations is attributable to the
loss of an efficient catalytic machinery in the FVII molecule causing a severe deficiency
of coagulant activities.
Keywords
Factor VII - extrinsic coagulation - tissue factor