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A novel heterozygous ITGB3 p.T720del inducing spontaneous activation of integrin αIIbβ3 in autosomal dominant macrothrombocytopenia with aggregation dysfunction

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Abstract

We identified a novel heterozygous ITGB3 p.T720del mutation in a pedigree with macrothrombocytopenia exhibiting aggregation dysfunction. Platelet aggregation induced by ADP and collagen was significantly reduced, while ristocetin aggregation was normal. Integrin αIIbβ3 was partially activated in a resting status, but platelet expression of αIIbβ3 was downregulated. Functional analysis using a cell line showed spontaneous phosphorylation of FAK in αIIb/β3 (p.T720del)-transfected 293T cells in suspension conditions. Abnormal cytoplasmic protrusions, membrane ruffling, and cytoplasmic localization of αIIbβ3 were observed in αIIb/β3 (p.T720del)-transfected CHO cells. Such morphological changes were reversed by treatment with an FAK inhibitor. These findings imply spontaneous, but partial, activation of αIIbβ3 followed by phosphorylation of FAK as the initial mechanism of abnormal thrombopoiesis. Internalization and decreased surface expression of αIIbβ3 would contribute to aggregation dysfunction. We reviewed the literature of congenital macrothrombocytopenia associated with heterozygous ITGA2B or ITGB3 mutations. Reported mutations were highly clustered at the membrane proximal region of αIIbβ3, which affected the critical interaction between αIIb R995 and β3 D723, resulting in a constitutionally active form of the αIIbβ3 complex. Macrothrombocytopenia caused by a heterozygous activating mutation of ITGA2B or ITGB3 at the membrane proximal region forms a distinct entity of rare congenital thrombocytopenia.

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Acknowledgments

We thank Professor Kazuhiko Matsuno (Rakuno Gakuen University, Ebetsu) for kind advice for flow cytometry.

Funding

There is no financial relationship with other people or organizations that could inappropriately influence their work.

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Authors and Affiliations

  1. Department of Hematology, Hokkaido University Faculty of Medicine, Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 0608638, Japan

    Naohiro Miyashita, Masahiro Onozawa, Kohei Okada, Hideki Goto, Masao Nakagawa, Daigo Hashimoto, Kaoru Kahata, Takeshi Kondo & Takanori Teshima

  2. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan

    Koji Hayasaka

  3. Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan

    Takahiro Yamada

  4. Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan

    Ohsuke Migita & Kenichiro Hata

  5. Department of Advanced Diagnosis, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Shinji Kunishima

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  1. Naohiro Miyashita
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Correspondence to Masahiro Onozawa.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. Informed consent was obtained from all patients for being included in the study. This study was approved by the Institutional Review Board of Hokkaido University Faculty of Medicine.

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Miyashita, N., Onozawa, M., Hayasaka, K. et al. A novel heterozygous ITGB3 p.T720del inducing spontaneous activation of integrin αIIbβ3 in autosomal dominant macrothrombocytopenia with aggregation dysfunction. Ann Hematol 97, 629–640 (2018). https://doi.org/10.1007/s00277-017-3214-4

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