Macrothrombocytopenia and dense granule deficiency associated with FLI1 variants: ultrastructural and pathogenic features

被引:35
作者
Saultier, Paul [1 ]
Vidal, Lea [1 ]
Canault, Matthias [1 ]
Bernot, Denis [1 ]
Falaise, Celine [2 ]
Pouymayou, Catherine [2 ]
Bordet, Jean-Claude [3 ]
Saut, Noemie [1 ,2 ]
Rostan, Agathe [1 ,2 ]
Baccini, Veronique [1 ,2 ]
Peiretti, Franck [1 ]
Favier, Marie [1 ]
Lucca, Pauline [4 ,5 ,6 ]
Deleuze, Jean-Francois [7 ]
Olaso, Robert [7 ]
Boland, Anne [7 ]
Morange, Pierre Emmanuel [1 ,2 ]
Gachet, Christian [8 ,9 ,10 ,11 ]
Malergue, Fabrice [12 ]
Faure, Sixtine [1 ]
Eckly, Anita [8 ,9 ,10 ,11 ]
Tregouet, David-Alexandre [4 ,5 ,6 ]
Poggi, Marjorie [1 ]
Alessi, Marie-Christine [1 ,2 ]
机构
[1] Aix Marseille Univ, INSERM, INRA, NORT, Marseille, France
[2] CHU Timone, APHM, French Reference Ctr Inherited Platelet Disorders, Marseille, France
[3] Unite Hemostase Biol, Bron, France
[4] ICAN Inst Cardiometab & Nutr, Paris, France
[5] INSERM, UMR S 1166, Team Genom & Pathophysiol Cardiovasc Dis, Paris, France
[6] Univ Pierre & Marie Curie UPMC Univ Paris 06, Sorbonne Univ, UMR S 1166, Paris, France
[7] CEA, Ctr Natl Genotypage, Inst Genom, Evry, France
[8] INSERM, UMR S949, Strasbourg, France
[9] Etab Francais Sang EFS Alsace, Strasbourg, France
[10] FMTS, Strasbourg, France
[11] Univ Strasbourg, Marseille, France
[12] Beckman Coulter Immunotech Life Sci Global Assay, Marseille, France
关键词
ETS TRANSCRIPTION FACTORS; STORAGE POOL DEFICIENCY; GFI1B MUTATION; HUMAN PLATELETS; THROMBOCYTOPENIA; PROMOTER; GENE; EXPRESSION; BINDING; FAMILY;
D O I
10.3324/haematol.2016.153577
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Congenital macrothrombocytopenia is a family of rare diseases, of which a significant fraction remains to be genetically characterized. To analyze cases of unexplained thrombocytopenia, 27 individuals from a patient cohort of the Bleeding and Thrombosis Exploration Center of the University Hospital of Marseille were recruited for a high-throughput gene sequencing study. This strategy led to the identification of two novel FLI1 variants (c. 1010G>A and c. 1033A>G) responsible for macrothrombocytopenia. The FLI1 variant carriers' platelets exhibited a defect in aggregation induced by low-dose adenosine diphosphate (ADP), collagen and thrombin receptor-activating peptide (TRAP), a defect in adenosine triphosphate (ATP) secretion, a reduced mepacrine uptake and release and a reduced CD63 expression upon TRAP stimulation. Precise ultrastructural analysis of platelet content was performed using transmission electron microscopy and focused ion beam scanning electron microscopy. Remarkably, dense granules were nearly absent in the carriers' platelets, presumably due to a biogenesis defect. Additionally, 25-29% of the platelets displayed giant a-granules, while a smaller proportion displayed vacuoles (7-9%) and autophagosome-like structures (0-3%). In vitro study of megakaryocytes derived from circulating CD34(+) cells of the carriers revealed a maturation defect and reduced proplatelet formation potential. The study of the FLI1 variants revealed a significant reduction in protein nuclear accumulation and transcriptional activity properties. Intraplatelet flow cytometry efficiently detected the biomarker MYH10 in FLI1 variant carriers. Overall, this study provides new insights into the phenotype, pathophysiology and diagnosis of FLI1 variant-associated thrombocytopenia.
引用
收藏
页码:1006 / 1016
页数:11
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