Inherited dysfunctional platelet P2Y12 receptor mutations associated with bleeding disorders

Anna Lecchi, Eti A. Femia, Silvia Paoletta, Arnaud Dupuis, Philippe Ohlmann, Christian Gachet, Kenneth A. Jacobson, Katharina Machura, Gian Marco Podda, Barbara Zieger, Marco Cattaneo

Research output: Contribution to journalArticlepeer-review

Abstract

The platelet adenosine 5'-diphosphate (ADP) receptor P2Y12 (P2Y12R) plays a critical role in platelet aggregation. The present report illustrates an update of dysfunctional platelet P2Y12R mutations diagnosed with congenital lifelong bleeding problems. Described patients with heterozygous or homozygous substitution in the P2Y12R gene and qualitative abnormalities of the platelet P2Y12R are summarized. Recently, a further dysfunctional variant of P2Y12R has been identified in two brothers who presented with a lifelong severe bleeding disorder. During in vitro aggregation studies, the patient's platelets show a markedly reduced and rapid reversible ADP-promoted aggregation. A homozygous c.561T > A substitution that changes the codon for His187 to Gln (p.His187Gln) in the P2Y12R gene has been identified. This mutation causes no change in receptor expression but decreases the affinity of the ligand for the receptor, even at high concentrations. Structure modelling studies indicated that the p.His187Gln mutation, located in the fifth transmembrane spanning domain (TM5), impairs conformational changes of the receptor. Structural integrity of the TM5 region is necessary for agonist and antagonist binding and for correct receptor function.

Original languageEnglish
Pages (from-to)279-283
Number of pages5
JournalHamostaseologie
Volume36
Issue number4
Publication statusPublished - 2016

Keywords

  • Mutation
  • P2Y receptor
  • Platelets

ASJC Scopus subject areas

  • Medicine(all)
  • Hematology

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