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Defective glycosylation of coagulation factor XII underlies hereditary angioedema type III.


ABSTRACT: Hereditary angioedema type III (HAEIII) is a rare inherited swelling disorder that is associated with point mutations in the gene encoding the plasma protease factor XII (FXII). Here, we demonstrate that HAEIII-associated mutant FXII, derived either from HAEIII patients or recombinantly produced, is defective in mucin-type Thr309-linked glycosylation. Loss of glycosylation led to increased contact-mediated autoactivation of zymogen FXII, resulting in excessive activation of the bradykinin-forming kallikrein-kinin pathway. In contrast, both FXII-driven coagulation and the ability of C1-esterase inhibitor to bind and inhibit activated FXII were not affected by the mutation. Intravital laser-scanning microscopy revealed that, compared with control animals, both F12-/- mice reconstituted with recombinant mutant forms of FXII and humanized HAEIII mouse models with inducible liver-specific expression of Thr309Lys-mutated FXII exhibited increased contact-driven microvascular leakage. An FXII-neutralizing antibody abolished bradykinin generation in HAEIII patient plasma and blunted edema in HAEIII mice. Together, the results of this study characterize the mechanism of HAEIII and establish FXII inhibition as a potential therapeutic strategy to interfere with excessive vascular leakage in HAEIII and potentially alleviate edema due to other causes.

SUBMITTER: Bjorkqvist J 

PROVIDER: S-EPMC4563738 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Defective glycosylation of coagulation factor XII underlies hereditary angioedema type III.

Björkqvist Jenny J   de Maat Steven S   Lewandrowski Urs U   Di Gennaro Antonio A   Oschatz Chris C   Schönig Kai K   Nöthen Markus M MM   Drouet Christian C   Braley Hal H   Nolte Marc W MW   Sickmann Albert A   Panousis Con C   Maas Coen C   Renné Thomas T  

The Journal of clinical investigation 20150720 8


Hereditary angioedema type III (HAEIII) is a rare inherited swelling disorder that is associated with point mutations in the gene encoding the plasma protease factor XII (FXII). Here, we demonstrate that HAEIII-associated mutant FXII, derived either from HAEIII patients or recombinantly produced, is defective in mucin-type Thr309-linked glycosylation. Loss of glycosylation led to increased contact-mediated autoactivation of zymogen FXII, resulting in excessive activation of the bradykinin-formin  ...[more]

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