Genotypic and phenotypic spectrum of VWF exon 20 variants in type 1 Von Willebrand disease: Insights from Eastern Saudi Arabia
Keywords:
phenotype, genotype, von willebrand disease type1, vWF gene, exon 20, mutation analysis, genotype-phenotype correlation, coagulation disorders, genetic variation, Saudi ArabiaAbstract
Background and aim: VWD is a genetic bleeding disorder, divided into three types VWD types 1,2, and 3. Aim was to determine whether a common SNP present at exon 20 of the VWD gene is associated with ABO groups, VWF levels, and platelet aggregation-related functional consequences in the Eastern Saudi Arabia.
Methods: It included 160 cases and controls, 60 of whom were cases from 19 families, all participants were categorized into four groups: 22 index cases who had previously been diagnosed with type 1 VWD, 21 family members who had also been diagnosed with type 1 VWD, 17 unaffected family members, and 100 healthy Saudi controls.
Results: The results indicate that the distribution of blood groups among different study groups was statistically significant. It also indicates that the VWF: Ag, VWF: RCO assay, VWF: RCO/ VWF: Ag ratio and FVIII: C are significantly lower in index cases and affected family members than in non-affected family members and control groups. Among the 60 DNA samples, one variant (c.2555A>G) was found in all 60 samples, with 83.3% homozygous and 16.6% heterozygous.
Conclusions: It appears that VWF levels are influenced by blood groups. One variant identified in exon 20 with a high prevalence in our population does not appear to be associated with disease status or may act in conjunction with other factors, so, further comprehensive genomic analyses of VWF are recommended to gain a better understanding of disease.
References
1. Berntorp E. Erik von Willebrand. Thromb Res. 2007;120(Suppl 1):S3-4. doi: 10.1016/j.thromres.2007.03.010.
2. Swami A, Kaur V. Von Willebrand disease: a concise review and update for the practicing physician. Clin Appl Thromb Hemost. 2017;23(8):900-910. doi: 10.1177/1076029616675969.
3. Du P, Bergamasco A, Moride Y, Truong Berthoz F, Ozen G, Tzivelekis S. Von Willebrand disease epidemiology, burden of illness and management: a systematic review. J Blood Med. 2023;14:189-208. doi: 10.2147/jbm.s389241.
4. Bharati KP, Prashanth UR. Von Willebrand disease: an overview. Indian J Pharm Sci. 2011;73(1):7-16. doi: 10.4103/0250-474x.89751.
5. Yadegari H, Oldenburg J. The current understanding of molecular pathogenesis of quantitative von Willebrand disease, types 1 and 3. Hamostaseologie. 2020;40(1):105-118. doi: 10.1055/s-0039-3400260.
6. Mannucci PM. Treatment of von Willebrand's disease. N Engl J Med. 2004;351(7):683-694. doi: 10.1056/nejmra040403.
7. Sharma R, Flood VH. Advances in the diagnosis and treatment of von Willebrand disease. Blood. 2017;130(22):2386-2391. doi: 10.1182/blood-2017-05-782029.
8. Goodeve A, Eikenboom J, Castaman G, et al. Phenotype and genotype of a cohort of families historically diagnosed with type 1 von Willebrand disease in the European study, Molecular and Clinical Markers for the Diagnosis and Management of Type 1 von Willebrand Disease (MCMDM-1VWD). Blood. 2007;109(1):112-121. doi: 10.1182/blood-2006-05-020784.
9. Sidonio RF, Lavin M. Diagnostic pitfalls and conundrums in type 1 von Willebrand disease. Hematology Am Soc Hematol Educ Program. 2022;2022(1):618-623. doi: 10.1182/hematology.2022000389.
10. Berber E. The molecular genetics of von Willebrand disease. Turk J Haematol. 2012;29(4):313-324. doi: 10.5505/tjh.2012.39205.
11. Gale AJ. Continuing education course #2: current understanding of hemostasis. Toxicol Pathol. 2011;39(1):273-280. doi: 10.1177/0192623310389474.
12. Tang W, Cushman M, Green D, et al. Gene-centric approach identifies new and known loci for FVIII activity and VWF antigen levels in European Americans and African Americans. Am J Hematol. 2015;90(6):534-540. doi: 10.1002/ajh.24005.
13. Vaidya D, Yanek LR, Herrera-Galeano J, et al. A common variant in the von Willebrand factor gene is associated with multiple functional consequences. Am J Hematol. 2010;85(12):971-973. doi: 10.1002/ajh.21859.
14. van Loon JE, Kavousi M, Leebeek FW, et al. Von Willebrand factor plasma levels, genetic variations and coronary heart disease in an older population. J Thromb Haemost. 2012;10(7):1262-1269. doi: 10.1111/j.1538-7836.2012.04771.x.
15. De Wee EM, Knol HM, Mauser-Bunschoten EP, et al. Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease. Thromb Haemost. 2011;106(5):885-892. doi: 10.1160/th11-03-0180.
16. Soucie MJ, Miller CH, Byams VR, et al. Occurrence rates of von Willebrand disease among people receiving care in specialized treatment centres in the United States. Haemophilia. 2021;27(3):445-453. doi: 10.1111/hae.14263.
17. Castaman G, Linari S. Diagnosis and treatment of von Willebrand disease and rare bleeding disorders. J Clin Med. 2017;6(4):45. doi: 10.3390/jcm6040045.
18. O'Donnell J, Laffan MA. The relationship between ABO histo-blood group, factor VIII and von Willebrand factor. Transfus Med. 2001;11(4):343-351. doi: 10.1046/j.1365-3148.2001.00315.x.
19. Manderstedt E, Lind-Hallden C, Lethagen S, Hallden C. Genetic variation in the von Willebrand factor gene in Swedish von Willebrand disease patients. TH Open. 2018;2(1):39-48. doi: 10.1055/s-0037-1618571.
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Copyright (c) 2025 Faisal M. Alzahrani, Asma A. Al Faris, Saeed Sattar Shaikh, Layla A. Bashawri, Fathelrahman Mahdi Hassan, Maryam A. Aldossary, Osama Al Sultan , Thekra N. Al-Maqati, Elmoeiz A. Elnagi, Faten Abdullah Alqahtani, Ahmed Adlan Mohammed Adam, Omar Alsuhaibani , Mohammed A. Alsahli

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