Summary
The B domain of the coagulation factor (F)VIII comprises some unique characteristics.
Though the B domain is important for processing, intracellular transport and secretion
of FVIII protein, its role in the coagulation still remains unclear. This study aims
to investigate the influence of 19 reported B domain variants on quantity and quality
of expressed FVIII protein. F8 variants were transiently expressed in HEK293T cells. Media and cell lysates were
collected after 72 hours. FVIII synthesis, relative secretion, activity and thermostability
were analysed in comparison to FVIII wild-type. Eleven of 19 analysed B domain variants
showed normal FVIII activity (FVIII:C), and antigen values (40–150 %). Eight variants
exhibited a decreased FVIII:C, corresponding to a mild phenotype most likely due to
impaired expression and secretion mechanism, reduced thermostability or combined mechanisms.
One variant, p.His1066Tyr, showed markedly reduced FVIII antigen in cell lysate. The
variants p.Asp845Glu, p.His998Gln, and p.Ala1610Ser revealed a significantly decreased
relative secretion. Additionally, six B domain variants significantly reduced stability
of FVIII. In conclusion, none of the analysed missense mutations was causative for
a severe haemophilia A (HA) phenotype. Nevertheless, the mutations p.Asp845Glu, p.Pro947Arg,
p.Glu1057Lys, p.His1066Tyr, p.Arg1126Trp, p.Arg1329His, p.Leu1481Pro, and p.Ala1610Ser
resulted in decreased FVIII:C values that may explain mild HA phenotypes.
Keywords
Factor VIII - B domain - missense mutation - genotype-phenotype relationship