Thromb Haemost 2005; 94(02): 233-234
DOI: 10.1160/TH05-07-0471
Editorial Focus
Schattauer GmbH

Genetic variants in the endothelial protein C receptor gene: reaching significance

Pablo García de Frutos
1   Department of Neurological and Vascular Research, Institute of Biomedical Research of Barcelona (IIBB-CSIC-IDIBAPS), Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Received: 04 July 2005

Accepted after major revision: 05 July 2005

Publication Date:
29 December 2017 (online)

Summary

Since the discovery of activated protein C (APC) resistance, mutations and genetic variants in the protein C pathway have been put into the spotlight of research in the pathophysiology of haemostasis. Although none of the more recently discovered mutations in the components of the natural anticoagulant pathways have equalled the clear-cut effect of factor V Leiden in thrombosis and its epidemiological importance, some recent work in several genes of the pathway have shown promising results in linking genotype and phenotype which could explain certain mechanisms in respective thrombosis associated pathologies. The discovery of a specific endothelial protein C receptor (EPCR) and the deciphering of its importance in the biology of protein C, opened up the possibility that genetic variants in the EPCR gene (PROCR) could play a role in the risk for thrombosis (1, 2). The EPCR functions to enhance the activation of anticoagulant protein C by the thrombin-thrombomodulin complex, and it is essential for the interaction of protein C with protease activated receptor 1. In this way, the EPCR acts in the anticoagulant, profibrinolytic and anti-inflammatory response (1, 3, 4). EPCR knock-out mice show early embryonic lethality (5), although a small amount of EPCR is sufficient to maintain the animals alive and fertile (6) …

 
  • References

  • 1 Fukudome K, Esmon CT. Molecular cloning and expression of murine and bovine endothelial cell protein C/activated protein C receptor (EPCR). The structural and functional conservation in human, bovine, and murine EPCR. J Biol Chem 1995; 270: 5571-7.
  • 2 Simmonds RE, Lane DA. Structural and functional implications of the intron/exon organization of the human endothelial cell protein C/activated protein C receptor (EPCR) gene: comparison with the structure of CD1/major histocompatibility complex alpha1 and alpha2 domains. Blood 1999; 94: 632-41.
  • 3 Riewald M, Petrovan RJ, Donner A. et al. Activation of endothelial cell protease activated receptor 1 by the protein C pathway. Science 2002; 296: 1880-2.
  • 4 Brueckmann M, Horn S, Lang S. et al. Recombinant human activated protein C upregulates cyclooxygenase- 2 expression in endothelial cells via binding to endothelial cell protein C receptor and activation of protease- activated receptor-1. Thromb Haemost 2005; 93: 743-50.
  • 5 Gu JM, Crawley JT, Ferrell G. et al. Disruption of the endothelial cell protein C receptor gene in mice causes placental thrombosis and early embryonic lethality. J Biol Chem 2002; 277: 43335-43.
  • 6 Castellino FJ, Liang Z, Volkir SP. et al. Mice with a severe deficiency of the endothelial protein C receptor gene develop, survive, and reproduce normally, and do not present with enhanced arterial thrombosis after challenge. Thromb Haemost 2002; 88: 462-72.
  • 7 Biguzzi E, Merati G, Liaw PC. et al. A 23bp insertion in the endothelial protein C receptor (EPCR) gene impairs EPCR function. Thromb Haemost 2001; 86: 945-8.
  • 8 Galligan L, Livingstone W, Mynett-Johnston L, Smith OP. Prevalence of the 23bp endothelial protein C receptor (EPCR) gene insertion in the Irish population. Thromb Haemost 2002; 87: 773-4.
  • 9 Poort SR, Vos HL, Rosendaal FR, Bertina RM. The endothelial protein C receptor (EPCR) 23 bp insert mutation and the risk of venous thrombosis. Thromb Haemost 2002; 88: 160-2.
  • 10 Grossmann R, Schwender S, Geisen U. et al. CBS 844ins68, MTHFR TT677 and EPCR 4031ins23 genotypes in patients with deep-vein thrombosis. Thromb Res 2002; 107: 13-5.
  • 11 Akar N, Gokdemir R, Ozel D, Akar E. Endothelial cell protein C receptor (EPCR) gene exon III, 23 bp insertion mutation in the Turkish pediatric thrombotic patients. Thromb Haemost 2002; 88: 1068-9.
  • 12 von Depka M, Czwalinna A, Eisert R. et al. Prevalence of a 23bp insertion in exon 3 of the endothelial cell protein C receptor gene in venous thrombophilia. Thromb Haemost 2001; 86: 1360-2.
  • 13 Saposnik B, Reny JL, Gaussem P. et al. A haplotype of the EPCR gene is associated with increased plasma levels of sEPCR and is a candidate risk factor for thrombosis. Blood 2004; 103: 1311-8.
  • 14 Uitte de Willige S, Van Marion V, Rosendaal FR. et al. Haplotypes of the EPCR gene, plasma sEPCR levels and the risk of deep venous thrombosis. J Thromb Haemost 2004; 2: 1305-10.
  • 15 Medina P, Navarro S, Estelles A. et al. Contribution of polymorphisms in the endothelial protein C receptor gene to soluble endothelial protein C receptor and circulating activated protein C levels, and thrombotic risk. Thromb Haemost 2004; 91: 905-11.
  • 16 Medina P, Navarro S, Estellés A. et al. Influence of the 4600A/G and 4678G/C polymorphisms in the endothelial protein C receptor (EPCR) gene on the risk of venous thromboembolism in carriers of factor V Leiden. Thromb Haemost 2005; 94: 389-94.
  • 17 Voetsch B, Loscalzo J. Genetic determinants of arterial thrombosis. Arterioscler Thromb Vasc Biol 2004; 24: 129-43.
  • 18 Rice GI, Futers TS, Grant PJ. Identification of novel polymorphisms within the protein Z gene,haplotype distribution and linkage analysis. Thromb Haemost 2001; 85: 1123-4.
  • 19 Muñoz X, Sumoy L, Ramírez-Lorca R. et al. Human Vitamin K-Dependent GAS6: gene structure, allelic variation and association with stroke. Human Mutation 2004; 23: 506-12.
  • 20 Zöller B, García de Frutos P, Hillarp A, Dahlbäck B. Thrombophilia as a multigenetic disease. Haematologica 1999; 84: 59-70.