• Luca Monaldini, Rosanna Asselta, Stefano Duga, Flora Peyvandi, Kanjaksha Ghosh, Massimo Malcovati, and Maria Luisa Tenchini.
• Department of Biology and Genetics for Medical Sciences, University of Milan, Milan, Italy. stefano.duga@unimi.it
• Haematologica. 2006 May 1; 91 (5): 628-33.

Background And ObjectivesAfibrinogenemia and hypofibrinogenemia are rare inherited coagulation disorders characterized by hemorrhagic manifestations of variable entity and by plasma fibrinogen deficiency. So far, 57 mutations have been associated with these disorders, and 18 of these are missense mutations. The aim of this study was to characterize the molecular mechanism underlying severe hypofibrinogenemia in a proband from India.Design And MethodsThe mutational screening was accomplished by DNA sequencing of the three fibrinogen genes. The mutant protein was expressed in COS-1 cells, and intracellular and secreted mutant fibrinogen was analyzed by means of pulse-chase experiments.ResultsA novel homozygous G-->A transition in exon 8 (nucleotide position 8017) was found in the proband's fibrinogen Bbeta-chain gene. The resulting G434D missense mutation (fibrinogen Mumbai) involves a highly conserved amino acid residue, located in the C-terminal globular D domain. In vitro expression experiments demonstrated intracellular retention of the mutant fibrinogen and marked reduction of its secretion.Interpretation And ConclusionsThe G434D substitution causes severe hypofibrinogenemia by impairing fibrinogen secretion. Expression data confirm the importance of Bbeta-chain D domain folding in the intracellular processing of fibrinogen.

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