Skip to main content
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1984 Oct;74(4):1221–1228. doi: 10.1172/JCI111531

Factor V (Quebec): a bleeding diathesis associated with a qualitative platelet Factor V deficiency.

P B Tracy, A R Giles, K G Mann, L L Eide, H Hoogendoorn, G E Rivard
PMCID: PMC425288  PMID: 6480825

Abstract

Studies were performed on a French-Canadian family afflicted with a bleeding disorder exhibiting an autosomal dominant inheritance pattern and a severe bleeding diathesis after trauma. Clinical laboratory coagulation tests were unimpressive; the only persistent abnormalities include mild thrombocytopenia and moderately reduced Factor V clotting activities. Some individuals had prolonged Stypven times when platelet-rich plasma was used, suggesting that their platelets could not support functional prothrombinase complex assembly. Detailed studies were performed by use of plasma and isolated, washed platelets from a sister and brother. Bioassay data indicate that both individuals had Factor V activities of approximately 40 and 36% of normal, respectively. A comparison of the Factor V radioimmunoassay and bioassay data on the brother's plasma indicated that the circulating amount of Factor V functional activity was low relative to Factor V antigen concentration (approximately 65-75%). In both individuals, the platelet Factor V functional activities were extremely low (2-4%) relative to antigen levels present as determined by radioimmunoassay. These discrepancies between Factor V activities and antigen concentration do not appear to be due to an unstable Factor V molecule or to the presence of a Factor V or Factor Va inhibitor or inactivator. Kinetics of prothrombin activation by use of purified clotting factors indicated that thrombin-activated platelets from both individuals supported prothrombinase complex assembly identical to controls in the presence of added purified Factor Va. Consequently, their bleeding diathesis appears to reflect their platelet, rather than their plasma, Factor V activity. These results suggest that platelet Factor V is an essential component in maintaining stable and prolonged hemostasis after trauma.

Full text

PDF
1225

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bajaj S. P., Rapaport S. I., Prodanos C. A simplified procedure for purification of human prothrombin, factor IX and factor X. Prep Biochem. 1981;11(4):397–412. doi: 10.1080/00327488108065531. [DOI] [PubMed] [Google Scholar]
  2. Chesney C. M., Pifer D., Colman R. W. Subcellular localization and secretion of factor V from human platelets. Proc Natl Acad Sci U S A. 1981 Aug;78(8):5180–5184. doi: 10.1073/pnas.78.8.5180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Davie E. W., Fujikawa K. Basic mechanisms in blood coagulation. Annu Rev Biochem. 1975;44:799–829. doi: 10.1146/annurev.bi.44.070175.004055. [DOI] [PubMed] [Google Scholar]
  4. Downing M. R., Butkowski R. J., Clark M. M., Mann K. G. Human prothrombin activation. J Biol Chem. 1975 Dec 10;250(23):8897–8906. [PubMed] [Google Scholar]
  5. FLETCHER A. P., ALKJAERSIG N., SHERRY S. The maintenance of a sustained thrombolytic state in man. I. Induction and effects. J Clin Invest. 1959 Jul;38(7):1096–1110. doi: 10.1172/JCI103886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gerrard J. M., Phillips D. R., Rao G. H., Plow E. F., Walz D. A., Ross R., Harker L. A., White J. G. Biochemical studies of two patients with the gray platelet syndrome. Selective deficiency of platelet alpha granules. J Clin Invest. 1980 Jul;66(1):102–109. doi: 10.1172/JCI109823. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ittyerah T. R., Rawala R., Colman R. W. Immunochemical studies of factor V of bovine platelets. Eur J Biochem. 1981 Nov;120(2):235–241. doi: 10.1111/j.1432-1033.1981.tb05694.x. [DOI] [PubMed] [Google Scholar]
  8. Kane W. H., Majerus P. W. The interaction of human coagulation factor Va with platelets. J Biol Chem. 1982 Apr 10;257(7):3963–3969. [PubMed] [Google Scholar]
  9. Katzmann J. A., Nesheim M. E., Hibbard L. S., Mann K. G. Isolation of functional human coagulation factor V by using a hybridoma antibody. Proc Natl Acad Sci U S A. 1981 Jan;78(1):162–166. doi: 10.1073/pnas.78.1.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kisiel W., Hermodson M. A., Davie E. W. Factor X activating enzyme from Russell's viper venom: isolation and characterization. Biochemistry. 1976 Nov 2;15(22):4901–4906. doi: 10.1021/bi00667a023. [DOI] [PubMed] [Google Scholar]
  11. Lundblad R. L., Uhteg L. C., Vogel C. N., Kingdon H. S., Mann K. G. Preparation and partial characterization of two forms of bovine thrombin. Biochem Biophys Res Commun. 1975 Sep 16;66(2):482–489. doi: 10.1016/0006-291x(75)90536-7. [DOI] [PubMed] [Google Scholar]
  12. Mann K. G. Prothrombin. Methods Enzymol. 1976;45:123–156. doi: 10.1016/s0076-6879(76)45016-4. [DOI] [PubMed] [Google Scholar]
  13. Miletich J. P., Jackson C. M., Majerus P. W. Properties of the factor Xa binding site on human platelets. J Biol Chem. 1978 Oct 10;253(19):6908–6916. [PubMed] [Google Scholar]
  14. Miletich J. P., Majerus D. W., Majerus P. W. Patients with congenital factor V deficiency have decreased factor Xa binding sites on their platelets. J Clin Invest. 1978 Oct;62(4):824–831. doi: 10.1172/JCI109194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Mustard J. F., Perry D. W., Ardlie N. G., Packham M. A. Preparation of suspensions of washed platelets from humans. Br J Haematol. 1972 Feb;22(2):193–204. doi: 10.1111/j.1365-2141.1972.tb08800.x. [DOI] [PubMed] [Google Scholar]
  16. Nesheim M. E., Katzmann J. A., Tracy P. B., Mann K. G. Factor V. Methods Enzymol. 1981;80(Pt 100):249–274. doi: 10.1016/s0076-6879(81)80023-7. [DOI] [PubMed] [Google Scholar]
  17. Nesheim M. E., Myrmel K. H., Hibbard L., Mann K. G. Isolation and characterization of single chain bovine factor V. J Biol Chem. 1979 Jan 25;254(2):508–517. [PubMed] [Google Scholar]
  18. Nesheim M. E., Prendergast F. G., Mann K. G. Interactions of a fluorescent active-site-directed inhibitor of thrombin: dansylarginine N-(3-ethyl-1,5-pentanediyl)amide. Biochemistry. 1979 Mar 20;18(6):996–1003. doi: 10.1021/bi00573a010. [DOI] [PubMed] [Google Scholar]
  19. Nesheim M. E., Taswell J. B., Mann K. G. The contribution of bovine Factor V and Factor Va to the activity of prothrombinase. J Biol Chem. 1979 Nov 10;254(21):10952–10962. [PubMed] [Google Scholar]
  20. PROCTOR R. R., RAPAPORT S. I. The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. Am J Clin Pathol. 1961 Sep;36:212–219. doi: 10.1093/ajcp/36.3.212. [DOI] [PubMed] [Google Scholar]
  21. Peake I. R., Bloom A. L., Giddings J. C. Inherited variants of factor-VIII-related protein in von Willebrand's disease. N Engl J Med. 1974 Jul 18;291(3):113–117. doi: 10.1056/NEJM197407182910301. [DOI] [PubMed] [Google Scholar]
  22. Raccuglia G. Gray platelet syndrome. A variety of qualitative platelet disorder. Am J Med. 1971 Dec;51(6):818–828. doi: 10.1016/0002-9343(71)90311-1. [DOI] [PubMed] [Google Scholar]
  23. Suttie J. W., Jackson C. M. Prothrombin structure, activation, and biosynthesis. Physiol Rev. 1977 Jan;57(1):1–70. doi: 10.1152/physrev.1977.57.1.1. [DOI] [PubMed] [Google Scholar]
  24. Tracy P. B., Eide L. L., Bowie E. J., Mann K. G. Radioimmunoassay of factor V in human plasma and platelets. Blood. 1982 Jul;60(1):59–63. [PubMed] [Google Scholar]
  25. Tracy P. B., Nesheim M. E., Mann K. G. Coordinate binding of factor Va and factor Xa to the unstimulated platelet. J Biol Chem. 1981 Jan 25;256(2):743–751. [PubMed] [Google Scholar]
  26. Tracy P. B., Peterson J. M., Nesheim M. E., McDuffie F. C., Mann K. G. Interaction of coagulation factor V and factor Va with platelets. J Biol Chem. 1979 Oct 25;254(20):10354–10361. [PubMed] [Google Scholar]
  27. Tracy P. B., Rohrbach M. S., Mann K. G. Functional prothrombinase complex assembly on isolated monocytes and lymphocytes. J Biol Chem. 1983 Jun 25;258(12):7264–7267. [PubMed] [Google Scholar]
  28. Vicic W. J., Lages B., Weiss H. J. Release of human platelet factor V activity is induced by both collagen and ADP and is inhibited by aspirin. Blood. 1980 Sep;56(3):448–455. [PubMed] [Google Scholar]
  29. Weiss H. J., Hoyer L. W., Rickles F. R., Varma A., Rogers J. Quantitative assay of a plasma factor deficient in von Willebrand's disease that is necessary for platelet aggregation. Relationship to factor VIII procoagulant activity and antigen content. J Clin Invest. 1973 Nov;52(11):2708–2716. doi: 10.1172/JCI107465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Young V. P., Giles A. R., Pater J., Corbett W. E. Sex differences in bleeding time and blood loss in normal subjects following aspirin ingestion. Thromb Res. 1980 Dec 1;20(5-6):705–709. doi: 10.1016/0049-3848(80)90160-7. [DOI] [PubMed] [Google Scholar]
  31. Zimmerman T. S., Ratnoff O. D., Littell A. S. Detection of carriers of classic hemophilia using an immunologic assay for antihemophilic factor (factor 8(). J Clin Invest. 1971 Jan;50(1):255–258. doi: 10.1172/JCI106481. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES