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Borràs N, Batlle J, Pérez-Rodríguez A, López-Fernández MF, Rodríguez-Trillo Á, Lourés E, Cid AR, Bonanad S, Cabrera N, Moret A, Parra R, Mingot-Castellano ME, Balda I, Altisent C, Pérez-Montes R, Fisac RM, Iruín G, Herrero S, Soto I, de Rueda B, Jiménez-Yuste V, Alonso N, Vilariño D, Arija O, Campos R, Paloma MJ, Bermejo N, Berrueco R, Mateo J, Arribalzaga K, Marco P, Palomo Á, Sarmiento L, Iñigo B, Nieto MDM, Vidal R, Martínez MP, Aguinaco R, César JM, Ferreiro M, García-Frade J, Rodríguez-Huerta AM, Cuesta J, Rodríguez-González R, García-Candel F, Cornudella R, Aguilar C, Vidal F, Corrales I. Molecular and clinical profile of von Willebrand disease in Spain (PCM-EVW-ES): comprehensive genetic analysis by next-generation sequencing of 480 patients. Haematologica 2017; 102:2005-2014. [PMID: 28971901 PMCID: PMC5709099 DOI: 10.3324/haematol.2017.168765] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 09/20/2017] [Indexed: 01/10/2023] Open
Abstract
Molecular diagnosis of patients with von Willebrand disease is pending in most populations due to the complexity and high cost of conventional molecular analyses. The need for molecular and clinical characterization of von Willebrand disease in Spain prompted the creation of a multicenter project (PCM-EVW-ES) that resulted in the largest prospective cohort study of patients with all types of von Willebrand disease. Molecular analysis of relevant regions of the VWF, including intronic and promoter regions, was achieved in the 556 individuals recruited via the development of a simple, innovative, relatively low-cost protocol based on microfluidic technology and next-generation sequencing. A total of 704 variants (237 different) were identified along VWF, 155 of which had not been previously recorded in the international mutation database. The potential pathogenic effect of these variants was assessed by in silico analysis. Furthermore, four short tandem repeats were analyzed in order to evaluate the ancestral origin of recurrent mutations. The outcome of genetic analysis allowed for the reclassification of 110 patients, identification of 37 asymptomatic carriers (important for genetic counseling) and re-inclusion of 43 patients previously excluded by phenotyping results. In total, 480 patients were definitively diagnosed. Candidate mutations were identified in all patients except 13 type 1 von Willebrand disease, yielding a high genotype-phenotype correlation. Our data reinforce the capital importance and usefulness of genetics in von Willebrand disease diagnostics. The progressive implementation of molecular study as the first-line test for routine diagnosis of this condition will lead to increasingly more personalized and effective care for this patient population.
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Affiliation(s)
- Nina Borràs
- Banc de Sang i Teixits, Barcelona, Spain
- Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Spain
| | - Javier Batlle
- Complexo Hospitalario Universitario A Coruña, INIBIC, Spain
| | | | | | | | - Esther Lourés
- Complexo Hospitalario Universitario A Coruña, INIBIC, Spain
| | - Ana Rosa Cid
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Noelia Cabrera
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Andrés Moret
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Rafael Parra
- Banc de Sang i Teixits, Barcelona, Spain
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Ignacia Balda
- Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | - Gemma Iruín
- Hospital Universitario Cruces, Barakaldo, Spain
| | | | | | | | | | | | - Dolores Vilariño
- Complejo Hospitalario Universitario Santiago de Compostela, Spain
| | - Olga Arija
- Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | | | | | - José Mateo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rosa Cornudella
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Francisco Vidal
- Banc de Sang i Teixits, Barcelona, Spain
- Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Spain
- CIBER de Enfermedades Cardiovasculares, Spain
| | - Irene Corrales
- Banc de Sang i Teixits, Barcelona, Spain
- Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Spain
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