Three novel β-propeller mutations causing Glanzmann thrombasthenia result in production of normally stable pro-αIIb, but variably impaired progression of pro-αIIbβ3 from endoplasmic reticulum to Golgi

Background: Glanzmann thrombasthenia (GT) is an autosomal recessive bleeding disorder characterized by lack of platelet aggregation in response to most physiological agonists and caused by either a lack or dysfunction of the platelet integrin alpha(IIb)beta(3) (glycoprotein IIb/IIIa). Objectives: To determine the molecular basis of GT and characterize the mutations by in vitro expression studies. Patients: We studied three unrelated patients from southern India whose diagnosis was consistent with GT. Results: Immunoprecipitation of the cell lysates and immunoblotting showed no detectable mature alpha(IIb) in the G128S mutant, in contrast to 6% and 33% of the normal amount of mature alpha(IIb) in the S287L and G357S mutants, respectively. Pulse-chase analysis demonstrated pro-alpha(IIb) in the mutants comparable with the normal pro-alpha(IIb), but no conversion to mature alpha(IIb) in the G128S mutant, and only trace conversion to mature alpha(IIb) in the S287L and G357S mutants. The disappearance of pro-alpha(IIb) in the three mutants was similar to that in cells expressing normal alpha(IIb)beta(3) or alpha(IIb) only. All three mutants demonstrated pro-alpha(IIb)beta(3) complexes and co-localized with an ER marker by immunofluorescence. The G128S mutant showed no co-localization with a Golgi marker, and the other two mutants showed minimal and moderate co-localization with the Golgi marker. Conclusions: These three beta-propeller mutations do not affect the production of pro-alpha(IIb), its ability to complex with beta(3), or its stability, but do cause variable defects in transport of pro-alpha(IIb)beta(3) complexes from the endoplasmic reticulum to the Golgi.