This study identified a new substitution in the B chain of an abnormal fibrinogen, denoted Longmont, where the residue Arg166 was changed to Cys. The variant was discovered in a young woman with an episode of severe hemorrhage at childbirth and a subsequent mild bleeding disorder. The neo-Cys residues were always found to be disulfide-bridged to either an isolated Cys amino acid or to the corresponding Cys residue of another abnormal fibrinogen molecule, forming dimers. Removing the dimeric molecules using gel filtration did not correct the fibrin polymerization defect. Fibrinogen Longmont had normal fibrinopeptide A and B release and a functional polymerization site "a." Thus, the sites "A" and "a" can interact to form protofibrils, as evidenced by dynamic light-scattering measurements. These protofibrils, however, were unable to associate in the normal manner of lateral aggregation, leading to abnormal clot formation, as shown by an impaired increase in turbidity. Therefore, it is concluded that the substitution of Arg1663Cys-Cys alters fibrinogen Longmont polymerization by disrupting interactions that are critical for normal lateral association of protofibrils.
IntroductionThe fibrinogen molecule is composed of 2 copies of 3 polypeptide chains called A␣, B, and ␥. The molecule consists of a central domain (E) linked to 2 distal domains (D) by a coiled-coil connector. The N-terminal ends of the 6 chains form the E domain, whereas the C-terminal parts of the ␥ and B chains and a short fragment of the C-terminal domain of the A␣ chain constitute the D domain.The fibrinogen-to-fibrin conversion is an ordered reaction. It is initiated by the cleavage of fibrinopeptides A and B (FpA and FpB) by thrombin, which unmasks polymerization sites "A" and "B" in the neo-N-terminal ends of the ␣ and  chains, respectively. 1 Thereafter, the fibrin monomers interact spontaneously and form a fibrin clot. Concomitantly, thrombin-activated factor XIII stabilizes the clot by introducing interchain cross-links between ␥ chains and between ␣ chains. [2][3][4] Fibrin polymerization is a 2-step process. First, half-staggered, end-to-end interactions form double-stranded protofibrils, which result from interactions between site "A" and its complementary site "a," 5 always present in the ␥ chain part of the D domain. 6 In fact, the peptide Gly-Pro-Arg-Pro (GPRP), which resembles the natural Gly-Pro-Arg-Val sequence of the N-terminus extremity of the ␣ chain depleted in FpA, prevents clot formation. 7 In the second step, termed "lateral association," the protofibrils are assembled into thick fibers of fibrin that branch to form a fibrin network. 8,9 The interactions involved in the lateral association are less well characterized. It has been proposed that the release of FpB enhances lateral association. 10,11 Alternatively, the release of FpB may be a consequence of fibrin formation. 12 Moreover, the C-terminal domains of the A␣ chain may also participate in lateral association. 13,14 In this report, we describe fibrinogen Longmont,...