Bleeding problems are associated with defects in platelet ␣-granules, yet little is known about how these granules are formed and released. Mutations affecting VPS33B, a novel Sec1/Munc18 protein, have recently been linked to arthrogryposis, renal dysfunction, and cholestasis (ARC) syndrome. We have characterized platelets from patients with ARC syndrome and observed reduced aggregation with arachidonate and adenosine diphosphate (ADP). Structural abnormalities seen in ARC platelets included increased platelet size, a pale appearance in blood films, elevated numbers of ␦-granules, and completely absent ␣-granules. Soluble and membrane-bound ␣-granule proteins were significantly decreased or undetectable in ARC platelets, suggesting that both the releasable protein pools and membrane components of ␣-granules were absent. The role of VPS33B in platelet granule biogenesis was evaluated by immunofluorescence microscopy in normal human megakaryocytes. VPS33B colocalized appreciably with markers of ␣-granules, moderately with late endosomes/lysosomes, minimally with ␦-granules/lysosomes, and not with cis-Golgi complexes. VPS33B protein expression determined by immunoblotting confirmed the presence of VPS33B in control fibroblasts but not in ARC fibroblasts, and in normal megakaryocytes but not in platelets. We conclude that like other Sec1/Munc18 proteins, VPS33B is involved in intracellular vesicle trafficking, being essential for the development of platelet ␣-granules but not for granule secretion.
IntroductionCongenital platelet disorders involving abnormalities in ␣ and/or dense (␦) granules are an important cause of inherited bleeding disorders. A number of genes have been linked to the ␦-granule defects associated with the Hermansky-Pudlak and ChediakHigashi syndromes, 1-6 and 16 genes have been identified in mice that regulate vesicle trafficking to platelet ␦-granules and melanosomes; some of these genes encode known vesicle trafficking proteins whereas others encode components of BLOC (biogenesis of lysosome-related organelles complexes) protein complexes. 3,7 Much less is known about the genes or proteins involved in ␣-granule defects, although some transcription factors and cellsurface glycoproteins have been implicated. For example, a family with X-linked macrothrombocytopenia and reduced ␣-granules was found to have an aspartate-to-glycine mutation in the transcription factor GATA1, 8 and hemizygous loss of the FLI1 transcription factor causes the Paris-Trousseau syndrome, characterized by abnormal megakaryocytes and giant ␣-granules. 9,10 In mice, loss of transcription factor NF-E2 expression produces abnormal megakaryocytes with absent ␣-granules, 11 and hematopoietic zinc finger (Hzf)-deficient mice have megakaryocytes and platelets with reduced ␣-granules and ␣-granule proteins. 12 Glycoprotein (GP) Ib-deficient mouse platelets contain abnormally large ␣-granules, 13 and giant ␣-granules have also been observed in platelets from a patient with Bernard-Soulier syndrome. 14 A deficiency of both platel...