Thromb Haemost 2016; 115(02): 415-423
DOI: 10.1160/th15-06-0520
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH

BRCA2 gene mutations and coagulation-associated biomarkers

Pedro Perez-Segura*
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
José J Zamorano-León*
2   Instituto Investigaciones Sanitarias, Hospital Clínico San Carlos, Madrid. Spain
,
Daniel Acosta
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
Juana María Santos-Sancho
3   School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
,
Javier Modrego
2   Instituto Investigaciones Sanitarias, Hospital Clínico San Carlos, Madrid. Spain
,
Trinidad Caldés
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
Miguel de la Hoya
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
Eduardo Díaz-Rubio
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
Isabel Díaz-Millán
1   Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
,
Natalia de las Heras
3   School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
,
Luis Alfonso Rico Zalba
4   Fundación Jiménez Díaz, Madrid, Spain
,
Vicente Lahera
3   School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
,
Olle Melander
5   Department of Clinical Sciences, Lund University, Malmö, Sweden
,
Antonio López Farré
3   School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
› Author Affiliations
Financial support: This work has been supported by a grant from Oncology Spanish Society, Fondos de Investigaciones de la Seguridad Social [Redes temáticas de Investigación Cooperativa (RETICs) RD12/0042/0040, RD12/0042/0033 and RD06/0020/0021], Fondo Europeo de Desarrollo Regional (Fondos FEDER).
Further Information

Publication History

Received: 30 June 2015

Accepted after major revision: 10 September 2015

Publication Date:
22 November 2017 (online)

Summary

Thromboembolic events are the second cause of death in cancer patients, although the mechanisms underlying this increased thromboembolic risk remain unclear. The aims of this study were to examine whether BRCA2 gene mutations may modify the circulating levels of thrombocoagulation biomarkers and whether breast cancer development may influence changes in such circulating biomarkers. The study was performed in 25 women with mutations in the BRCA2 gene (n=12 breast cancer, n=13 breast cancer-free) and in 13 BRCA2 nonmutant controls. Results revealed that plasma levels of fibrinogen gamma chain isotypes 2 and 3, haptoglobin isotypes 4 and 5, serotransferrin isotypes 3 and 4 and convertase C3/C5 isotypes 4 and 5 were significantly higher in BRCA2 mutation carriers compared to controls. However, plasma levels of vitamin D binding protein isotype 1 and alpha1-antitrypsin isotypes 2, 3 and 4 were significantly decreased in BRCA2 mutation carriers compared to controls. Plasma expression of PF4 and P-selectin was significantly higher in BRCA2 mutations carriers than in controls. BRCA2 truncated mutations conserving a binding region for RAD51 were associated with increased plasma levels of alpha1-antitrypsin isotypes 3 and 4 with respect to women showing BRCA2 mutations that loss the binding RD51 region to BRCA2. Only plasma levels of vitamin D binding protein isotypes 1 and 3 were significantly reduced and alpha 1-antitrypsin isotype 1 was increased in cancer-free BRCA2 mutation carriers compared to BRCA2 mutation carriers with breast cancer. The presence of BRCA2 mutations is associated with increased plasma levels of thrombo-coagulating-related proteins, which are independent to breast cancer development.

* These authors contributed equally to the manuscript.


 
  • References

  • 1 Zhu T, Martinez I, Emmerich J. Venous thromboembolism: risk factors for recurrence. Arterioscler Thromb Vasc Biol 2009; 29: 298-310.
  • 2 Prandoni P, Lensing AW, Piccioli A. et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 2002; 100: 3484-3488.
  • 3 Khorana AA, Francis CW, Culakova E. et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost 2007; 05: 632-634.
  • 4 Sorensen HT, Mellemkjaer L, Olsen JH. et al. Prognosis of cancers associated with venous thromboembolism. N Engl J Med 2000; 343: 1846-1850.
  • 5 Mousa SA. Role of current and emerging antithrombotics in thrombosis and cancer. Drugs Today 2006; 42: 331-350.
  • 6 Kim SH, Lim KM, Noh JY. et al. Doxorubicin-induced platelet procoagulant activities: an important clue for chemotherapy-associated thrombosis. Toxicol Sci 2011; 124: 215-2124.
  • 7 Moll S. Venous thromboembolism: a need for more public awareness and research into mechanisms. Arterioscler Thromb Vasc Biol 2008; 28: 367-369.
  • 8 Schmidt MB. Die Verbreitungswege der Karcinome und die Beziehung generalisierter Sarkome zu den leukmischen Neubildungen. Jena: G. Fischer; 1903: 99.
  • 9 Baron JA, Gridley G, Weiderpass E. et al. Venous thromboembolism and cancer. Lancet 1998; 351: 1077-1080.
  • 10 Sørensen HT, Mellemkjaer L, Steffensen FH. et al. The risk of a diagnosis of cancer after primary deep venous thrombosis or pulmonary embolism. N Engl J Med 1998; 338: 1169-1173.
  • 11 Custodio A, López-Farré AJ, Zamorano-León JJ. et al. Changes in the expression of plasma proteins associated with thrombosis in BRCA1 mutation carriers. J Cancer Res Clin Oncol 2012; 138: 867-875.
  • 12 Paul A, Paul S. The breast cancer susceptibility genes (BRCA) in breast and ovarian cancers. Front Biosci Landmark Ed 2014; 605-618.
  • 13 Moynahan ME, Pierce AJ, Jasin M. BRCA2 is required for homology-directed repair of chromosomal breaks. Mol Cell 2001; 07: 263-272.
  • 14 Tutt A, Bertwistle D, Valentine J. et al. Mutation in Brca2 stimulates error-prone homology-directed repair of DNA double-strand breaks occurring between repeated sequences. EMBO J 2001; 20: 4704-4716.
  • 15 Chen FM, Hou MF, Chang MY. et al. High frequency of somatic missense mutation of BRCA2 in female breast cancer from Taiwan. Cancer Lett 2005; 220: 177-184.
  • 16 Tal A, Arbel-Goren R, Stavans J. Cancer-associated mutations in BRC domains of BRCA2 affect homologous recombination induced by Rad51. J Mol Biol 2009; 393: 1007-1012.
  • 17 Antoniou A, Pharoah PD, Narod S. et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case Series uns-elected for family history: a combined analysis of 22 studies. Am J Hum Genet 2003; 72: 1117-1130.
  • 18 Fentiman IS, Fourquet A, Hortobagyi GN. Male breast cancer. Lancet 2006; 367: 595-604.
  • 19 De la Hoya M, Pérez-Segura P, Van Orsouw N. et al. Spanish family study on hereditary breast and/or ovarian cancer: analysis of the BRCA1 gene. Int J Cancer 2001; 91: 137-140.
  • 20 De la Hoya M, Osorio A, Godino J. et al. Association between BRCA1 and BRCA2 mutations and cancer phenotype in Spanish breast/ovarian cancer families: Implications for genetic screening. Int J Cancer 2002; 97: 466-471.
  • 21 López-Farré AJ, Zamorano-León JJ, Segura A. et al. Plasma desmoplakin I biomarker of vascular recurrence after ischemic stroke. J Neurochem 2012; 121: 314-325.
  • 22 Alonso-Orgaz S, Moreno L, Macaya C. et al. Proteomic study of plasma from moderate hypercholesterolemic patients. J Proteome Res 2006; 05: 2301-2308.
  • 23 Zamorano-León JJ, Olivier C, de Las Heras N. et al. Vardenafil improves penile erection in type 2 diabetes mellitus patients with erectile dysfunction: role of tropomyosin. J Sex Med 2013; 10: 3110-3120.
  • 24 Mateos-Cáceres PJ, García-Méndez A, López Farré A. et al. Proteomic analysis of plasma from patients during an acute coronary syndrome. J Am Coll Cardiol 2004; 44: 1578-1583.
  • 25 van Hylckama Vlieg A, Rosendaal FR. High levels of fibrinogen are associated with the risk of deep venous thrombosis mainly in the elderly. J Thromb Hae-most 2003; 01: 2677-2678.
  • 26 Fredenburgh JC, Stafford AR, Leslie BA. et al. Bivalent binding to yA/yB-fibrin engages both exosites of thrombin and protects it from inhibition by the anti-thrombin-heparin complex. J Biol Chem 2008; 283: 2470-2477.
  • 27 Jones JM, McGonigle NC, McAnespie M. et al. Plasma fibrinogen and serum C-reactive protein are associated with non-small cell lung cancer. Lung Cancer 2006; 53: 97-101.
  • 28 Guo Q, Zhang B, Dong X. et al. Elevated levels of plasma Fibrinogen in patients with pancreatic cancer: possible role of a distant metastasis predictor. Pancreas 2009; 38: 75-79.
  • 29 Polterauer S, Grimm C, Seebacher V. et al. Plasma fibrinogen levels and prognosis in patients with ovarian cancer: a multicenter study. Oncologist 2009; 14: 979-985.
  • 30 Levine SP, Wohl H. Human platelet factor 4: Purification and characterization by affinity chromatography. Purification of human platelet factor 4. J Biol Chem 1976; 251: 324-328.
  • 31 Hsu-Lin S, Berman CL, Furie BC. et al. A platelet membrane protein expressed during platelet activation and secretion. Studies using a monoclonal antibody specific for thrombin-activated platelets. J Biol Chem 1984; 259: 9121-9126.
  • 32 Poruk KE, Firpo MA, Huerter LM. et al. Serum platelet factor 4 is an independent predictor of survival and venous thromboembolism in patients with pancreatic adenocarcinoma. Cancer Epidemiol Biomarkers Prev 2010; 19: 2605-2610.
  • 33 Vasconcellos CA, Lind SE. Coordinated inhibition of actin induced platelet aggregation by plasma gelsolin and vitamin D-binding protein. Blood. 1993; 82: 3648-3457.
  • 34 Kinoshita T. Biology of complement: the overture. Immunol Today. 1991; 12: 291-295.
  • 35 Pierangeli SS, Girardi G, Vega-Ostertag M. et al. Requirement of activation of complement C3 and C5 for antiphospholipid antibody-mediated thrombophi-lia. Arthritis Rheum 2005; 52: 2120-2124.
  • 36 Levi M, van der Poll T, Büller HR. Bidirectional relation between inflammation and coagulation. Circulation 2004; 109: 2698-2704.
  • 37 Parmar JS, Mahadeva R, Reed BJ. et al. Polymers of a1-Antitrypsin Are Che-motactic for Human Neutrophils. Am J Respir Cell Mol Biol 2002; 26: 723-730.
  • 38 Freedman JE. Oxidative stress and platelets. Arterioscler Thromb Vasc Biol 2008; 28: S11-16.
  • 39 Martinez-Outschoorn UE, Balliet R, Lin Z. et al. BRCA1 mutations drive ox-idative stress and glycolysis in the tumour microenvironment: implications for breast cancer prevention with antioxidant therapies. Cell Cycle 2012; 11: 4402-4413.
  • 40 Sage JM, Gildemeister OT, Knight KL. Discovery of a Novel Function for Human Rad51. Maintenance of the mitochondrial genome. J Biol Chem 2010; 285: 18984-18990.