Factor v Leiden in recurrent abortion

1. The Role of Factor V Leiden mutation
In Recurrent and Spontaneous Abortion
Ahmad A. Al-Qudah

2. The Role of Factor V Leiden mutation
In Recurrent and Spontaneous Abortion
- Identification of Factor V .
- Identification of APCR and FVL .
- Recurrent and Spontaneous Abortion .
- Goal’s of our study
- Significance of work .
- Patients and controls.
- Samples .
- Methodology.
- Budget
- Bibliography .

3. Factor V
- Factor V (also called Labile Factor ) is a protein of the
coagulation system.
- The gene is located on the first chromosome (1q23) and
is homologous to coagulation factor VIII.
- consists of 25 exons, and the resulting protein has a
relative molecular mass of approximately 330kDa.

4. - Factor V made primarily by cells in the liver , and
circulates in plasma as a single-chain molecule with a
plasma half-life of about 12 hours.
- able to bind to activated platelets , and activated by
thrombin, degraded by activated protein C, one of the
principal physiological inhibitors of coagulation .
Factor V

5. Activated protein C resistance (APCR)
- Activated protein C resistance (APCR) is an inherited
hemostatic disorder characterized by the inability of Activated
protein C to cleave Factor Va and/or Factor VIIIa.
- Allow for longer duration of thrombin generation and may
lead to a hypercoagulable state, Resulting in an increased risk
of venous thrombosis, which can cause problems with
circulation.

6. - The disorder can be acquired or inherited, the hereditary
form having an autosomal dominant inheritance pattern.
- Up to 64% of patients with venous thromboembolism might
have activated protein C resistance.
Activated protein C resistance (APCR)

7. - Factor V Leiden is an inherited disorder of blood clotting.
- Mutation of this gene is a single nucleotide polymorphism
(SNP).
- As a missense substitution it changes a protein's amino acid
in which the Leiden variant of factor V cannot be inactivated
and degraded by activated protein C.
- it is the most common hereditary hypercoagulability
disorder.
Factor V Leiden

8. Recurrent and Spontaneous Abortion
- Thrombosis of placenta, umbilical cord, or the fetus. Can be
a major cause of recurrent and spontaneous abortion.
- Activated protein C resistance is the most common genetic
predisposition to thrombosis in European countries and the
United States.
- Recurrent Abortion mean’s that there is a history of at least
three Abortions, with no complete pregnancy .
- However, the association between the Factor V Leiden
mutation and Abortion is still controversial.

9. Our study
1. Identification of Factor V and Protein C , and their
Function in Coagulation system .
2. Identification of Coagulopathies and Factor V Leiden .
3. Identification of the Activated Protein C Resistance
related to Factor V Leiden .
4. Investigate the Role of Factor V Leiden in Recurrent
and Spontaneous Abortion .

10. Significance of work
- Many previous studies have shown that Activated
Protein C Resistance , such as Activated Protein C
Resistance related to Factor VIII mutation , is a
disorder that leads to Abortion .
- Other studies have shown that Factor II mutation and
other Coagulation Factors and Cofactors mutations ,
that lead to the Formation of Placental Thrombosis
lead to Abortion .

11. - In this study , The Role of Activated Protein C
Resistance related to Factor V Leiden mutation is
going to be determined in Females with Recurrent
and Spontaneous Abortion .
Significance of work

12. Patients and controls
- One hundred and twenty five Fertile women ( n = 125 ) .
- Divided into :
- Fifty ( 50 ) women with history of three or more
Abortions
- Fifty ( 50 ) with history of completed pregnancies
and early Spontaneous Abortion .
- The control group consisted of twenty five ( 25 ) women
with history of completed pregnancies without any
problems or complications.

13. Samples
- One 5 ml EDTA tube sample will be Taken from
each individual , for Factor V Leiden mutation
Assay .

14. Methodology
Detection of Factor V Leiden mutation :
- Factor V Leiden mutation will be detected in patient's Blood
using PCR and Cross Linking hybridization .
- After DNA extraction , and beginning of Amplification ,
Oligonucleotides complementary to sequences within exon
10 and intron 10 of the factor V gene were synthesized.
- PCR results loaded into wells Plate .

15. - Allele-specific capture probes complementary to nucleotides,
either the normal factor V gene or the mutant factor V (Leiden)
gene .
- These probes contained a biotin molecule at the 3′ terminus and
a photoactive coumarin cross-linking agent that was positioned
opposite the thymidine residue at certain position .
Methodology

16. - These are three types of Probes , Normal , mutant and Control
set of both .
- incubate in water bath for 30 min at 45° , then wash to remove
unhybridized probes and any other unwanted materials .
Methodology

17. - binding of conjugate to the probe–target complex , wash to
remove unbound conjugate, and development and detection of
a fluorescent .
Methodology

19. 1. Duga S, Asselta R, Tenchini ML. "Coagulation factor V". Int. J. Biochem.
Cell Biol. (2005) 36 (8): 1393–9 .
2. Dahlbäck B. "The discovery of activated protein C resistance". J.
Thrombosis. Haemost. (2003) 1 (1): 3–9
3. Bernadette F. Rodak, G.A.F., Elaine M. Keohane, Hematology: Clinical
principles and applications. 3th ed. 2007: Elsevier Saunders.
4. Koster T, Rosendaal FR, De Ronde H, Briët E, Vandenbroucke JP, Bertina
RM. "Venous thrombosis due to poor anticoagulant response to
activated protein C: Leiden Thrombophilia Study". Lancet. 1993 Dec;
342 (8886–8887): 1503–6.
5. Nicolaes GA, Dahlbäck B. "Congenital and acquired activated protein C
resistance". Semin Vasc Med. (2003) 3 (1): 33–46.
Bibliography