Protein S functions as a cofactor to activated
protein C (APC) in the degradation of FVa and FVIIIa. In
protein S, the
thrombin sensitive region (TSR) and the first
EGF-like domain are important for expression of the APC cofactor activity. A naturally occurring Thr103Asn (
T103N) mutation in the first
EGF-like domain of
protein S has been associated with functional (type II)
protein S deficiency. To elucidate the functional consequences of the
T103N mutation,
recombinant protein S mutant was expressed in mammalian cells and functionally characterised. The expression level of
protein S T103N from transiently transfected COS 1 cells was equal to that of wild type
protein S. The
mutant protein S and wild type
protein S were also expressed in 293 cells after stable transfection, and the
recombinant proteins purified. In APTT- and PT-based coagulation assays, the
mutant protein demonstrated approximately 50% lower
anticoagulant activity as compared to wild type
protein S. The functional defect was further investigated in FVa- and FVIIIa-degradation assays. The functional defect of
mutant protein S was attenuated at increasing concentrations of APC. The results demonstrate the region around residue 103 of
protein S to be of functional importance, possibly through a direct interaction with APC.