The Journal of Immunology, 1998, 161: 3762-3766.
Copyright © 1998 by The American Association of Immunologists
Genetic Basis of Human Complement C8
-
Deficiency1
Takeshi Kojima*,
Takahiko Horiuchi2,*,
Hiroaki Nishizaka*,
Yasuo Fukumori
,
Tetsuki Amano
,
Kohei Nagasawa§,
Yoshiyuki Niho* and
Kenshi Hayashi¶
*
First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan;
Department of Research, Osaka Red Cross Blood Center, Osaka, Japan;
Third Department of Internal Medicine, Faculty of Medicine, Okayama University, Okayama, Japan;
§
Department of Internal Medicine, Saga Medical School, Saga, Japan; and
¶
Institute of Genetic Information, Kyushu University, Fukuoka, Japan
 |
Abstract
|
|---|
Deficiency of the
-
subunit of the eighth component of
complement (C8
-
D) is frequently associated with recurrent
neisserial infections, especially meningitis caused by Neisseria
meningitidis. We here report the molecular basis of C8
-
D
in two unrelated Japanese subjects. Screening all 11 exons of the C8
gene and all 7 exons of the C8
gene and their boundaries by
exon-specific PCR/single-strand conformation polymorphism demonstrated
aberrant single-stranded DNA fragments in exon 2 of C8
gene in case
1 and in exons 2 and 9 of C8
gene in case 2. Nucleotide sequencing
of the amplified DNA fragments in case 1 revealed a homozygous
single-point mutation at the second exon-intron boundary, inactivating
the universally conserved 5' splice site consensus sequence of the
second intron (IVS2+1G
T). Case 2 was a compound heterozygote for the
splice junction mutation, IVS2+1G
T, and a nonsense mutation at
Arg394 (R394X). R394X was caused by a C to T transition at
nucleotide 1407, the first nucleotide of the codon CGA for
Arg394, leading to a stop codon TGA. No mutations were
detected in the C8
gene by our method. Our results indicate that the
pathogenesis of C8
-
D might be caused by heterogeneous molecular
defects in the C8
gene.
 |
Introduction
|
|---|
The
eighth component of complement (C8) plays an important role in the
function of membrane attack complex
(MAC)3
that is generated on target cells upon activation of the complement
system. MAC is generated by sequential addition of C5b, C6, C7, C8, and
C9 molecules, which results in the transmembrane pore and eventual cell
lysis. After binding to C8, C5b-7 complex, by itself transiently bound
to membrane surface and nonfunctional, is endowed with the ability to
cause membrane damage and polymerization of C9 that greatly accelerate
MAC activity (1). C8 is a 151-kDa molecule consisting of three
nonidentical polypeptide chains:
(Mr = 64
kDa), ß (Mr = 64 kDa), and
(Mr = 22 kDa) (2). Genetic studies of C8
polymorphisms established that
-
and ß are encoded at different
loci (3, 4, 5). The genes for C8
and C8ß are located on chromosome
1p32 (6, 7), whereas the gene for C8
is located on chromosome 9q
(8). The
and ß subunits of C8 show an overall structural homology
to C6, C7, and C9 (9). The
subunit shows structural homology to
protein HC (10). The
subunit is composed of 553 amino acid residues
(11), has a domain that interacts with ß subunit (12), and comprises
the binding site for C9 on C5b-8 (13). The
subunit also has several
membrane surface-seeking domains and a possible transmembrane domain
(11). The ß subunit also has a domain that interacts with target
membranes and a domain that specifically mediates recognition and
binding of C8 to C5b-7 (14). The
subunit is composed of 182 amino
acid residues and is disulfide linked to the
subunit (10, 15).
However, the
subunit is not essential for hemolytic activity, as
evidenced by the fact that a C8 derivative composed of only
and ß
is functionally equivalent to the normal protein (12). Individuals with
inherited deficiencies of the component of MAC frequently suffer from
recurrent neisserial infections, predominantly meningococcal infections
of rare serotypes (16, 17, 18). Two functionally distinct C8 deficiency
states have been described, depending on which of the C8 subunits
(
-
or ß) is defective. The C8
-
deficiency (C8
-
D) is
predominantly reported in Blacks, Hispanics, and Japanese, whereas
C8ßD has been reported primarily in Caucasians (19, 20, 21). Molecular
defects leading to inherited deficiencies of C8ß as well as the other
components of MAC such as C5, C6, C7, and C9 have been described
recently (22, 23, 24, 25, 26, 27, 28, 29). However, defects causing C8
-
D have not been
reported as yet. In the present study, we investigated the genetic
basis of C8
-
D in two unrelated Japanese subjects, using
exon-specific PCR/single-strand conformation polymorphism (SSCP)
analysis of C8
and C8
genes (30), followed by direct DNA
sequencing anomalously migrating exons to identify mutations. Although
there were no mutations detected in the C8
gene by this method in
either case, a homozygous (case 1) and a compound heterozygous mutation
(case 2) were identified in the C8
gene. A homozygous G to T
transversion in the exon 2/intron 2 splice junction (IVS2+1G
T) of
the C8
gene that would cause splicing error was detected in case 1.
In case 2, a heterozygous mutation identical with that of case 1 as
well as a heterozygous C to T transition in exon 9 at the first
nucleotide of CGA codon for Arg394 (R394X) of the C8
gene were detected.
 |
Materials and Methods
|
|---|
C8
-
D subjects
Two unrelated individuals were included in this study. Case 1
was a 63-yr-old Japanese male who was admitted to Okayama University
Hospital (Okayama, Japan) with macrocytic hyperchromic anemia. He had
inactive pulmonary tuberculosis and ulcerative colitis. Total hemolytic
activity (CH50) was undetectable, and a subsequent analysis
of complement components revealed that C8 protein was also undetectable
in his serum (<0.5 mg/dl) by single radial immunodiffusion assay.
Total hemolytic activity was restored to 75% of the normal range by
adding purified C8, but not by adding serum from a C8
-
D patient.
Case 2 was a 42-yr-old Japanese female who was found to be C8
-
D
during a large scale screening for inherited deficiencies of late
acting complement components among healthy blood donors in Osaka, Japan
(21). The serum C8 concentration in case 2 was below the detectable
level either by hemolytic assay for C8 activity or by single radial
immunodiffusion assay. The C8 hemolytic activity of case 2 was
effectively restored by the addition of the purified C8
-
subunit
(21). Therefore, these two cases were classified as C8
-
D. They
had no history of meningitis or systemic neisserial infections. We were
unable to perform family studies in either case.
PCR/SSCP analysis
The primers for exon-specific PCR for all 11 exons of the C8
gene and all 7 exons of the C8
gene were synthesized on the basis of
the flanking intronic sequences (31, 32) and are listed in Table I
and Table II
. Genomic DNA was purified from PBMC as
previously described (33). Exon-specific PCR was conducted using 50 ng
of genomic DNA as template, 0.2 µM of each primer, 25 µM dNTP
including 2 µCi [
-32P]dCTP (ICN, Irvine, CA), and
0.125 U Taq polymerase in a 5-µl total reaction volume. Thirty cycles
consisting of 1 min at 94°C and 2 min at 60°C were conducted using
a thermal cycler PJ2000 (Perkin-Elmer/Cetus, Norwalk, CT). The PCR
products were subjected to electrophoresis on 5% nondenaturing
acrylamide gels at 4°C without glycerol or at 25°C containing 5%
glycerol, using 45 mM Tris-borate and 1 mM EDTA buffer, pH 8.3, at 13
V/cm. DNA fragments were visualized by exposing the gels to Fuji RX5
film (Fuji, Kanagawa, Japan).
Genomic DNA sequencing of PCR fragments
DNA fragments of interest were excised from PCR/SSCP acrylamide
gels, purified on SUPREC-01 columns (Takara Shuzo, Otsu, Japan), and
reamplified by PCR reagent kit (Perkin-Elmer/Cetus), according to the
manufacturers instructions, for 20 cycles consisting of 1 min at
95°C and 2 min at 60°C by using 2 µM of each primer, 200 µM
dNTP, and 0.625 U Taq polymerase in a 25-µl total reaction volume.
Reaction products were purified by Microcon 100 (Amicon, Beverly, MA)
and directly sequenced using the Amplicycle sequencing kit
(Perkin-Elmer/Cetus) and radiolabeled primers according to the
manufacturers instructions. Primers were labeled using T4
polynucleotide kinase (New England Biolabs, Beverly, MA) and
[
-32P]ATP (ICN) at 37°C for 20 min.
 |
Results
|
|---|
Detection of C8
and C8
gene mutation by PCR/SSCP analysis
SSCP analysis of all 11 C8
exon-specific PCR fragments resulted
in the detection of aberrant bands in exon 2 of case 1 and in exons 2
and 9 of case 2. As shown in Figure 1
a, the exon 2-specific PCR
fragments of case 1 displayed two bands at 4°C without glycerol
migrating differently from those of the C8-sufficient control run in
parallel. Case 2 displayed the mixed pattern of case 1 and the control.
Additionally, in case 2 the exon 9-specific PCR fragments displayed
three bands at 4°C without glycerol, one of which migrated
differently from those of C8-sufficient controls (Fig. 1
b).
Analysis of the PCR fragments of the C8 deficiency cases at 25°C with
glycerol did not show any difference compared with those of controls
(data not shown). These results suggest that in case 1, a homozygous
C8
gene mutation, resides in exon 2, while in case 2 a compound
heterozygous mutation exists in exons 2 and 9. No other aberrant bands
were detected in any other exons of the C8
and C8
genes in either
of the C8
-
D cases.
Determination of the splice junction mutation in intron 2
The DNA fragment detected by PCR/SSCP analysis of C8
exon 2
from case 1 (Fig. 1
a, fragment a) as well as the
DNA fragment from a control (Fig. 1
a, fragment b)
were directly sequenced in its entirety. The nucleotide sequence was
identical with that reported previously (30), except that nucleotide
308+1 was a T instead of a G (IVS2+1G
T; Fig. 2
a). Nucleotide 308+1 is the
first nucleotide of the C8
intron 2. The G to T transversion in
intron 2 (IVS2+1G
T) would cause the truncation of the C8
protein
by a splicing error (Fig. 2
b). Direct sequencing of the
C8
exon 2 showed that case 2 was heterozygous for the mutation
IVS2+1G
T that was identified in case 1 (data not shown).
Determination of the mutation in exon 9
Two single-stranded DNA fragments detected by PCR/SSCP analysis of
the C8
exon 9 (Fig. 1
b, fragments a and
b) from case 2 were isolated from the gel and sequenced in
their entirety. The nucleotide sequence of fragment b was
identical with the corresponding sequence of the normal C8
gene. The
nucleotide sequence of fragment a revealed C to T transition
at nucleotide 1407 (Fig. 3
a).
Nucleotide 1407 is the first nucleotide of the codon CGA for
Arg394 of the C8
gene. The C to T transition generates a
termination codon, TGA, which would cause the truncation of the encoded
C8
protein (Fig. 3
b).
 |
Discussion
|
|---|
We describe here the molecular basis of C8
-
D in two
unrelated Japanese subjects. This is the first description of the
molecular defects leading to C8
-
D. A homozygous splice junction
mutation in the first case and a compound heterozygous mutation in the
second case consisting of the same splice mutation and a nonsense
mutation were shown to be the causes of the deficiency.
C8D appears to have an ethnic predominance. The C8ßD is exclusively
identified in Caucasians, whereas C8
-
D has been found mostly in
non-Caucasians (19, 20, 21). A review of complement deficiencies published
in 1984 described 31 C8D individuals in 22 kindreds (19). Twelve of the
31 C8D subjects had one or more episodes of meningococcal disease.
Among the 31 C8D subjects, six individuals in five kindreds
(four Blacks and one Hispanic) were confirmed to be
C8
-
D. In Japan, four C8
-
D individuals, one of whom was case
2 in the present study, were identified among sera from 145,640 healthy
blood donors in Osaka (21).
To identify the molecular defects causing C8
-
D we adapted a
two-step procedure with PCR-SSCP analysis as a first step followed by a
second step of sequencing the aberrant bands. In the first step, all 11
exons of the C8
and the 7 exons of the C8
gene were amplified by
PCR, and the resulting DNA fragments were analyzed by SSCP. This
approach enabled us to detect target exons and avoid sequencing the
entire coding region of the C8
and C8
genes of the deficient
individuals. The strategy provides a rapid, sensitive, and simple
method to investigate the whole coding region of genes and has been
successfully used by our group for the molecular analysis of C6-, C7-,
and C9-deficient individuals (24, 25, 29).
We have identified a possible RNA splicing defect in both cases. The
mutation is a single-base G to T transversion destroying the highly
conserved sequence at the 5' splice site of intron 2 of the C8
gene.
Since the G at position +1 of the splice site sequence is completely
conserved in eukaryotes (34), this mutation undoubtedly affects
maturation of RNA. A widely accepted model for vertebrate pre-mRNA
splicing proposed that exons are recognized and defined as units during
early assembly by binding of splicing factors to the 3' end of the
preceding intron, followed by a search for a suitable 5' donor site
sequence, (C/A)AG:GT(A/G)AGT (the colon denotes the site of cleavage)
(35, 36, 37). A point mutation at the 5' splice site at IVS2+1 results in
two aberrant splicing patterns. The first is the activation of cryptic
sites either upstream in the exon or downstream in the intron, which
are ignored when the authentic splice site is present (38, 39). Such
junctional abnormalities are reported in many disorders, such as
ß-thalassemia (39), human cystic fibrosis (40), and muscle
phosphofructokinase deficiency (41). The second pattern is exon
skipping. The exon adjacent to the mutation is not recognized by the
splicing factors involved in splice site selection. Exon skipping
occurs if no suitable new 5' donor site can be identified by the
spliceosome complex within approximately 300 bp downstream of the 3'
site (42). An exon-skipping phenotype has also been demonstrated in
many cases of naturally occurring mutations (43, 44, 45, 46, 47, 48). As C8
transcripts were not identified in PBMC from healthy controls or the
C8D individuals (our unpublished observation), we were unable to
analyze the aberrant transcripts caused by the mutation, IVS2+1G
T.
Another single molecular defect identified in case 2 was a heterozygous
C to T transition at the first nucleotide of the codon for
Arg394 in exon 9. The mutation resulted in the generation
of a termination codon. Nonsense mutations in human disease genes
frequently cause severe reduction in mRNA levels and even when normally
transcribed, truncated proteins are quickly degraded (49, 50, 51, 52). Even if
translated, the mutant C8
gene encodes a polypeptide lacking the
carboxyl-terminal 29% of the molecular size. As shown in Figure 4
, this putative mutant C8
polypeptide
in case 2 would be missing the perforin region, the epidermal growth
factor-like region, and the thrombospondin region. In our two cases, no
mutations were detected in the C8
gene by our method. This would be
consistent with the report that the
subunit has no direct role in
the hemolytic activity of C8 (12). In conclusion, our result provides
evidence that like most other complement deficiencies, C8
-
D is
caused by heterogeneous mutational events.

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FIGURE 4. Schematic diagram of the molecular structure of normal C8 (adapted
from Ref. 9) and the positions of mutations in cases 1 and 2. Modules
are designated, according to the recommendations of a recent workshop
(53), as follows: T1, thrombospondin, type 1; LA, low density
lipoprotein receptor, type A; EG, epidermal growth factor.
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 |
Footnotes
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1 This work was supported in part by grants-in-aid from the Ministry of Education, Science, and Culture of Japan (08670522), the Fukuoka Cancer Society, and the Yokoyama Foundation. 
2 Address correspondence and reprint requests to Dr. Takahiko Horiuchi, First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, Japan. E-mail address: 
3 Abbreviations used in this paper: MAC, membrane attack complex; C8
-
D, C8
-
deficiency; SSCP, single-strand conformation polymorphism. 
4 Throughout this paper, nucleotide and amino acid residues numbering for C8
is according to Rao et al. (11). 
Received for publication October 21, 1997.
Accepted for publication May 27, 1998.
 |
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