The effect of the chemical chaperone 4-phenylbutyrate on secretion and activity of the p.Q160R missense variant of coagulation factor FVII

Background: Congenital coagulation factor (F) VII defciency is a rare bleeding disorder caused by mutations in the F7 gene. The missense factor FVII variant p.Q160R is the disease-causing mutation in all Norwegian FVII defcient patients and results in reduced biological activity and antigen levels of FVII in patient plasma. Previous in vitro studies on this variant demonstrated impaired intracellular trafcking and reduced secretion, possibly due to protein misfolding. The aim of the study was therefore to assess the impact of chemical chaperones on cellular processing and secretion of this variant using a cell model based on overexpression of the recombinant protein. Results: Through screening of compounds, we identifed 4-phenylbutyrate (4-PBA) to increase the secretion of recombinant (r) FVII-160R by~2.5-fold. Additionally, treatment with 4-PBA resulted in a modest increase in specifc biological activity. Intracellular localization studies revealed that upon treatment with 4-PBA, rFVII-160R was secreted through Golgi and Golgi reassembly-stacking protein (GRASP)-structures. Conclusions: The present study demonstrates that the chemical chaperone 4-PBA, restores intracellular trafcking and increases the secretion of a missense FVII variant with functional properties in the extrinsic coagulation pathway.