Study Shows How Mutation Linked to Economy-Class Syndrome Causes Excessive Clotting

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People who dread flying have, in recent years, been given yet more fodder for their fear. Individuals who remain seated without moving during long flights can develop dangerous blood clots. Susceptibility to the condition that can lead to so-called economy-class syndrome and other clotting-related problems¿a disorder known as thrombophilia¿has a known genetic risk factor: a mutation in the gene that codes for the coagulation factor prothrombin. Yet exactly how this mutation, which occurs in 1 to 2 percent of the population, causes thrombophilia has eluded scientists. Oddly, the mutation raises prothrombin levels in the blood but does not alter the composition of the prothrombin protein. Now new research published in the current issue of Nature Genetics finally reveals the mysterious mechanism.

Andreas Kulozik of Humboldt University in Berlin and his colleagues found that the mutation influences the production of prothrombin RNA, which directs synthesis of the protein. Prothrombin RNA production normally proceeds such that the prothrombin RNA precursor molecule is cleaved at one end, releasing the mature prothrombin RNA. The mutation, it turns out, renders this cleavage site extra-sensitive, thus spurring the production rate of mature prothrombin RNA, which in turn yields more of the coagulation factor itself. This enhanced processing efficiency, the authors note, "represents a remarkable example of how a quantitatively minor activation of RNA processing can predispose to a common and serious disease."

Kate Wong is an award-winning science writer and senior editor for features at Scientific American, where she has focused on evolution, ecology, anthropology, archaeology, paleontology and animal behavior. She is fascinated by human origins, which she has covered for nearly 30 years. Recently she has become obsessed with birds. Her reporting has taken her to caves in France and Croatia that Neandertals once called home to the shores of Kenya’s Lake Turkana in search of the oldest stone tools in the world, as well as to Madagascar on an expedition to unearth ancient mammals and dinosaurs, the icy waters of Antarctica, where humpback whales feast on krill, and a “Big Day” race around the state of Connecticut to find as many bird species as possible in 24 hours. Wong is co-author, with Donald Johanson, of Lucy’s Legacy: The Quest for Human Origins. She holds a bachelor of science degree in biological anthropology and zoology from the University of Michigan. Follow her on Bluesky @katewong.bsky.social

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