Evidence map›Paper›PMID 42049675›Full record

ArticleInternational journal of laboratory hematology2026

Two Novel PKLR Variants in Pyruvate Kinase Deficiency: Insights From Clinical, Molecular and Functional Analysis.

Huaxia Xiang, Yuxiu Wen, Mengxin Yang, Jiali Jiang, Yuping Li, Changjin He, Zhihao Lin, Hongying Wei

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Article in International journal of laboratory hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Huaxia XiangDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.ORCID 0009-0006-4262-3945
Yuxiu WenDepartment of Pediatrics, The Affiliated Hospital of Guilin Medical College, Guilin, Guangxi, China.
Mengxin YangDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.ORCID 0009-0003-3502-1231
Jiali JiangDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Yuping LiDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Changjin HeDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Zhihao LinDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.ORCID 0009-0002-2676-1345
Hongying WeiDepartment of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Funding

National Natural Science Foundation of China 82260027
6 · The paper itself

Abstract

introductionPyruvate kinase deficiency (PKD) is a rare cause of hereditary non-spherocytic hemolytic anemia. This study reports the clinical and molecular characterization of three pediatric PKD cases, focusing on two novel PKLR variants.

methodsClinical and laboratory data were reviewed. PKLR gene was analyzed by next-generation sequencing and validated by Sanger sequencing. Pathogenicity was predicted using in silico tools and ACMG criteria. Structural consequences were modeled with AlphaFold3 and Chimera-X. Functional impact was assessed by Western blot and immunofluorescence in transfected 293T cells.

resultsAll patients presented with neonatal hemolytic anemia. Genetic analysis revealed compound heterozygosity for PKLR mutations. Two novel variants were identified: c.1708G>A (p.Val570Met) and c.1430C>T (p.Thr477Ile). In silico analysis predicted both as damaging. Structural modeling suggested p.Val570Met disrupts inter-subunit hydrogen bonds, while p.Thr477Ile lies within the fructose-1,6-bisphosphate (FBP) binding loop. In vitro, both mutants showed reduced protein expression compared to wild-type but normal cytoplasmic localization.

conclusionWe identified two novel PKLR variants expanding the mutational spectrum of PKD. Integrated analysis suggests p.Val570Met may impair tetramer stability, whereas p.Thr477Ile likely affects allosteric regulation. These findings underscore the value of combining clinical phenotyping with functional studies for accurate variant interpretation in PKD.

Indexed as

Anemia, Hemolytic, Congenital NonspherocyticMutationPyruvate KinasePyruvate Metabolism, Inborn ErrorsHEK293 CellsHumansInfant, NewbornMaleModels, MolecularPKLR protein, humanPyruvate Kinasenovel mutationpathogenicitypyruvate kinasepyruvate kinase deficiencyR‐pyruvate kinase

Identifiers

PMID42049675
PMCPMC13357903

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