The regulation of human factor XIIa by plasma proteinase inhibitors

Histidine-rich glycoprotein inhibits contact activation of blood coagulation

Histidine-rich glycoprotein has been purified from bovine plasma employing two different purification procedures. The first procedure was one-step ion-exchange chromatography using phosphocellulose, while the second procedure involved fractionation using polyethyleneglycol 6000 followed by column chromatography employing CM-Sepharose and heparin-Sepharose. The effect of purified bovine histidine-rich glycoprotein on the contact activation of blood coagulation was studied in human plasma by using as activating surface either an ellagic acid-phospholipid suspension (Cephotest) or sulfatide. Contact activation was monitored by the generation of amidolytic activity towards a synthetic chromogenic substrate (S-2302) for factor XIIa and plasma kallikrein. Bovine histidine-rich glycoprotein inhibits the contact activation induced by both of these activating surfaces.

Methylprednisolone induces activation of the contact system in a dose-dependent manner. An in vitro study

The effect of methylprednisolone sodium succinate (MP) on the contact system of plasma was studied in human citrated pool plasma. Contact activation was demonstrated by the presence of plasma kallikrein (KK) activity and activated Hageman factor (FXIIa) and/or KK in complex with C1 inhibitor (C1inh), detected by chromogenic peptide substrates or radioimmunoassays, using monoclonal antibodies directed to neodeterminants exposed on complexed C1inh, respectively. When plasma and different doses of MP were incubated for a period of 24 hours, the highest dose of MP (10 mg/ml) gave rapid and marked increases in KK activities and concentrations of C1inh complexes. MP at 5 mg/ml plasma also induced activation of the contact system, although this activation was less pronounced. Even the lower dose of MP (1 mg/ml), which is equivalent to doses used in humans, increased plasma concentrations of KK-C1inh complexes. In conclusion, this in vitro study shows that MP in a dose-dependent way activates the contact system of plasma.

Methylprednisolone affects inhibitors of the complement and the contact systems; functional and immunochemical studies on alpha 2-macroglobulin and C1 inhibitor

The effects of methylprednisolone sodium succinate (MP) on main inhibitors of the classical pathway of complement and on the contact system were studied in citrated pool plasma. Endotoxin (2.10(9) ng/l, lipopolysaccharide B, E. coli 026: B6 Difco Laboratories, Detroit, Michigan, USA) and/or MP in doses of 0.1, 1, 5 and 10 mg/ml were incubated with plasma at 37 degrees C. Plasma samples were obtained at timed intervals up to 24 hours for determination of C1 inhibitor (C1inh) and alpha 2-macroglobulin (alpha 2M) values using both functional and immunochemical assays. Plasma containing endotoxin without MP revealed decreases of C1inh and alpha 2M values after 12 hours. Addition of MP in high doses (10 mg/ml) gave an additive effect on the endotoxin-induced decreases of C1inh and alpha 2M values, evident 1 and 12 hours after the beginning of incubation, respectively. When MP alone was added to plasma (5 and 10 mg/ml) also significant decreases in C1inh and alpha 2M values were seen. MP in low doses (0.1 and 1 mg/ml) did not either influence the endotoxin-induced changes in the protease inhibitor functions, or induce significant changes in C1inh and alpha 2M values when incubated in plasma without endotoxin. This study demonstrates that MP in high doses induces marked decreases in plasma C1inh and alpha 2M inhibitory functions and that MP has an additive effect on the endotoxin-induced decreases of these inhibitors.

Normal haemostasis and its regulation

Regulation of normal haemostasis and blood flow involves complex interactions between plasma proteins and blood cells, including platelets, leukocytes and the endothelial lining of blood vessels. Thrombin acts as a pivot in the maintenance of the haemostatic balance; the vascular endothelial cell in particular limits the generation of thrombin by localisation of anticoagulant processes on its luminal membrane. The endothelial cell synthesises key molecules in this process and also binds exogenously derived molecules, as well as releasing proteins of the fibrinolysis cascade. The thromboresistance of the luminal surface is further regulated by lipoxygenase and cyclo-oxygenase metabolites of unsaturated fatty acids synthesised by the endothelial cell. In response to trauma, inflammatory reactions, normal wound healing and in association with a variety of disease states, the anticoagulant and fibrinolytic mechanisms are downregulated and the procoagulant and thrombotic mechanisms predominate with resultant generation of thrombin, fibrin clot formation and subsequent platelet adhesion and aggregation. Pro-inflammatory and prothrombotic cytokines downregulate the fibrinolytic and activated protein C pathways as well as inducing synthesis of specific procoagulant and prothrombotic mediators by platelets and leukocytes as well as endothelium.

Contributions of negatively charged chemical groups to the surface-dependent activation of human plasma by soluble dextran derivatives

Negatively charged surfaces are known to promote contact activation. The mechanism responsible for increasing affinity for surfaces is not yet quite understood, although the presence of negative charge densities is thought to be a prerequisite. With the availability of soluble dextran derivatives, varyingly substituted with charged methylcarboxylate, methylbenzylamide sulphonate and uncharged methylbenzylamide residues, we were able to discriminate between the contributions of these chemical moieties to contact activation, thus suggesting that the stimulating properties of synthetic negatively charged surfaces should also be described in terms of specific interactions instead of global negative charge density. This could be effected by quantifying the activating capacities as a function of the chemical group composition. A direct correlation linking activating capacities to anticoagulant properties has been observed.

Effect of heparin on the inhibition of the contact system enzymes

1. One can accurately predict the contribution of each inhibitor to the total inactivation of an enzyme in plasma once its pseudo-first-order reaction rate constant and concentration are known. 2. Because the mechanism of augmentation of the inactivation rate of an enzyme by ATIII occurs via formation of an ATIII-heparin complex, the degree of potentiation can be predicted by knowing the binding capacity (sites per mole) of the heparin preparation and the concentration of heparin in the reaction (to calculate the concentration of the ATIII-heparin complex). 3. The augmentation by heparin of the inactivation rate of a particular enzyme by ATIII is dependent upon the presence of other enzymes with higher kassoc, since these would strongly compete for the ATIII-heparin complex. 4. In a plasma environment, using therapeutic levels of heparin, there is no augmentation of the inactivation rate of any of the contact enzymes.

A monoclonal antibody recognizing an iscosapeptide sequence in the heavy chain of human factor XII inhibits surface-catalyzed activation

A monoclonal antibody (mAb B7C9) to human factor XII was produced which blocked the surface mediated coagulant activity of factor XII but not the amidolysis of H-D-ProPheArg-pNA. The mAb epitope was localized to a 20 amino acid sequence of 2.5 kDa in the heavy chain of factor XII.

Expression of functional cell surface C1-inactivator by U937 cells

We have previously shown that the human monocyte-like cell line U937 synthesizes C1-INA and expresses cell surface C1-INA. In this report we provide evidence that this surface-expressed C1-INA is functionally active. Intact U937 cells demonstrated functional C1-INA activity in a hemolytic assay. This activity was blocked when the cells were incubated with monospecific antibody to C1-INA, and was not detectable in cell-free supernatants of U937 cells. SDS-PAGE analysis of radiolabeled U937 cell surface proteins purified by anti-C1-INA affinity chromatography revealed two distinct bands. One protein had a Mr of 105 kDa identical to plasma C1-INA, and the second had a Mr of 200 kDa. We were unable to determine the identity of the 200 kDa protein by Western blotting with anti-C1-INA. However, the possibility exists that this 200 kDa molecule may represent a C1-INA receptor, a dimeric form of C1-INA, or an unrelated cell surface protein with affinity for C1-INA. Furthermore, we show that treatment of U937 cells with phorbol ester resulted in an increase in the percentage of cells expressing surface C1-INA. These results suggest that U937 cells express functional cell surface C1-INA, which could function in vivo to protect these human tumor cells from lysis by host complement.

Contact activation of blood coagulation is inhibited by plasma factor XIII b-chain

The effect of the purified bovine plasma factor XIII b-chain on contact activation of blood coagulation was studied in human and bovine plasma using either an ellagic acid-phospholipid suspension (Cephotest) or dextran sulfate as activating surface. Contact activation was monitored by the generation of amidolytic activity towards a synthetic chromogenic substrate (S-2302) for factor XIIa and plasma kallikrein. The factor XIII b-chain, which is released from tetrameric factor XIII (a2b2) in the late stages of blood coagulation, inhibits contact activation induced by both activation surfaces mentioned. It was shown that a 5 min preincubation of the factor XIII b-chain with the activation surface increases its inhibitory effect. Light scattering measurements indicated a concurrent binding of the factor XIII b-chain to the Cephotest material. Because factor XIII (a2b2) itself had no such inhibitory activity, the present finding that the factor XIII b-chain inhibits contact activation may point to a novel feed-back inhibition mechanism of blood coagulation.

A new assay for high molecular weight kininogen in human plasma using a chromogenic substrate

High molecular weight kininogen (HK), the cofactor of contact-activated plasma proteolysis, is currently assayed by coagulant or immunological methods. The former is limited by the need for rare, congenitally-deficient plasma and a high coefficient of variation (CV), and the latter, by failure to distinguish nonfunctional protein. The surface activation of factor XI requires HK as its cofactor to transport its zymogen form to a negatively-charged surface where it is converted to its enzymatic form by factor XIIa. Based on this principle, we developed an assay for HK using the chromogenic substrate pyroGlu-Pro-Arg-p-nitroanilide (S-2366, KabiVitrum), which is hydrolyzed by factor XIa. Plasma is first acidified to inactivate protease inhibitors. After neutralization and dilution, the plasma is incubated with an excess of factor XI, factor XIIa, and soybean trypsin inhibitor (to inactivate generated kallikrein), in the presence of a negatively-charged surface (kaolin) in order to form factor XIa. EDTA is included in the buffer to prevent calcium-dependent reactions. This activation process is stopped by adding corn trypsin inhibitor to inactivate the enzyme in this reaction, factor XIIa. Then, S-2366 is added and is hydrolyzed by the factor XIa that was formed. Since factor XI and factor XIIa are in excess of the concentration of HK in the diluted plasma, HK is the rate-limiting protein in this assay for the formation of factor XIa (after subtracting the small amount of factor XIa generated in the absence of HK). The assay is specific for HK, since no activity is detected in kininogen-deficient plasma, and when compared with the HK coagulant assay, r = 0.95 and slope = 0.95. The mean of 21 normal donors was 0.98 U/ml (range 0.68 - 1.28 U/ml) as compared with pooled, normal plasma. The CV for 1 U/ml HK for the chromogenic assay was 2% as compared with 9.5% for the coagulant assay. When purified reagents become commercially available, this assay could prove useful in clinical laboratories or intensive care units for monitoring the progression of various disease states in which contact activation occurs.

Interaction of trypsin, beta-factor XIIa, and plasma kallikrein with a trypsin inhibitor isolated from barley seeds: a comparison with the corn inhibitor of activated Hageman factor

A trypsin inhibitor was purified from barley seeds by a modification of published procedures. We determined the dissociation constant, Ki, for the complexes of the barley inhibitor with trypsin, beta-Factor XIIa, and plasma kallikrein. We compared these constants for those of the same enzymes with the corn Hageman Factor inhibitor, which is a homolog of the barley inhibitor. The strength of interaction of the barley inhibitor with the three enzymes was: trypsin greater than beta-Factor XIIa greater than plasma kallikrein. In contrast, the corn inhibitor inhibits beta-Factor XIIa most strongly and does not inhibit plasma kallikrein at all. A possible structural basis for the difference in inhibition specificity is discussed.

Aspects of C1-inhibitor biochemistry and pathophysiology

During the last few years, the structure and function of human C1-inhibitor have been elucidated. Chromogenic substrate assays for determination of C1-inhibitor activity in plasma are available, and have proved to be of value not only for the diagnosis of hereditary angioedema but also in acquired diseases involving C1-inhibitor, such as cold urticaria and autoimmune disorders as well as acute-phase types of disease states.

Effect of negatively charged activating compounds on inactivation of factor XIIa by Cl inhibitor

Human factor XII, upon exposure to negatively charged surfaces such as kaolin, sulfatides, and heparin, is converted to enzymatic forms, factor XIIa and factor XIIf. Cl inhibitor has been quantitatively demonstrated to be the primary plasma inhibitor of both factor XIIa and factor XIIf. Studies were performed to determine whether the presence of artificial, negatively charged surfaces influenced the ability of Cl inhibitor to inhibit factors XIIa and XIIf. Kaolin and sulfatides slowed the rate of inhibition of factor XIIa by Cl inhibitor 4.8- and 2-fold, respectively, whereas they had no effect on the inhibition of factor XIIf by Cl inhibitor. Heparin in a concentration of 65 U/ml decreased the inhibition rate of factor XIIa by Cl inhibitor, but, at the same concentration, had less of an effect on the ability of Cl inhibitor to inhibit factor XIIf. These studies indicate that negatively charged surfaces protect factor XIIa but not factor XIIf from inhibition from Cl inhibitor. Since the difference between factors XIIa and XIIf consists of the presence of a surface binding region in factor XIIa, the basis of this protection must reside in the surface binding residues of factor XII. These in vitro events suggest that surface-bound factor XIIa may hydrolyze its physiologic substrates, factor XI and prekallikrein, in an environment partially protected from inhibition by Cl inhibitor.

Natural proteinase inhibitors: blood coagulation inhibition and evolutionary relationships

1. Natural proteinase inhibitors are divided into polysaccharides, plasma proteinase inhibitors and natural non-plasma inhibitors. 2. Polysaccharides are antithrombin-III and heparin co-factor-II dependent or independent regarding their biological activity. Knowledge of the inhibitory mechanism at a molecular level was gained by the study of heparin. 3. Antithrombin-III, heparin-co-factor-II and alpha 2-macroglobulin are the most important plasma proteinase inhibitors involved in coagulation. alpha 2-macroglobulin has a particular inhibitory mechanism. 4. Non-plasma proteinase inhibitors were isolated from many species. They inhibit mainly the contact activation and fibrinolysis. 5. The evolutionary relationships are poorly understood.

Enhanced specificity of immunoblotting using radiolabeled antigen overlay: studies of blood coagulation factor XII and prekallikrein in plasma

Immunoblotting of blood coagulation Factor XII and plasma prekallikrein in whole plasma was performed using radiolabeled antigen for detection. After sodium dodecyl sulfate-polyacrylamide gel electrophoresis of plasma and transfer to nitrocellulose sheets, the blots were first reacted with polyclonal goat anti-Factor XII or anti-prekallikrein antisera and then with 125I-Factor XII or 125I-prekallikrein, respectively. A major advantage of using radiolabeled antigen rather than radiolabeled secondary antibody was enhanced specificity of immunodetection of these antigens in plasma. This procedure was sensitive to approximately 0.3 ng of either Factor XII or prekallikrein antigen and was useful for detection of Factor XII cleavage fragments in contact activated plasma. Radiolabeled antigen overlay may improve the specificity of immunoblotting of trace antigens in any complex mixtures.

Purification of human factor XII from plasma using zinc chelate affinity chromatography

Human factor XII (Hageman Factor) was isolated from human plasma to apparent homogeneity using a four step procedure with yields up to 30%. The method, which is more rapid than the current conventional procedures, consists of a 25-50% ammonium sulfate fractionation, two affinity chromatography steps using Zinc Chelate Sepharose, followed by gel filtration. The isolated zymogen factor XII was a single protein component when examined by SDS PAGE with a Mr of 80,000. Activation of zymogen factor XII to its active enzymatic forms by kallikrein resulted in factor XIIa and factor XIIf as observed with factor XII purified by other procedures.

The contact activation system: biochemistry and interactions of these surface-mediated defense reactions

This review is intended to be a critical state-of-the-art overview of the activation and inhibition of the proteins (factor XII, prekallikrein, high molecular weight kininogen, and factor XI) of the contact phase of coagulation. Specifically, this review will reconsider the concept of the reciprocal activation of the proteases of the contact phase of coagulation, factor XII, and prekallikrein, in light of much recent evidence indicating that factor XII, itself, autoactivates when associated with negatively charged surfaces. In addition, the mechanisms for amplification of activation of the proteins of the contact phase of coagulation will be discussed from the pivotal role of high molecular weight kininogen, or one of its altered forms, serving as a cofactor to order the activation of the zymogens it is associated with. The role and relative importance of each of the naturally occurring plasma protease inhibitors (C1-inhibitor, alpha-2-macroglobulin, alpha-1-antitrypsin, antithrombin III, and alpha-1-antiplasmin) will be assessed as they relate to the dampening of contact phase activation. Finally, the contact phase of coagulation activation will be discussed not only as a plasma proteolytic mechanism, but also as it interacts with platelets.