Human blood platelet adhesion to artery subendothelium is mediated by factor VIII-Von Willebrand factor bound to the subendothelium

Arteriosclerosis in normal and von Willebrand pigs: long-term prospective study and aortic transplantation study

In a long-term prospective study, five normal control pigs and five pigs with homozygous von Willebrand's disease received a nonfatty diet from age 3 months to 4 years; then the aortas were analyzed. The fibrous arteriosclerotic plaques in the distal abdominal aortic region involved an average of 28% of the surface area in control pigs and only 7% of the surface area in pigs with von Willebrand's disease (P less than 0.01). In a subsequent study of 3-month-old pigs, the distal abdominal aortic segments from nine normal pigs were cross-transplanted with segments from nine other normal pigs (control study), and aortic segments from four normal pigs were transplanted into four host pigs with von Willebrand's disease (exchange study). All pigs received a 2% cholesterol diet for up to 6 months; then the transplanted aortic segments were analyzed. The donor normal aortic segments in the host normal pigs developed arteriosclerosis that involved an average of 20% of the surface; the endothelial fluorescent pattern of von Willebrand factor was identified. In contrast, the donor normal aortic segments in the host pigs with von Willebrand's disease had arteriosclerosis that involved an average of only 4% of the surface (P less than 0.01); the endothelial cell von Willebrand factor was not identified. The long-term prospective study indicates that pigs with von Willebrand's disease are resistant to the development of spontaneous arteriosclerosis. The aortic transplantation data are compatible with the hypothesis that the absence of von Willebrand factor in pigs with von Willebrand's disease may cause impairment of platelet-arterial wall interaction and resistance to arteriosclerosis.

Culture-produced subendothelium. II. Effect of plasma, F.VIIIR:WF and fibronectin on interaction of normal platelets with normal and von Willebrand porcine aortic subendothelium

Culture-produced normal and von Willebrand (vWd) porcine aortic subendothelium (SE) was prepared on glass and fibronectin (FN)-coated surfaces. Washed porcine platelets reacted extensively with normal SE (on glass) as single adherent non-spread and spread (5%) platelets, whereas vWd SE (on glass)-platelet interaction was decreased with no spreading. Normal porcine plasma increased normal SE-platelet interaction 3 to 5-fold and spreading 5-fold (20-30%); vWd SE-platelet interaction was increased 2 to 4-fold with no spreading. vWd porcine plasma did not affect normal or vWd SE-platelet interaction or spreading. Purified porcine F.VIIIR:WF (0.5-2 U/ml) increased both normal and vWd SE-platelet interaction 2 to 4-fold without increasing spreading. Purified human FN (50-200 micrograms/ml) did not increase normal of vWd SE-platelet interaction but increased spreading 5 to 7-fold (25-35%) with normal SE. F.VIIIR:WF (2 U/ml) plus FN (200 micrograms/ml) increased normal SE-platelet interaction 4 to 5-fold and spreading 8 to 9-fold (41%) with extensive SE-associated microaggregate formation; vWd SE-platelet interaction was increased about 6-fold with no spreading. Platelets reacted more extensively with normal and vWd SE prepared on FN-coated surfaces than SE on glass. Normal SE (on FN)-platelet interaction increased 6 to 7-fold and spreading 12-fold (60%); vWd SE (on FN)-platelet interaction increased about 110-fold with about 10% spreading. Plasma (normal and vWd), and F.VIIIR:WF did not significantly increase normal or Vwd SE (on FN)-platelet interaction or spreading. Results suggest a possible role for FN as a spreading factor in SE-platelet interactions.

Analysis of platelet adhesion with a radioactive chemical crosslinking reagent: interaction of thrombospondin with fibronectin and collagen

We have analyzed the interactions of platelets and platelet-secreted proteins with proteins bound to glass substrata. Using a newly developed radioactive crosslinking reagent, N-succinimidyl-3-[(2-nitro-4-azidophenyl)-2-aminoethyldithio] propionate, we observed crosslinking between thrombospondin released from the platelets and surface-bound fibronectin or collagen. The crosslinking was selective and specific, since thrombospondin showed little crosslinking to substratum-bound bovine serum albumin or ovalbumin, even though it bound to these surfaces. Furthermore, although albumin and fibrinogen released by platelets bound to fibronectin-coated substrata as well as did thrombospondin, these two proteins crosslinked at much lower levels than seen for thrombospondin. Interaction between fibronectin and thrombospondin was confirmed by affinity chromatography. These results suggest that thrombospondin and fibronectin may interact during platelet-substratum adhesion or during platelet-platelet aggregation, or both.

Immunolocalization of von Willebrand protein in Weibel-Palade bodies of human endothelial cells

Immunofluorescence staining of cultured human umbilical vein endothelial cells has shown the presence of von Willebrand protein in the perinuclear region, in small rodlike structures through the cytoplasm, and on filaments of the extracellular matrix. Nonendothelial cells showed no staining with anti-von Willebrand protein antiserum. At the light microscope level, immunoperoxidase treatment of endothelial cells revealed the same pattern and antibody specificity as the fluorescence staining. Thin sections of the peroxidase-stained cells showed decorated filaments close to the substratum and also specific deposits in the endoplasmic reticulum and Weibel-Palade bodies. Control antisera against other selected proteins in endothelial cells failed to stain the Weibel-Palade bodies. These data suggest that the Weibel-Palade bodies of endothelial cells are storage and/or processing organelles for von Willebrand protein.

Platelet adhesion to damaged coronary arteries: Comparison in normal and von Willebrand disease swine

The early response to coronary artery injury was investigated in normal swine and in swine with von Willebrand disease (vWD). Thirty minutes after coronary endothelial denudation, a monolayer of platelets was adherent to areas of simple injury in both bleeder and normal swine. The number of adherent platelets was not significantly different in the two phenotypes. Injury involving the media of the vessel produced platelet-fibrin thrombi. Platelet activation, as judged by pseudopod formation and platelet spreading over areas of simple injury, was significantly less in bleeder animals than in normal animals. These studies suggest that chemotaxis and initial contact adhesion of platelets to injured arterial wall is independent of the von Willebrand factor. On the other hand, the spreading and activation of platelets on the subendothelium appear to be dependent on the presence of plasma von Willebrand factor. Through this mechanism von Willebrand factor may contribute to arterial thrombosis and atherogenesis.

Peripheral and integral proteins of human blood platelet membranes. alpha-Actinin is not identical to glycoprotein III

Isolation of human platelet membranes on polylysine beads and selective solubilization of membrane proteins allowed classification of membrane-associated proteins into integral and peripheral proteins. No major integral protein was found that was not exposed on the surface. Glycoprotein Ic was the only surface-exposed protein that behaved as a peripheral protein. The localization and identification of alpha-actinin was performed with an antibody against porcine skeletal muscle alpha-actinin. Human platelet alpha-actinin had an apparent molecular weight of 100 000 and a pI of 5.7-6.3. It was membrane-associated and behaved as a peripheral protein. Immunoisolation on protein A beads, as well as the 'Western Blot' technique applied to two-dimensional gels, demonstrated that alpha-actinin is not identical to GP III as was previously suggested (Gerrard, J.M., Schollmeyer, J.V., Phillips, D.R. and White, J.G. (1979) Am. J. Pathol. 94, 509-528).

Pseudo-von Willebrand's disease. An intrinsic platelet defect with aggregation by unmodified human factor VIII/von Willebrand factor and enhanced adsorption of its high-molecular-weight multimers

Four members (from four generations) of a family with a mild bleeding disorder and intermittent thrombocytopenia had decreased plasma levels of properties related to factor VIII/von Willebrand factor (FVIII/VWF), an absence of high-molecular-weight forms of FVIII/VWF in the plasma (but normal multimeric structure in the platelets), and increased ristocetin-induced platelet aggregation, as in Type IIB von Willebrand's disease. However, unlike the abnormality in FVIII/VWF in Type IIB disease, the basic defect in this family was in their platelets, which absorbed FVIII/VWF high-molecular-weight multimers at lower concentrations of ristocetin than did normal platelets. In addition, either in platelet-rich plasma or suspended in buffer, their platelets were aggregated by unmodified normal human FVIII/VWF without ristocetin. Since the abnormalities of plasma FVIII/VWF in this family may be secondary to the platelet abnormalities, the term "pseudo-von Willbrand's disease" may be suitably descriptive of their disorder.

Adsorption of von Willebrand factor by fibrillar collagen--implications concerning the adhesion of platelets to collagen

Von Willebrand factor is adsorbed from plasma by fibrillar collagen in a manner which is dependent upon the time of incubation and collagen concentration. The adsorption does not require divalent cations and is temperature independent. As purified von Willebrand factor is also adsorbed by fibrillar collagen it is unlikely that the adsorption is mediated by other plasma proteins. Denatured collagen has no effect on von Willebrand factor activity and does not inherit the adsorption of the factor by native fibrillar collagen. The adsorbed von Willebrand factor can be eluted from fibrillar collagen with 1M NaCl. The similarities between the adhesion of platelets to collagen and the adsorption of von Willebrand factor by collagen suggest that von Willebrand factor may have a role in collagen-platelet adhesion. The observed inhibition of platelet adhesion to collagen by antiserum to von Willebrand factor is consistent with this hypothesis.

Monoclonal antibody to human platelet glycoprotein I. II. Effects on human platelet function

The effect on platelet function of a monoclonal platelet antibody to platelet membrane glycoprotein I was tested. This antibody, AN51, inhibited ristocetin or bovine factor VIII-induced aggregation but did not modify ADP, collagen type I or type III, thrombin or arachidonic acid induced aggregations. Furthermore, the adhesion-aggregation of platelets induced by microfibrils was also inhibited by the antibody. Platelet adhesion to rabbit aorta subendothelium was impaired by the antibody. The persistent adhesion of platelets to collagenase-treated subendothelium was also inhibited. These findings strongly suggested that platelet membrane glycoprotein I could interact with a non-collagenic microfibrillar component of subendothelium. The binding of factor VIII/von Willebrand factor to platelet membrane in the presence of ristocetin was decreased in the binding site for factor VIII/von Willebrand factor to allow platelet adhesion to subendothelium.

Alterations of factor VIII von Willebrand factor in clinical conditions associated with an increase in its plasma concentration

Factor VIII-related antigen (VIIIR:Ag) was consistently higher than factor-VIII procoagulant activity (VIII:C) in 57 patients with clinical conditions characterized by acute-phase reactions. Two different methods for measuring VIII:C (one- and two-stage assays) and VIIIR:Ag (electroimmunodiffusion and immunoradiometric assay) gave concordant results in the majority of cases. In 43% of plasma samples, crossed immunoelectrophoresis in agarose gel was characterized by the appearance of an additional, fast-moving precipitin peak which was immunologically identical with the major, slower-moving VIIIR:Ag peak. The fast-moving peak was detected in all the patients with clinical conditions typically associated with increased plasma proteolysis (DIC, acute pancreatitis, during thrombolytic therapy). It was present in a smaller proportion of cases with liver and renal failure and malignancies and in the post-operative period. The additional VIIIR:Ag peak is thought to be the result of in vivo factor VIII/von Willebrand factor fragmentation by proteolytic enzymes.

Properties of human asialo-factor VIII. A ristocetin-independent platelet-aggregating agent

Human Factor VIII desialylated by treatment with Vibrio cholerae neuraminidase (ASVIII) aggregated human platelets in the absence of ristocetin in platelet-rich plasma and, to a lesser extent, in washed platelet suspensions. Aggregation is accompanied by thromboxane formation and is completely inhibited by EDTA. Aspirin blocks the second phase of aggregation and abolishes thromboxane production. Subaggregating doses of ASVIII and of either ADP, epinephrine, or collagen produce prompt and complete platelet aggregation. Bernard-Soulier syndrome platelets either did not aggregate with ASVIII (Two cases) or showed markedly decreased aggregation (one cases). Factor VIII complex was prepared from the plasma of two patients with variant von Willebrand's disease (sialic acid content 142 and 75 nmol/mg, respectively); neither protein generated platelet-aggregating activity upon desialylation. [3H]ASVIII binds rapidly to platelets and 37 degrees C, while tritiated, fully sialylated factor VIII binds to a negligible extent. As little as 1--2 micrograms ASVIII bound/10(9) platelets is capable of inducing platelet aggregation. ASVIII may be a useful tool for investigating platelet-Factor VIII interactions in the absence of ristocetin. Furthermore, desialylated Factor VIII might play a physiologic role in Factor VIII-mediated platelet reactions in vivo.

Platelet-vessel-wall interactions: experiences with von Willebrand platelets

Adhesion of platelets from 15 patients with von Willebrand's disease was tested in an ex vivo human umbilical vein model. Experiments employed umbilical veins still in their umbilical cords taken from patients undergoing cesarean section and platelets (fetal, adult and vW) either apyrase-washed or used as platelet-rich plasma or whole blood. F VIII R:Ag, F VIII:Rcof, and F VIII:C were measured in initial fresh plasma and in effluents from the umbilical vein segments. F VIII:Rcof increased in most perfusates. Binding of latex-linked specific antihuman F VIII R:Ag demonstrated that F VIII R:Ag existed on subendothelium and on injured endothelial cells. Scanning electron microscopy three-dimensionally displayed vW platelet--vessel-wall interactions. Although vW platelets adhered to injured vein, both qualitative and quantitative differences existed in comparison with adhesion of normal platelets. The differences correlated best with the plasma F VIII:Rcof level. The best adhesion shown by vW platelets was only 51 percent of the adhesion of control fetal or adult platelets. vW platelets had less surface activity, fewer pseudopods, and little ability to spread and pave the exposed subendothelium. Pretreatment of the vein with F VIII R:Ag antibody partly blocked adhesion. Coperfusion of cryoprecipitate with vW platelets improved their adhesivity, state of activation on subendothelium, and ability to form aggregates. ABO differences in blood cell types of fetal material and platelet donors seemed without effect, which further establishes this model's validity for studies of platelet dysfunction and platelet or endothelial reactive agents.

Factor VIII complex in uraemia and effects of haemodialysis

Levels of the factor VIII complex were found to be raised in patients with chronic renal failure and further raised by regular dialysis. Increased fibrinogen concentrations were also found. These results suggest the existence of a prothrombotic state in uraemia that is exacerbated by haemodialysis. Ristocetin-induced platelet agglutination, however, was depressed in uraemia and worsened by dialysis. This defect may be transferred to normal platelets from dialysed uraemic plasma, suggesting the existence of an inhibitor of the interaction between factor VIII and platelet glycoprotein. These results may help to explain the anomaly of a prolonged bleeding time together with accelerated atherogenesis that is found in patients with uraemia receiving dialysis.

Interaction of porcine von Willebrand factor (platelet aggregating factor) with human platelets

The binding of 125I-labeled porcine von Willebrand factor to washed human platelets was examined. In the absence of ristocetin, binding was found to be rapid, specific and saturable and was decreased in the presence of urea or at high ionic strength. Platelets were found to contain approx. 4760 binding sites for porcine von Willebrand factor with an average binding constant of 2.92 x 10(-7) M assuming the von Willebrand factor to be a tetramer with a molecular weight of 9 x 10(5). Although ristocetin was not absolutely required for binding, in its presence binding was increased.

Involvement of fibronectin, Von Willebrand factor, and fibrinogen in platelet interaction with solid substrata

The proteins fibronectin (FN), Von Willebrand factor (VWF), and fibrinogen are believed to play a role in platelet function. They are distributed between the plasma and the platelet pool in the resting state and undergo redistribution upon platelet activation. We have studied their expression on the surface of the platelet and their mobilization following platelet binding to substrata. For the purpose of studying protein expression on the surface of intact platelets either adherent to a substratum or in suspension, the enzyme-linked immunosorbent assay (ELISA) was elaborated and modified. Using this technique as well as immunofluorescence, we found that antiserum raised against carefully washed human platelets recognized FN, VWF, and fibrinogen as well as platelet surfaces. However, specific antisera against these three proteins failed to bind to the surface of unactivated gel-filtered platelets. When gel-filtered platelets were exposed to plastic or fibrillar collagen, they adhered and spread. Such platelets did bind antibodies against FN, VWF, and fibrinogen, Moreover, when the adherent platelets were incubated with FN or with VWF in the absence of ristocetin, they bound these proteins in a concentration-dependent fashion. The patterns of the bound proteins were not similar, suggesting a different spatial distribution of binding sites. These findings indicate that platelet activation by adhesion to substrata mobilize both endogenous and exogenous pools of these proteins, thereby making them surface associated and probable participants in further binding properties of the activated platelet.