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C-glyco“RGD” as αIIbβ3 and αvβ integrin ligands for imaging applications: Synthesis, in vitro evaluation and molecular modeling. Bioorg Med Chem 2019; 27:4101-4109. [DOI: 10.1016/j.bmc.2019.07.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 01/03/2023]
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Oral Bruton tyrosine kinase inhibitors selectively block atherosclerotic plaque-triggered thrombus formation in humans. Blood 2018; 131:2605-2616. [PMID: 29559479 DOI: 10.1182/blood-2017-09-808808] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 03/14/2018] [Indexed: 11/20/2022] Open
Abstract
Interaction of von Willebrand factor (VWF) with platelet glycoprotein Ib (GPIb) and interaction of collagen with GPVI are essential for thrombus formation on ruptured or eroded atherosclerotic plaques (atherothrombosis). GPIb and GPVI signal through Bruton tyrosine kinase (Btk), which can be blocked irreversibly by oral application of ibrutinib, an established therapy for chronic lymphocytic leukemia (CLL) with long-term safety. We found that ibrutinib and the novel Btk inhibitors acalabrutinib and ONO/GS-4059 block GPVI-dependent static platelet aggregation in blood exposed to human plaque homogenate and collagen but not to ADP or arachidonic acid. Moreover, Btk inhibitors prevented platelet thrombus formation on human atherosclerotic plaque homogenate and plaque tissue sections from arterially flowing blood, whereas integrin α2β1 and VWF-dependent platelet adhesion to collagen, which is important for physiologic hemostasis, was not affected. This plaque-selective platelet inhibition was also observed in CLL patients taking 450 mg of ibrutinib and in volunteers after much lower and intermittent dosing of the drug. We conclude that Btk inhibitors, by targeting GPIb and GPVI signal transduction, suppress platelet thrombus accretion from flowing blood on atherosclerotic plaque but spare hemostatic platelet function. Btk inhibitors hold promise as the first culprit lesion-focused oral antiplatelet drugs and are effective at low doses.
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Jamasbi J, Ayabe K, Goto S, Nieswandt B, Peter K, Siess W. Platelet receptors as therapeutic targets: Past, present and future. Thromb Haemost 2017; 117:1249-1257. [DOI: 10.1160/th16-12-0911] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/08/2017] [Indexed: 01/08/2023]
Abstract
SummaryAnti-platelet drugs reduce arterial thrombosis after plaque rupture and erosion, prevent stent thrombosis and are used to prevent and treat myocardial infarction and ischaemic stroke. Some of them may also be helpful in treating less frequent diseases such as thrombotic thrombocytopenic purpura. The present concise review aims to cover current and future developments of anti-platelet drugs interfering with the interaction of von Willebrand factor (VWF) with glycoprotein (GP) Ibα, and directed against GPVI, GPIIb/IIIa (integrin αIIbβ3), the thrombin receptor PAR-1, and the ADP receptor P2Y12. The high expectations of having novel antiplatelet drugs which selectively inhibit arterial thrombosis without interfering with normal haemostasis could possibly be met in the near future.
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Mojica Muñoz AK, Jamasbi J, Uhland K, Degen H, Münch G, Ungerer M, Brandl R, Megens R, Weber C, Lorenz R, Siess W. Recombinant GPVI-Fc added to single or dual antiplatelet therapy in vitro prevents plaque-induced platelet thrombus formation. Thromb Haemost 2017; 117:1651-1659. [DOI: 10.1160/th16-11-0856] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/04/2017] [Indexed: 11/05/2022]
Abstract
SummaryThe efficiency of current dual antiplatelet therapy might be further improved by its combination with a glycoprotein (GP) VI-targeting strategy without increasing bleeding. GPVI-Fc, a recombinant dimeric fusion protein binding to plaque collagen and concealing binding sites for platelet GPVI, acts as a lesion-focused antiplatelet drug, and does not increase bleeding in vivo. We investigated, whether GPVI-Fc added in vitro on top of acetylsalicylic acid (ASA), the P2Y12 antagonist ticagrelor, and the fibrinogen receptor antagonist abciximab alone or in combination would increase inhibition of platelet activation by atherosclerotic plaque. Under static conditions, GPVI-Fc inhibited plaque-induced platelet aggregation by 53%, and increased platelet inhibition by ASA (51%) and ticagrelor (64%) to 66% and 80%, respectively. Under arterial flow, GPVI-Fc inhibited plaque-induced platelet aggregation by 57%, and significantly increased platelet inhibition by ASA (28%) and ticagrelor (47%) to about 81% each. The triple combination of GPVI-Fc, ASA and ticagrelor achieved almost complete inhibition of plaque-induced platelet aggregation (93%). GPVI-Fc alone or in combination with ASA or ticagrelor did not increase closure time measured by the platelet function analyzer (PFA)-200. GPVI-Fc added on top of abciximab, a clinically used anti-fibrinogen receptor antibody which blocks platelet aggregation, strongly inhibited total (81%) and stable (89%) platelet adhesion. We conclude that GPVI-Fc added on top of single or dual antiplatelet therapy with ASA and/or a P2Y12 antagonist is likely to improve anti-atherothrombotic protection without increasing bleeding risk. In contrast, the strong inhibition of platelet adhesion by GPVI-Fc in combination with GPIIb/IIIa inhibitors could be harmful.Note: The review process for this manuscript was fully handled by Gregory Y. H. Lip, Editor in Chief.Supplementary Material to this article is available at www.thrombosis-online.com.
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Jamasbi J, Megens RTA, Bianchini M, Uhland K, Münch G, Ungerer M, Sherman S, Faussner A, Brandl R, John C, Buchner J, Weber C, Lorenz R, Elia N, Siess W. Cross-Linking GPVI-Fc by Anti-Fc Antibodies Potentiates Its Inhibition of Atherosclerotic Plaque- and Collagen-Induced Platelet Activation. JACC Basic Transl Sci 2016; 1:131-142.. [PMID: 27766315 PMCID: PMC5063538 DOI: 10.1016/j.jacbts.2016.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/08/2016] [Indexed: 10/26/2022]
Abstract
To enhance the antithrombotic properties of recombinant glycoprotein VI fragment crystallizable (GPVI-Fc), the authors incubated GPVI-Fc with anti-human Fc antibodies to cross-link the Fc tails of GPVI-Fc. Cross-linking potentiated the inhibition of human plaque- and collagen-induced platelet aggregation by GPVI-Fc under static and flow conditions without increasing bleeding time in vitro. Cross-linking with anti-human-Fc Fab2 was even superior to anti-human-Fc immunoglobulin G (IgG). Advanced optical imaging revealed a continuous sheath-like coverage of collagen fibers by cross-linked GPVI-Fc complexes. Cross-linking of GPVI into oligomeric complexes provides a new, highly effective, and probably safe antithrombotic treatment as it suppresses platelet GPVI-plaque interaction selectively at the site of acute atherothrombosis.
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Affiliation(s)
- Janina Jamasbi
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany
| | - Remco T A Megens
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Mariaelvy Bianchini
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany
| | | | | | | | - Shachar Sherman
- Department of Life Sciences, Ben Gurion University, Beer-Sheva, Israel
| | - Alexander Faussner
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany
| | - Richard Brandl
- St. Mary's Square Institute for Vascular Surgery and Phlebology, Munich, Germany
| | - Christine John
- Department of Biotechnology, Technical University of Munich, Garching, Germany
| | - Johannes Buchner
- Department of Biotechnology, Technical University of Munich, Garching, Germany
| | - Christian Weber
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany; Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Reinhard Lorenz
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany
| | - Natalie Elia
- Department of Life Sciences, Ben Gurion University, Beer-Sheva, Israel
| | - Wolfgang Siess
- Institute for the Prevention of Cardiovascular Diseases, University of Munich (LMU Munich), Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
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Medical leech therapy in plastic reconstructive surgery. Wien Med Wochenschr 2015; 165:419-25. [DOI: 10.1007/s10354-015-0382-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
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Metharom P, Berndt MC, Baker RI, Andrews RK. Current state and novel approaches of antiplatelet therapy. Arterioscler Thromb Vasc Biol 2015; 35:1327-38. [PMID: 25838432 DOI: 10.1161/atvbaha.114.303413] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/19/2015] [Indexed: 01/22/2023]
Abstract
An unresolved problem with clinical use of antiplatelet therapy is that a significant number of individuals either still get thrombosis or run the risk of life-threatening bleeding. Antiplatelet drugs are widely used clinically, either chronically for people at risk of athero/thrombotic disease or to prevent thrombus formation during surgery. However, a subpopulation may be resistant to standard doses, while the platelet targets of these drugs are also critical for the normal hemostatic function of platelets. In this review, we will briefly examine current antiplatelet therapy and existing targets while focusing on new potential approaches for antiplatelet therapy and improved monitoring of effects on platelet reactivity in individuals, ultimately to improve antithrombosis with minimal bleeding. Primary platelet adhesion-signaling receptors, glycoprotein (GP)Ib-IX-V and GPVI, that bind von Willebrand factor/collagen and other prothrombotic factors are not targeted by drugs in clinical use, but they are of particular interest because of their key role in thrombus formation at pathological shear.
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Affiliation(s)
- Pat Metharom
- From the Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia (P.M., M.C.B); Western Australian Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Western Australia, Australia (R.I.B.); and Australian Centre for Blood Diseases, Department of Clinical Haematology, Monash University, Melbourne, Victoria, Australia (R.K.A.)
| | - Michael C Berndt
- From the Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia (P.M., M.C.B); Western Australian Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Western Australia, Australia (R.I.B.); and Australian Centre for Blood Diseases, Department of Clinical Haematology, Monash University, Melbourne, Victoria, Australia (R.K.A.).
| | - Ross I Baker
- From the Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia (P.M., M.C.B); Western Australian Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Western Australia, Australia (R.I.B.); and Australian Centre for Blood Diseases, Department of Clinical Haematology, Monash University, Melbourne, Victoria, Australia (R.K.A.)
| | - Robert K Andrews
- From the Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia (P.M., M.C.B); Western Australian Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Western Australia, Australia (R.I.B.); and Australian Centre for Blood Diseases, Department of Clinical Haematology, Monash University, Melbourne, Victoria, Australia (R.K.A.)
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‘Click’ glycosylation of peptides through cysteine propargylation and CuAAC. Bioorg Med Chem 2014; 22:6672-6683. [DOI: 10.1016/j.bmc.2014.09.056] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/19/2014] [Accepted: 09/25/2014] [Indexed: 01/26/2023]
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