Conversion of Glu-plasminogen to plasmin by urokinase in the presence of tranexamic acid

Computational model of tranexamic acid on urokinase mediated fibrinolysis

Understanding the coagulation process is critical to developing treatments for trauma and coagulopathies. Clinical studies on tranexamic acid (TXA) have resulted in mixed reports on its efficacy in improving outcomes in trauma patients. The largest study, CRASH-2, reported that TXA improved outcomes in patients who received treatment prior to 3 hours after the injury, but worsened outcomes in patients who received treatment after 3 hours. No consensus has been reached about the mechanism behind the duality of these results. In this paper we use a computational model for coagulation and fibrinolysis to propose that deficiencies or depletions of key anti-fibrinolytic proteins, specifically antiplasmin, a1-antitrypsin and a2-macroglobulin, can lead to worsened outcomes through urokinase-mediated hyperfibrinolysis.

Inhibition by tranexamic acid of the conversion of single-chain tissue plasminogen activator to its two chain form by plasmin: the presence on tissue plasminogen activator of a site to bind with lysine binding sites of plasmin

The addition of tranexamic acid inhibited the conversion of single chain tissue plasminogen activator (sct-PA) to its two chain form (tct-PA) by plasmin. Increase in the concentrations of tranexamic acid resulted in more inhibition of the conversion, with 50% inhibition being obtained at 0.251 mM of the concentration of tranexamic acid. The addition of the fragments of plasminogen such as kringle 1 to 3 (K1-3), and K4 resulted in the facilitation of the conversion of sct-PA to tct-PA by plasmin. The addition of tranexamic acid to the mixture of sct-PA and K4 inhibited the rate of the conversion of sct-PA by plasmin. These results suggest that binding of lysine binding sites of plasmin or plasminogen with sct-PA enhanced its conversion to tct-PA by plasmin, and that there is a site on a t-PA molecule to bind to plasminogen or plasmin.

Degradation of Glu- and Lys-plasminogen by elastase in the presence or absence of tranexamic acid

Glu-plasminogen (Glu-plg) was degraded by elastase in the presence or absence of tranexamic acid. Glu-plg was degraded faster in the presence of tranexamic acid. Increase in the concentration of tranexamic acid resulted in increase in the appearance of degradation products, reaching a plateau level at 1 mM of tranexamic acid. Fifty percent increase in the concentration of one of degradation products was obtained at 0.22 mM of tranexamic acid, which is similar to a dissociation constant (Kd) of low affinity lysine binding sites (LBS) with tranexamic acid. As to the degradation rate of two isozymes of Glu-plg (Glu-plg I and II), Glu-plg II containing one carbohydrate chain was degraded faster than Glu-plg I containing two carbohydrate chains. Comparison of the degradation rates of Glu-plg and Lys-plg indicated that Lys-plg was degraded faster.

Reduced cofactor function of human high molecular weight kininogen induced by rat plasma kallikrein

Plasma kallikrein purified from acetone-activated, plasminogen-free rat plasma yielded in polyacrylamide gel electrophoresis protein bands corresponding to Mr values of 143,000 (main band) and 135,000 (lighter band). After SDS treatment without reduction the protein pattern had changed to two strong bands corresponding to Mr values of 87,000 and 78,000. Gel electrophoresis of kallikrein purified from plasma of rats pretreated with clinical dextran (200 mg/kg intravenously) produced main bands corresponding to Mr values of 120,000-130,000 and 78,000-80,000 for native samples and SDS-treated samples respectively (Johansen & Briseid 1983). Both kinds of kallikrein reduced the capacity of human high molecular weight kininogen to function as a cofactor in the surface-mediated activation of factor XII in a crude plasma preparation. The preparation obtained from plasma of dextran-treated rats was significantly more potent than was the normal kallikrein preparation, both as regards the effect against HMrK, and as an activator of plasminogen.

Effects of fibrinogen and fibrin on the activation of Glu- and Lys-plasminogen by urokinase

Glu- and Lys-plasminogen (plg) were mixed with fibrinogen or fibrinogen plus thrombin in the presence of various units of urokinase (UK) and S-2251 (H-D-Val-Leu-Lys-pNA). Time course of the hydrolysis of S-2251 and the increment of OD405/min were monitored by using a spectrophotometer. Glu-plg was activated better by UK in the presence of fibrinogen and fibrin than in their absence. The effects of fibrin were larger than those of fibrinogen in the activation of Glu-plg. When Lys-plg was used for the similar experiments, the activation rate of Lys-plg was slightly increased in the presence of fibrinogen and fibrin (fibrin greater than fibrinogen), but their effects were smaller than in the case of the activation of Glu-plg.

Fluorescence spectrophotometric studies on the conformational changes induced by omega-aminoacids in two isozymes of Glu-plasminogen (I and II)

Glu-plasminogen I (Glu-plg I: with two carbohydrate chains) and Glu-plg II (with one carbohydrate chain) were separated by a gradient elution of 6 aminohexanoic acid (6AHA) through lysine-Sepharose. Each preparation was excited with ultraviolet light of wave length at 291 nm. The intensity of fluorescence was measured at 340 nm. The intensity of fluorescence increased to a small extent at 0.02 mM of tranexamic acid (t-x) for Glu-plg I and then quickly increased from 0.1 mM of t-x to reach the peak at 0.6 mM. The intensity of fluorescence for Glu-plg II started to increase at 0.2 mM to reach the peak at 0.7 mM. No small increase of fluorescence was observed at less than 0.2 mM of t-x for Glu-plg II. Kdobs of Glu-plg I for t-x and 6AHA were 0.34 mM and 1.35 mM, respectively, whereas Kdobs of Glu-plg II for t-x and 6AHA were 0.46 mM and 3.3 mM, respectively. When Glu-plg I and II were activated by urokinase (UK) and the hydrolysis of S-2251 was measured, the extent of hydrolysis increased in the presence of t-x and 6AHA. The rate of the increase of S-2251 hydrolysis (thus activation rate of Glu-plg I and II with UK) increased in parallel with increase in fluorescence intensity of Glu-plg I and II in the presence of omega-aminoacids. In conclusion, changes in the activation rate with UK and in fluorescence intensity were observed at lower concentrations of omega-aminoacids for Glu-plg I than for Glu-plg II.

Fluorescence polarization and spectropolarimetric studies on the conformational changes induced by omega-aminoacids in two isozymes of Glu-plasminogen (I and II)

Conformational changes of two isozymes of Glu-plasminogen (Glu-plg I and II) induced by omega-aminoacids were studied by using fluorescence polarization and spectropolarimetry. The rotational relaxation times (Pn) of FITC labeled Glu-Plg I and II decreased in the presence of 6 aminohexanoic acid (6AHA) or tranexamic acid (t-x), which may mean increase in Brownian motion of FITC labeled region (possibly N-terminal region) of Glu-plg I and II when 6AHA or t-x binds with lysine binding sites (LBS) of these plasminogens. Glu-plg II seems to have longer rotational relaxation time compared to that of Glu-plg I, which may mean smaller extent of Brownian motion of FITC labeled region of Glu-plg II in comparison to that of Glu-plg I. The far ultraviolet circular dichroism (CD) spectra indicate that there may be some difference in the polypeptide backbone between Glu-plg I and II, possibly more of beta-structure and less of random coil structure in Glu-plg II in comparison to Glu-plg I. The presence of 6AHA or t-x gave rise to larger change of the negative ellipticity at around 208 nm in Glu-plg I in comparison to its change in Glu-plg II, which may mean the larger extent of conformational change of Glu-plg I induced by 6AHA or t-x than that of Glu-plg II.

The activation of two isozymes of glu-plasminogen (I and II) by urokinase and streptokinase

Glu-plasminogen (Glu-plg) was eluted through lysine-Sepharose by using a gradient of 6 aminohexanoic acid, and two peaks corresponding to Glu-plg I and II were obtained. Glu-plg I has a molecular weight of 93,000 and Glu-plg II has a molecular weight of 89,000. When these plgs were activated by urokinase (UK) or streptokinase (SK) in the presence of S-2251 (H-D-Val-Leu-Lys-pNA0, the hydrolysis of S-2251 by Glu-plg I activated by UK or SK was larger than that by Glu-plg II activated by UK or SK. The results of SDS-PAGE indicate that the conversion of Glu-plg I to plasmin by UK was faster than that of Glu-plg II. It may be concluded that Glu-plg I is activated better to plasmin by activators than Glu-plg II.

Activation pathway of glu-plasminogen to Lys-plasmin by urokinase

When Glu-plasminogen (Glu-plg) was incubated with plasmin for various time intervals, and the mixture was activated by urokinase (UK), the activation rate increased gradually as incubation time increased. The presence of fibrin not only enhanced the activation rate of Glu-plg but also that of proteolytically modified form to some extent. The results of SDS-PAGE indicated that the release of N-terminal peptides from Glu-plg or Glu-plasmin takes place gradually when the concentration of plg was about 1 microM, and that Glu-plasmin I of larger molecular weight is more slowly converted to Lys-plasmin than Glu-plasmin II of smaller molecular weight. The amounts of carbohydrate moieties on the heavy chain of plasmin may influence the release of N-terminal peptide from Glu-plasmin. Kinetic studies indicate that Lys-plasmin has smaller km than Glu-plasmin, thus the former being better enzymatically than the latter.