The biologic and clinical spectrum of Glanzmann's thrombasthenia: implications of integrin alpha IIb beta 3 for its pathogenesis

The Structure of a Full-length Membrane-embedded Integrin Bound to a Physiological Ligand

Increased ligand binding to integrin ("activation") underpins many biological processes, such as leukocyte trafficking, cell migration, host-pathogen interaction, and hemostasis. Integrins exist in several conformations, ranging from compact and bent to extended and open. However, the exact conformation of membrane-embedded, full-length integrin bound to its physiological macromolecular ligand is still unclear. Integrin αIIbβ3, the most abundant integrin in platelets, has been a prototype for integrin activation studies. Using negative stain electron microscopy and nanodisc-embedding to provide a membrane-like environment, we visualized the conformation of full-length αIIbβ3 in both a Mn(2+)-activated, ligand-free state and a Mn(2+)-activated, fibrin-bound state. Activated but ligand-free integrins exist mainly in the compact conformation, whereas fibrin-bound αIIbβ3 predominantly exists in a fully extended, headpiece open conformation. Our results show that membrane-embedded, full-length integrin adopts an extended and open conformation when bound to its physiological macromolecular ligand.

Novel ITGB6 mutation in autosomal recessive amelogenesis imperfecta

Objective

Hereditary defects in tooth enamel formation, amelogenesis imperfecta (AI), can be non-syndromic or syndromic phenotype. Integrins are signaling proteins that mediate cell–cell and cell–extracellular matrix communication, and their involvement in tooth development is well known. The purposes of this study were to identify genetic cause of an AI family and molecular pathogenesis underlying defective enamel formation.

Materials and Methods

We recruited a Turkish family with isolated AI and performed mutational analyses to clarify the underlying molecular genetic etiology.

Results

Autozygosity mapping and exome sequencing identified a novel homozygous ITGB6 transversion mutation in exon 4 (c.517G>C, p.Gly173Arg). The glycine at this position in the middle of the βI-domain is conserved among a wide range of vertebrate orthologs and human paralogs. Clinically, the enamel was generally thin and pitted with pigmentation. Thicker enamel was noted at the cervical area of the molars.

Conclusions

In this study, we identified a novel homozygous ITGB6 mutation causing isolated AI, and this advances the understanding of normal and pathologic enamel development.

Expression analysis of integrin β1 isoforms during zebrafish embryonic development

Integrins are a superfamily of the major metazoan receptors for cell-cell and cell-extracellular matrix adhesion. Integrins and their ligands play critical roles in a variety of fundamental cellular processes. Integrins are heterodimeric cell surface glycoproteins comprised of non-covalently bound α- and β-subunits. A variety of integrin subunits have been identified in mouse, chicken, zebrafish, Xenopus laevis and other vertebrates. In zebrafish multiple integrin β1 homologs have been identified. However, zebrafish embryo is a largely untapped model for analyzing integrin β1 isoforms temporal-spatial expression pattern, function and its relevance to human disease in whole animal level. Currently, we systematically analyzed the expression pattern of zebrafish integrin β1 including integrin beta 1a (itgb1a), integrin beta 1b (itgb1b), integrin beta 1b.1 (itgb1b.1), and integrin beta 1b.2 (itgb1b.2) at embryo stage using whole amount in situ hybridization. We show itgb1a, itgb1b and itgb1b.1 were maternally expressed in zygote, cleavage and blastula periods, while itgb1b.2 was not detectable in the corresponding stages. A more tissue specific pattern emerges during organogenesis, including heart expression for itgb1a, myotome borders for itgb1b, intestinal epithelium for itgb1b.1, and branchial arch for itgb1b.2. All are similarly expressed in the early embryonic epidermis and notochord. Additionally, itgb1a, itgb1b and itgb1b.2 shared the common expression in otic vesicle. Our study provides new insight into the integrin β1 expression and the use of this model organism to tackle future studies on the role of integrin β1 in embryo development.

Effect of mixed transplantation of autologous and allogeneic microskin grafts on wound healing in a rat model of acute skin defect

The treatment of extensive thermal injuries with insufficient autologous skin remains a great challenge to burn surgeons. In this study, we investigated the influence of the ratio of autologous and allogeneic tissue in mixed microskin grafts on wound healing in order to develop an effective method for using limited donor skin to cover a large open wound. Four different mixtures were tested: autologous microskin at an area expansion ratio of 10∶1 with allogeneic microskin at an area expansion ratio of 10∶1 or 10∶3 and autologous microskin at an expansion ratio of 20∶1 with allogeneic microskin at an expansion ratio of 20∶3 or 20∶6. Wound healing, wound contraction, and integrin β1 expression were measured. Mixed microskin grafting facilitated wound healing substantially. The mixture of autologous microskin at an expansion ratio of 10∶1 with the same amount of allogeneic microskin achieved the most satisfactory wound healing among the 4 tested mixtures. Histological examination revealed the presence of obviously thickened epidermis and ectopic integrin β1 expression. Keratinocytes expressing integrin β1 were scattered in the suprabasal layer. Higher levels of integrin β1 expression were associated with faster wound healing, implying that ectopic expression of integrin β1 in keratinocytes may play a pivotal role in wound healing. In conclusion, this study proves that this new skin grafting technique may improve wound healing.

Identification of novel integrin binding partners for calcium and integrin binding protein 1 (CIB1): structural and thermodynamic basis of CIB1 promiscuity

The short cytoplasmic tails of the α- and β-chains of integrin adhesion receptors regulate integrin activation and cell signaling. Significantly less is known about proteins that bind to α-integrin cytoplasmic tails (CTs) as opposed to β-CTs to regulate integrins. Calcium and integrin binding protein 1 (CIB1) was previously identified as an αIIb binding partner that inhibits agonist-induced activation of the platelet-specific integrin, αIIbβ3. A sequence alignment of all α-integrin CTs revealed that key residues in the CIB1 binding site of αIIb are well-conserved, and was used to delineate a consensus binding site (I/L-x-x-x-L/M-W/Y-K-x-G-F-F). Because the CIB1 binding site of αIIb is conserved in all α-integrins and CIB1 expression is ubiquitous, we asked if CIB1 could interact with other α-integrin CTs. We predicted that multiple α-integrin CTs were capable of binding to the same hydrophobic binding pocket on CIB1 with docking models generated by all-atom replica exchange discrete molecular dynamics. After demonstrating novel in vivo interactions between CIB1 and other whole integrin complexes with co-immunoprecipitations, we validated the modeled predictions with solid-phase competitive binding assays, which showed that other α-integrin CTs compete with the αIIb CT for binding to CIB1 in vitro. Isothermal titration calorimetry measurements indicated that this binding is driven by hydrophobic interactions and depends on residues in the CIB1 consensus binding site. These new mechanistic details of CIB1-integrin binding imply that CIB1 could bind to all integrin complexes and act as a broad regulator of integrin function.

Overview: studying integrins in vivo

Integrins are adhesive proteins that have evolved to mediate cell-cell and cell-matrix communication that is indispensable for development and postnatal physiology. Despite their widespread expression, the genetic deletion of specific integrin family members in lower organisms as well as mammals leads to relatively distinct abnormalities. Many of the processes in which integrins participate have a requirement for strong adhesion coincident with times of mechanical stress. In Drosophila, the absence of specific integrins leads to detachment of muscle from the gut and body wall and separation of the two epithelial layers in the wing. In mice and humans, a deletion of either subunit of the laminin-binding integrin, α6β4 leads to severe skin blistering and defects in other epithelial layers. In addition, integrins have also evolved to serve more subspecialized roles ranging from the establishment of a stem cell niche in Drosophila and mammals, to the regulation of pathogenic tumor vascularization, platelet adhesion, and leukocyte transmigration in mammalian systems. However, some cells seem to function normally in the absence of all integrins, as revealed by the very surprising finding that deletion of all the major integrin types on dendritic cells of mice has no effect on the ability of these cells to migrate within the interstitium of the skin and enter into lymphatics. In addition to serving as transmembrane mechanical links, integrins in vertebrates synergize with a number of receptors including growth factor receptors, to enhance responses. This leads to the activation of a large signaling network that affects cell proliferation and differentiation, as well as cell shape and migration. In vivo studies, in lower organisms, knockout mouse models as well as in inherited human diseases together have provided important insights into how this major, primordial family of adhesion receptors have remained true to their name "integrins" as their diverse functions have in common the ability to integrate extracellular stimuli into intracellular signals that affect cell behavior.

Ancient ubiquitous protein 1 and Syk link cytoplasmic tails of the integrin alpha(IIb)beta(3)

It is currently accepted that activity of the integrin alpha(IIb)beta(3) is modulated by direct interaction between its cytoplasmic tails (CTs) and association of cytoplasmic proteins with them, and disruption of the close linkage between CTs leads to activation of alpha(IIb)beta(3) (inside-out signaling). We previously reported that ancient ubiquitous protein (Aup1) binds to the membrane-proximal sequence of integrin alphaCTs that plays a pivotal role in the inside-out signaling. To explore biological function of Aup1, we examined in this study interaction of Aup1 with Src and Syk that are quickly activated in platelets before fibrinogen binding following thrombin stimulation. By immunoprecipitation assay with resting platelets, we first found that alpha(IIb)beta(3), Src, Syk, and Aup1 are constitutively complexed. In vitro binding study with recombinant Syk and glutathione (GSH) S-transferase (GST) - Src, -Aup1, and -alpha(IIb) and - beta(3) CTs that are immobilized to GSH- beads revealed direct binding of Syk to Aup1 as well as the beta(3) CT. Dot blot analysis with synthetic peptides for alpha(IIb) and beta(3) CTs, and GST-Aup1 and -Src immobilized to PVDF membrane exhibited concordant result with the GST pull-down assay. Immunoprecipitation of platelet lysates 10 seconds after thrombin stimulation, when activity and tyrosine phosphorylation of Syk are maimum, exhibited that active Syk does not coprecipitate with Aup1. In vitro kinase assay with GST-Syk and -Aup1 proteins at the presence or absence of active Src, a potent activator of Syk, revealed that Aup1 does not directly influence activation of Syk by autophosphorylation or tyrosine phosphorylation by Src. These results indicate that Aup1 is an adaptor recruiting Syk to the alpha(IIb) CT, and suggest that the alpha(IIb) -Aup1- Syk- beta(3) complex formation links alpha(IIb) and beta(3) CTs to sustain alpha(IIb)beta(3) in an inactive state and Syk dissociates from Aup1 after activation.

The use of recombinant factor VIla in a primigravida with Glanzmann's thrombasthenia during delivery

Glanzmann's thrombasthenia is an inherited hemorrhagic disorder characterized by a severe reduction in, or absence of, platelet aggregation in response to multiple physiologic agonists due to qualitative or quantitative abnormalities of platelet glycoprotein IIb-IIIa. Glanzmann's thrombasthenia is characterized by potentially major mucocutaneous bleeding and prolonged bleeding time. Platelet counts, platelet morphology, prothrombin, and activated thromboplastin times are all within normal ranges in patients with Glanzmann's thrombasthenia. Pregnancy and delivery are rare in Glanzmann thrombasthenia patients and have been associated with immediate postpartum hemorrhage. We describe the peripartum management of a 31-year-old primipara with Glanzmann's thrombasthenia who underwent spontaneous vaginal delivery. Four units of single-donor platelets, two units of packed red blood cells, 36 microg/kg recombinant human coagulation Factor VIIa (rFVIIa) were given during peripartum management.

Plasma fibronectin promotes thrombus growth and stability in injured arterioles

Mice lacking both of the best-known platelet ligands, von Willebrand factor and fibrinogen, can still form occlusive thrombi in injured arterioles. The platelets of these animals accumulate excessive amounts of fibronectin (FN). These observations led us to examine the contribution of plasma FN (pFN) to thrombus formation. Inactivation of the FN gene in FN conditional knockout mice reduced pFN levels to <2% and platelet FN to approximately 20% of the levels in similarly treated control mice. The mice were then observed in a model of arterial injury to evaluate their capacity to form thrombi. The deficiency of pFN did not affect the initial platelet adhesion, but a delay of several minutes in thrombus formation was observed in the arterioles of pFN-deficient mice as compared with control mice. The thrombi that formed in the absence of pFN were stably anchored to the vessel wall but continuously shed platelets or small platelet clumps, thus slowing their growth significantly; the platelet/platelet cohesion was apparently diminished. Consequently the occlusion of pFN-deficient vessels was delayed, with the majority of vessels remaining patent at the end of the 40-min observation period. We conclude that, in addition to von Willebrand factor and fibrinogen, FN plays a significant role in thrombus initiation, growth, and stability at arterial shear rates and that deficiency in each of the three platelet ligands has its own specific impact on platelet plug formation.

Integrins: bidirectional, allosteric signaling machines

In their roles as major adhesion receptors, integrins signal across the plasma membrane in both directions. Recent structural and cell biological data suggest models for how integrins transmit signals between their extracellular ligand binding adhesion sites and their cytoplasmic domains, which link to the cytoskeleton and to signal transduction pathways. Long-range conformational changes couple these functions via allosteric equilibria.

Ancient ubiquitous protein 1 binds to the conserved membrane-proximal sequence of the cytoplasmic tail of the integrin alpha subunits that plays a crucial role in the inside-out signaling of alpha IIbbeta 3

Modification of the cytoplasmic tails of the integrin alpha(IIb)beta(3) plays an important role in the signal transduction in platelets. We searched for proteins that bind to the alpha(IIb) cytoplasmic tail using the yeast two-hybrid assay with a cDNA library of the megakaryocyte-derived cell line and identified a protein, ancient ubiquitous protein 1 (Aup1), that is ubiquitously expressed in human cells. Observation of UT7/TPO cells expressing a red fluorescent protein-tagged Aup1 indicated its localization in the cytoplasm. Immunoprecipitation of UT7/TPO cells by an antibody for Aup1 revealed that approximately 40% of alpha(IIb) is complexed with Aup1. Binding study with an alpha(IIb) cytoplasmic tail peptide and glutathione S-transferase-Aup1 fusion protein revealed a low affinity (K(d) = 90 microm). Subsequent yeast two-hybrid assay indicated binding of Aup1 to cytoplasmic tails of other integrin alpha subunits. Binding study with the purified Aup1 and various glutathione S-transferase-alpha(IIb) cytoplasmic tail peptides revealed specific binding of Aup1 to the membrane-proximal sequence (KVGFFKR) that is conserved among the integrin alpha subunits and plays a crucial role in the alpha(IIb)beta(3) inside-out signaling. As Aup1 possesses domains related to signal transduction, these results suggest involvement of Aup1 in the integrin signaling.

A new model of dual interacting ligand binding sites on integrin alphaIIbbeta3

The platelet integrin alphaIIbbeta3 mediates platelet aggregation and platelet adhesion. This integrin is the key to hemostasis and also to pathologic vascular occlusion. A key domain on alphaIIbbeta3 is the ligand binding site, which can bind to plasma fibrinogen and to a number of Arg-Gly-Asp (RGD)-type ligands. However, the nature and function of the ligand binding pocket on alphaIIbbeta3 remains controversial. Some studies suggest the presence of two ligand binding pockets, whereas other reports indicate a single binding pocket. Here we use surface plasmon resonance to show that alphaIIbbeta3 contains two distinct ligand binding pockets. One site binds to fibrinogen, and a separate site binds to RGD-type ligands. More importantly, however, the two ligand binding pockets are interactive. RGD-type ligands are capable of binding to alphaIIbbeta3 even when it is already occupied by fibrinogen. Once bound, RGD-type ligands induce the dissociation of fibrinogen from alphaIIbbeta3. This allosteric cross-talk has important implications for anti-platelet therapy because it suggests a novel approach for the dissolution of existing platelet thrombi.