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CT-001 is a rapid clearing factor VIIa with enhanced clearance and hemostatic activity for the treatment of acute bleeding in non-hemophilia settings. Thromb Res 2022; 215:58-66. [DOI: 10.1016/j.thromres.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/16/2022] [Indexed: 11/21/2022]
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Muster V, Gary T. Contrasts in Glioblastoma-Venous Thromboembolism versus Bleeding Risk. Cells 2021; 10:cells10061414. [PMID: 34200229 PMCID: PMC8228034 DOI: 10.3390/cells10061414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 12/13/2022] Open
Abstract
Glioblastoma is among the tumor entities with an extreme thrombogenic potential and patients are at very high risk of developing a venous thromboembolism (VTE) over the course of the disease, with an incidence of up to 30% per year. Major efforts are currently being made to understand and gain novel insights into the underlying pathomechanisms of the development of VTE in patients with glioblastoma and to find appropriate biomarkers. Yet, patients with glioblastoma not only face a high thromboembolic risk but are also at risk of bleeding events. In the case of VTE, a therapeutic anticoagulation with low molecular weight heparin or, in the case of low bleeding risk, treatment with a direct oral anticoagulant, is recommended, according to recently published guidelines. With respect to an elevated bleeding risk in glioblastoma patients, therapeutic anticoagulation remains challenging in this patient group and prospective data for this vulnerable patient group are scarce, particularly with regard to direct oral anticoagulants.
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Grover SP, Mackman N. Tissue Factor: An Essential Mediator of Hemostasis and Trigger of Thrombosis. Arterioscler Thromb Vasc Biol 2018; 38:709-725. [PMID: 29437578 DOI: 10.1161/atvbaha.117.309846] [Citation(s) in RCA: 429] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/25/2018] [Indexed: 12/21/2022]
Abstract
Tissue factor (TF) is the high-affinity receptor and cofactor for factor (F)VII/VIIa. The TF-FVIIa complex is the primary initiator of blood coagulation and plays an essential role in hemostasis. TF is expressed on perivascular cells and epithelial cells at organ and body surfaces where it forms a hemostatic barrier. TF also provides additional hemostatic protection to vital organs, such as the brain, lung, and heart. Under pathological conditions, TF can trigger both arterial and venous thrombosis. For instance, atherosclerotic plaques contain high levels of TF on macrophage foam cells and microvesicles that drives thrombus formation after plaque rupture. In sepsis, inducible TF expression on monocytes leads to disseminated intravascular coagulation. In cancer patients, tumors release TF-positive microvesicles into the circulation that may contribute to venous thrombosis. TF also has nonhemostatic roles. For instance, TF-dependent activation of the coagulation cascade generates coagulation proteases, such as FVIIa, FXa, and thrombin, which induce signaling in a variety of cells by cleavage of protease-activated receptors. This review will focus on the roles of TF in protective hemostasis and pathological thrombosis.
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Affiliation(s)
- Steven P Grover
- From the Thrombosis and Hemostasis Program, Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill
| | - Nigel Mackman
- From the Thrombosis and Hemostasis Program, Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill.
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Fujii E, Watanabe K, Nishihara K, Suzuki M, Kato A. Hazard characterization of an anti-human tissue factor antibody by combining results of tissue cross-reactivity studies and distribution of hemorrhagic lesions in monkey toxicity studies. Regul Toxicol Pharmacol 2017; 90:289-296. [DOI: 10.1016/j.yrtph.2017.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/16/2022]
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Selective factor VIII activation by the tissue factor-factor VIIa-factor Xa complex. Blood 2017; 130:1661-1670. [PMID: 28729433 DOI: 10.1182/blood-2017-02-767079] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/06/2017] [Indexed: 12/23/2022] Open
Abstract
Safe and effective antithrombotic therapy requires understanding of mechanisms that contribute to pathological thrombosis but have a lesser impact on hemostasis. We found that the extrinsic tissue factor (TF) coagulation initiation complex can selectively activate the antihemophilic cofactor, FVIII, triggering the hemostatic intrinsic coagulation pathway independently of thrombin feedback loops. In a mouse model with a relatively mild thrombogenic lesion, TF-dependent FVIII activation sets the threshold for thrombus formation through contact phase-generated FIXa. In vitro, FXa stably associated with TF-FVIIa activates FVIII, but not FV. Moreover, nascent FXa product of TF-FVIIa can transiently escape the slow kinetics of Kunitz-type inhibition by TF pathway inhibitor and preferentially activates FVIII over FV. Thus, TF synergistically primes FIXa-dependent thrombin generation independently of cofactor activation by thrombin. Accordingly, FVIIa mutants deficient in direct TF-dependent thrombin generation, but preserving FVIIIa generation by nascent FXa, can support intrinsic pathway coagulation. In ex vivo flowing blood, a TF-FVIIa mutant complex with impaired free FXa generation but activating both FVIII and FIX supports efficient FVIII-dependent thrombus formation. Thus, a previously unrecognized TF-initiated pathway directly yielding FVIIIa-FIXa intrinsic tenase complex may be prohemostatic before further coagulation amplification by thrombin-dependent feedback loops enhances the risk of thrombosis.
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Rothmeier AS, Marchese P, Langer F, Kamikubo Y, Schaffner F, Cantor J, Ginsberg MH, Ruggeri ZM, Ruf W. Tissue Factor Prothrombotic Activity Is Regulated by Integrin-arf6 Trafficking. Arterioscler Thromb Vasc Biol 2017; 37:1323-1331. [PMID: 28495929 DOI: 10.1161/atvbaha.117.309315] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/01/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Coagulation initiation by tissue factor (TF) is regulated by cellular inhibitors, cell surface availability of procoagulant phosphatidylserine, and thiol-disulfide exchange. How these mechanisms contribute to keeping TF in a noncoagulant state and to generating prothrombotic TF remain incompletely understood. APPROACH AND RESULTS Here, we study the activation of TF in primary macrophages by a combination of pharmacological, genetic, and biochemical approaches. We demonstrate that primed macrophages effectively control TF cell surface activity by receptor internalization. After cell injury, ATP signals through the purinergic receptor P2rx7 induce release of TF+ microvesicles. TF cell surface availability for release onto microvesicles is regulated by the GTPase arf6 associated with integrin α4β1. Furthermore, microvesicles proteome analysis identifies activation of Gαi2 as a participating factor in the release of microvesicles with prothrombotic activity in flowing blood. ATP not only prevents TF and phosphatidylserine internalization but also induces TF conversion to a conformation with high affinity for its ligand, coagulation factor VII. Although inhibition of dynamin-dependent internalization also exposes outer membrane procoagulant phosphatidylserine, the resulting TF+ microvesicles distinctly lack protein disulfide isomerase and high affinity TF and fail to produce fibrin strands typical for microvesicles generated by thrombo-inflammatory P2rx7 activation. CONCLUSIONS These data show that procoagulant phospholipid exposure is not sufficient and that TF affinity maturation is required to generate prothrombotic microvesicles from a variety of cell types. These findings are significant for understanding TF-initiated thrombosis and should be considered in designing functional microvesicles-based diagnostic approaches.
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Affiliation(s)
- Andrea S Rothmeier
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Patrizia Marchese
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Florian Langer
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Yuichi Kamikubo
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Florence Schaffner
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Joseph Cantor
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Mark H Ginsberg
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Zaverio M Ruggeri
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.)
| | - Wolfram Ruf
- From the Department of Immunology and Microbiology (A.S.R., F.S., W.R.) and Molecular Medicine (P.M., Y.K., Z.M.R.), The Scripps Research Institute, La Jolla, CA; II. Medical Clinic and Polyclinic, University Medical Center Eppendorf, Hamburg, Germany (F.L.); Department of Medicine, University of California San Diego, La Jolla (J.C., M.H.G.); Center for Thrombosis and Hemostasis, Johannes Gutenberg University Medical Center, Mainz, Germany (W.R.).
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Rothmeier AS, Marchese P, Petrich BG, Furlan-Freguia C, Ginsberg MH, Ruggeri ZM, Ruf W. Caspase-1-mediated pathway promotes generation of thromboinflammatory microparticles. J Clin Invest 2015; 125:1471-84. [PMID: 25705884 DOI: 10.1172/jci79329] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/09/2015] [Indexed: 12/30/2022] Open
Abstract
Extracellular ATP is a signal of tissue damage and induces macrophage responses that amplify inflammation and coagulation. Here we demonstrate that ATP signaling through macrophage P2X7 receptors uncouples the thioredoxin (TRX)/TRX reductase (TRXR) system and activates the inflammasome through endosome-generated ROS. TRXR and inflammasome activity promoted filopodia formation, cellular release of reduced TRX, and generation of extracellular thiol pathway-dependent, procoagulant microparticles (MPs). Additionally, inflammasome-induced activation of an intracellular caspase-1/calpain cysteine protease cascade degraded filamin, thereby severing bonds between the cytoskeleton and tissue factor (TF), the cell surface receptor responsible for coagulation activation. This cascade enabled TF trafficking from rafts to filopodia and ultimately onto phosphatidylserine-positive, highly procoagulant MPs. Furthermore, caspase-1 specifically facilitated cell surface actin exposure, which was required for the final release of highly procoagulant MPs from filopodia. Together, the results of this study delineate a thromboinflammatory pathway and suggest that components of this pathway have potential as pharmacological targets to simultaneously attenuate inflammation and innate immune cell-induced thrombosis.
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Bode MF, Mackman N. Protective and pathological roles of tissue factor in the heart. Hamostaseologie 2014; 35:37-46. [PMID: 25434707 DOI: 10.5482/hamo-14-09-0042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 11/19/2014] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED Tissue factor (TF) is expressed in the heart where it is required for haemostasis. High levels of TF are also expressed in atherosclerotic plaques and likely contribute to atherothrombosis after plaque rupture. Indeed, risk factors for atherothrombosis, such as diabetes, hypercholesterolaemia, smoking and hypertension, are associated with increased TF expression in circulating monocytes, microparticles and plasma. Several therapies that reduce atherothrombosis, such as statins, ACE inhibitors, beta-blockers and anti-platelet drugs, are associated with reduced TF expression. In addition to its haemostatic and pro-thrombotic functions, the TF : FVIIa complex and downstream coagulation proteases activate cells by cleavage of protease-activated receptors (PARs). In mice, deficiencies in either PAR-1 or PAR-2 reduce cardiac remodelling and heart failure after ischaemia-reperfusion injury. This suggests that inhibition of coagulation proteases and PARs may be protective in heart attack patients. In contrast, the TF/thrombin/PAR-1 pathway is beneficial in a mouse model of Coxsackievirus B3-induced viral myocarditis. We found that stimulation of PAR-1 increases the innate immune response by enhancing TLR3-dependent IFN-β expression. Therefore, inhibition of the TF/thrombin/PAR-1 pathway in patients with viral myocarditis could have detrimental effects. CONCLUSION The TF : FVIIa complex has both protective and pathological roles in the heart.
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Affiliation(s)
| | - N Mackman
- Nigel Mackman, Ph.D., FAHA, University of North Carolina at Chapel Hill, Division of Hematology and Oncology, Department of Medicine, McAllister Heart Institute, 111 Mason Farm Road, 2312B Medical Biomolecular Research Bldg., CB #7126, Chapel Hill, NC 27599, USA, E-mail:
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Wang YH, Cheng TY, Chen TY, Chang KM, Chuang VP, Kao KJ. Plasmalemmal Vesicle Associated Protein (PLVAP) as a therapeutic target for treatment of hepatocellular carcinoma. BMC Cancer 2014; 14:815. [PMID: 25376302 PMCID: PMC4233082 DOI: 10.1186/1471-2407-14-815] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 10/27/2014] [Indexed: 11/24/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a malignancy with poor survival outcome. New treatment options for the disease are needed. In this study, we identified and evaluated tumor vascular PLVAP as a therapeutic target for treatment of HCC. Methods Genes showing extreme differential expression between paired human HCC and adjacent non-tumorous liver tissue were investigated. PLVAP was identified as one of such genes with potential to serve as a therapeutic target for treatment of HCC. A recombinant monoclonal anti-PLVAP Fab fragment co-expressing extracellular domain of human tissue factor (TF) was developed. The potential therapeutic effect and toxicity to treat HCC were studied using a Hep3B HCC xenograft model in SCID mice. Results PLVAP was identified as a gene specifically expressed in vascular endothelial cells of HCC but not in non-tumorous liver tissues. This finding was confirmed by RT-PCR analysis of micro-dissected cells and immunohistochemical staining of tissue sections. Infusion of recombinant monoclonal anti-PLVAP Fab-TF into the main tumor feeding artery induced tumor vascular thrombosis and extensive tumor necrosis at doses between 2.5 μg and 12 μg. Tumor growth was suppressed for 40 days after a single treatment. Systemic administration did not induce tumor necrosis. Little systemic toxicity was noted for this therapeutic agent. Conclusions The results of this study suggest that anti-PLVAP Fab-TF may be used to treat HCC cases for which transcatheter arterial chemoembolization (TACE) is currently used and potentially avoid the drawback of high viscosity of chemoembolic emulsion for TACE to improve therapeutic outcome. Anti-PLVAP Fab-TF may become a viable therapeutic agent in patients with advanced disease and compromised liver function. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-815) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | - Kuo-Jang Kao
- Department of Research, Koo Foundation Sun Yat-Sen Cancer Center, Lih-Der Road, Taipei, Taiwan.
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Nagakura T, Tabata K, Kira K, Hirota S, Clark R, Matsuura F, Hiyoshi H. Selective tissue factor/factor VIIa Inhibitor, ER-410660, and its prodrug, E5539, have anti-venous and anti-arterial thrombotic effects with a low risk of bleeding. Thromb Res 2013; 132:271-9. [PMID: 23827699 DOI: 10.1016/j.thromres.2013.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/12/2013] [Accepted: 06/12/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Many anticoagulant drugs target factors common to both the intrinsic and extrinsic coagulation pathways, which may lead to bleeding complications. Since the tissue factor (TF)/factor VIIa complex is associated with thrombosis onset and specifically activates the extrinsic coagulation pathway, compounds that inhibit this complex may provide therapeutic and/or prophylactic benefits with a decreased risk of bleeding. MATERIALS AND METHODS The in vitro enzyme profile and anticoagulation selectivity of the TF/VIIa complex inhibitor, ER-410660, and its prodrug E5539 were assessed using enzyme inhibitory and plasma clotting assays. In vivo effects of ER-410660 and E5539 were determined using a TF-induced, thrombin generation rhesus monkey model; a stasis-induced, venous thrombosis rat model; a photochemically induced, arterial thrombosis rat model; and a rat tail-cut bleeding model. RESULTS ER-410660 selectively prolonged prothrombin time, but had a less potent anticoagulant effect on the intrinsic pathway. It also exhibited a dose-dependent inhibitory effect on thrombin generation caused by TF-injection in the rhesus monkey model. ER-410660 also reduced venous thrombus weights in the TF-administered, stasis-induced, venous thrombosis rat model and prolonged the occlusion time induced by arterial thrombus formation after vascular injury. The compound was capable of doubling the total bleeding time in the rat tail-cut model, albeit with a considerably higher dose compared to the effective dose in the venous and arterial thrombosis models. Moreover, E5539, an orally available ER-410660 prodrug, reduced the thrombin-anti-thrombin complex levels, induced by TF-injection, in a dose-dependent manner. CONCLUSION Selective TF/VIIa inhibitors have potential as novel anticoagulants with a lower propensity for enhancing bleeding.
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Affiliation(s)
- Tadashi Nagakura
- Eisai Company, Ltd., Tsukuba Research Laboratories, 5-1-3 Tokodai, Tsukuba, Ibaraki 300-2635, Japan.
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Tissue factor and PAR1 promote microbiota-induced intestinal vascular remodelling. Nature 2012; 483:627-31. [PMID: 22407318 DOI: 10.1038/nature10893] [Citation(s) in RCA: 199] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 01/23/2012] [Indexed: 01/07/2023]
Abstract
The gut microbiota is a complex ecosystem that has coevolved with host physiology. Colonization of germ-free (GF) mice with a microbiota promotes increased vessel density in the small intestine, but little is known about the mechanisms involved. Tissue factor (TF) is the membrane receptor that initiates the extrinsic coagulation pathway, and it promotes developmental and tumour angiogenesis. Here we show that the gut microbiota promotes TF glycosylation associated with localization of TF on the cell surface, the activation of coagulation proteases, and phosphorylation of the TF cytoplasmic domain in the small intestine. Anti-TF treatment of colonized GF mice decreased microbiota-induced vascular remodelling and expression of the proangiogenic factor angiopoietin-1 (Ang-1) in the small intestine. Mice with a genetic deletion of the TF cytoplasmic domain or with hypomorphic TF (F3) alleles had a decreased intestinal vessel density. Coagulation proteases downstream of TF activate protease-activated receptor (PAR) signalling implicated in angiogenesis. Vessel density and phosphorylation of the cytoplasmic domain of TF were decreased in small intestine from PAR1-deficient (F2r(-/-)) but not PAR2-deficient (F2rl1(-/-)) mice, and inhibition of thrombin showed that thrombin-PAR1 signalling was upstream of TF phosphorylation. Thus, the microbiota-induced extravascular TF-PAR1 signalling loop is a novel pathway that may be modulated to influence vascular remodelling in the small intestine.
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Raife TJ, Dwyre DM, Stevens JW, Erger RA, Leo L, Wilson KM, Fernández JA, Wilder J, Kim HS, Griffin JH, Maeda N, Lentz SR. Human thrombomodulin knock-in mice reveal differential effects of human thrombomodulin on thrombosis and atherosclerosis. Arterioscler Thromb Vasc Biol 2011; 31:2509-17. [PMID: 21885846 PMCID: PMC3202707 DOI: 10.1161/atvbaha.111.236828] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We sought to develop a murine model to examine the antithrombotic and antiinflammatory functions of human thrombomodulin in vivo. METHODS AND RESULTS Knock-in mice that express human thrombomodulin from the murine thrombomodulin gene locus were generated. Compared with wild-type mice, human thrombomodulin knock-in mice exhibited decreased protein C activation in the aorta (P<0.01) and lung (P<0.001). Activation of endogenous protein C following infusion of thrombin was decreased by 90% in knock-in mice compared with wild-type mice (P<0.05). Carotid artery thrombosis induced by photochemical injury occurred more rapidly in knock-in mice (12±3 minutes) than in wild-type mice (31±6 minutes; P<0.05). No differences in serum cytokine levels were detected between knock-in and wild-type mice after injection of endotoxin. When crossed with apolipoprotein E-deficient mice and fed a Western diet, knock-in mice had a further decrease in protein C activation but did not exhibit increased atherosclerosis. CONCLUSION Expression of human thrombomodulin in place of murine thrombomodulin produces viable mice with a prothrombotic phenotype but unaltered responses to systemic inflammatory or atherogenic stimuli. This humanized animal model will be useful for investigating the function of human thrombomodulin under pathophysiological conditions in vivo.
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Affiliation(s)
- Thomas J. Raife
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Denis M. Dwyre
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Jeff W. Stevens
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | | | - Lorie Leo
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Katina M. Wilson
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Jose A. Fernández
- Department of Molecular & Experimental Medicine, Scripps Research Institute, La Jolla, CA
| | - Jennifer Wilder
- Department of Pathology, University of North Carolina, Chapel Hill, NC
| | - Hyung-Suk Kim
- Department of Pathology, University of North Carolina, Chapel Hill, NC
| | - John H. Griffin
- Department of Molecular & Experimental Medicine, Scripps Research Institute, La Jolla, CA
| | - Nobuyo Maeda
- Department of Pathology, University of North Carolina, Chapel Hill, NC
| | - Steven R. Lentz
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
- Veterans Affairs Medical Center, Iowa City, IA
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Badeanlou L, Furlan-Freguia C, Yang G, Ruf W, Samad F. Tissue factor-protease-activated receptor 2 signaling promotes diet-induced obesity and adipose inflammation. Nat Med 2011; 17:1490-7. [PMID: 22019885 PMCID: PMC3210891 DOI: 10.1038/nm.2461] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 08/04/2011] [Indexed: 01/08/2023]
Abstract
Tissue factor (TF), the initiator of the coagulation cascade, mediates coagulation factor VIIa-dependent activation of protease activated receptor-2 (PAR2). Here we delineate an unexpected role for coagulation signaling in obesity and its complications. Mice lacking PAR2 (F2rl1) or the cytoplasmic domain of TF (F3) are protected from high fat diet (HFD) induced weight gain and insulin resistance. In hematopoietic cells, genetic deletion of TF-PAR2 signaling reduces adipose tissue macrophage inflammation and specific pharmacological inhibition of macrophage TF signaling rapidly ameliorates insulin resistance. In contrast, non-hematopoietic cell TF-VIIa-PAR2 signaling specifically promotes obesity. Mechanistically, adipocyte TF cytoplasmic domain dependent VIIa signaling suppresses Akt phosphorylation with concordant adverse transcriptional changes of key regulators of obesity and metabolism. Pharmacological blockade of adipocyte TF in vivo reverses these effects of TF-VIIa signaling and rapidly improves energy expenditure. Thus, TF signaling is a potential therapeutic target to improve impaired metabolism and insulin resistance in obesity.
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Affiliation(s)
- Leylla Badeanlou
- Department of Cell Biology, Torrey Pines Institute for Molecular Studies, San Diego, California, USA
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Abstract
Constitutive expression of tissue factor (TF) by cancer cells triggers local and systemic activation of the coagulation cascade and is a major cause of cancer-associated thrombosis. Primary breast cancer biopsies show a marked upregulation of TF and protease activated receptor (PAR) 2, as well as increased TF cytoplasmic domain phosphorylation that is correlated with cancer relapse. TF signaling involving PAR2 and integrins has multiple effects on angiogenesis and tumor progression. The non-coagulant, alternatively spliced form of TF retains an integrin-binding site and, upon deposition into the tumor stroma, stimulates angiogenesis by ligating endothelial integrins alpha(v)beta(3) and alpha(6)beta(1). On tumor cells, full-length TF is constitutively associated with laminin-binding beta(1) integrins that support TF-VIIa-PAR2 signaling leading to upregulation of pro-angiogenic and immune modulatory cytokines and growth factors. Deficiency of PAR2, but not of the thrombin receptor PAR1, delays spontaneous breast cancer development and the angiogenic switch in mice. In addition, human xenograft breast cancer growth and angiogenesis is suppressed by selective antibody inhibition of TF-VIIa-PAR2 signaling, but not by blocking TF initiated coagulation. Thus, interruption of TF signaling represents a potential anti-angiogenic strategy that does not carry an increased risk of bleeding associated with prolonged inhibition of the TF coagulation pathway.
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Affiliation(s)
- Wolfram Ruf
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA 92037, USA.
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Abstract
Antiphospholipid syndrome (APS) is an acquired autoimmune disorder defined by the presence of an antiphospholipid antibody (aPL) and the occurrence of at least one associated clinical condition that includes venous thrombosis, arterial thrombosis or pregnancy morbidity. The aPL detected in APS have long been thought to have a direct prothrombotic effect in vivo. However, the pathophysiology underlying their coagulopathic effect has not been defined. Emerging data suggest a role for the procoagulant protein tissue factor (TF). In this review we provide an overview of TF, describe mouse models used in the evaluation of the role of TF in thrombosis, as well as summarize recent work on TF and APS.
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Affiliation(s)
- J Boles
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7005, USA
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Amirkhosravi A, Mousa SA, Amaya M, Meyer T, Davila M, Robson T, Francis JL. Assessment of anti-metastatic effects of anticoagulant and antiplatelet agents using animal models of experimental lung metastasis. Methods Mol Biol 2010; 663:241-259. [PMID: 20617422 DOI: 10.1007/978-1-60761-803-4_10] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
It is well established that the blood coagulation system is activated in cancer. In addition, there is considerable evidence to suggest that clotting activation plays an important role in the biology of malignant tumors, including the process of blood-borne metastasis. For many years our laboratory has used experimental models of lung metastasis to study the events that follow the introduction of procoagulant-bearing tumor cells into circulating blood. This chapter focuses on the basic methods involved in assessing the anti-metastatic effects of anticoagulants and anti-platelet agents using rodent models of experimental metastasis. In addition, it summarizes our experience with these models, which collectively suggests that intravascular coagulation and platelet activation are a necessary prelude to lung tumor formation and that interruption of coagulation pathways or platelet aggregation may be an effective anti-metastatic strategy.
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Affiliation(s)
- Ali Amirkhosravi
- Florida Hospital Center for Thrombosis Research, Orlando, FL, USA
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PTX3 as a potential biomarker of acute lung injury: supporting evidence from animal experimentation. Intensive Care Med 2009; 36:356-64. [PMID: 19921147 DOI: 10.1007/s00134-009-1720-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 10/16/2009] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Increased expression of long pentraxin 3 (PTX3) has been found in patients with sepsis or acute respiratory distress syndrome. Tissue factor (TF) activation plays an important role in the pathogenesis of acute lung injury. The present study sought to determine the relationship between PTX3 expression and TF activation in acute lung injury. METHODS Lung injury was induced by intratracheal instillation of lipopolysaccharide (LPS) in mice, and the PTX3 expression, TF activation and lung injury were determined. We also treated the lung injury with an anti-human tissue factor monoclonal antibody in human tissue factor knock-in (hTF-KI) mice. RESULTS Balb/c mice were challenged with increasing doses of LPS. After 24 h, PTX3 protein in the bronchioalveolar lavage fluid was increased in parallel with the severity of lung injury, and correlated with tissue factor (TF) activity. The expression and distribution of PTX3 and TF were further documented in detail 6 h after LPS (5 mg/kg) instillation. Treatment with anti-human TF monoclonal antibody dramatically attenuated LPS-induced lung injury, alveolar fibrin deposition and inflammatory cell infiltration in"humanized" hTF-KI mice 6 h after LPS challenge. The PTX3 expression was significantly decreased by the anti-coagulant therapy. CONCLUSION These results support the clinical finding that PTX3 may be a useful biomarker to the reflect severity of lung injury and provide effective therapies. The interplay between PTX3 and TF could be a potential mechanism that mediates lung injury.
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Schaffner F, Ruf W. Tissue factor and PAR2 signaling in the tumor microenvironment. Arterioscler Thromb Vasc Biol 2009; 29:1999-2004. [PMID: 19661489 DOI: 10.1161/atvbaha.108.177428] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diverse oncogenic transformations result in the constitutive expression of tissue factor (TF) in cancer cells. The local and systemic activation of the coagulation cascade has long been a recognized hallmark for aggressive cancer, but genetic mouse models and new experimental therapeutics have only recently demonstrated crucial roles for TF initiated cell signaling in the pathogenesis of cancer. On tumor cells, the TF-VIIa binary complex mediates activation of protease activated receptor (PAR) 2 and thereby shapes the tumor microenvironment by inducing an array of proangiogenic and immune modulating cytokines, chemokines, and growth factors. PAR2 also uniquely triggers tumor cell migration by G protein-independent pathways through beta-arrestin scaffolding. Metastatic tumor cells use additional signaling networks of the coagulation cascade by activating PAR1 through thrombin or the ternary TF-VIIa-Xa signaling complex in the vascular and potentially lymphatic system. Selective antagonists of TF-VIIa-PAR2 signaling may be used as antiangiogenic therapy without increasing the risk of bleeding, whereas coagulation and associated signaling pathways on platelets and other host cells may be targeted for therapeutic benefit in advanced cancer and metastatic disease.
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Affiliation(s)
- Florence Schaffner
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA 92037, USA
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Abstract
Tissue factor (TF) is a transmembrane receptor for Factor VII/VIIa (FVII/VIIa). It is constitutively expressed by cells surrounding blood vessels. The endothelium physically separates this potent "activator" from its circulating ligand FVII/FVIIa and prevents inappropriate activation of the clotting cascade. Breakage of the endothelial barrier leads to exposure of extravascular TF and rapid activation of the clotting cascade. TF is also expressed in certain tissues, such as the heart and brain, and provides additional hemostatic protection to these tissues. Small amounts of TF are also present in blood in the form of microparticles, which are small membrane vesicles derived from activated and apoptotic cells. Levels of microparticle TF increase in a variety of diseases, such as sepsis and cancer, and this so-called "blood-borne" TF may contribute to thrombosis associated with these diseases. Recombinant FVIIa has been developed as an effective hemostatic drug for the treatment of hemophilia patients with inhibitory antibodies. In addition, it is used for patients with bleeding that do not respond to conventional therapy. However, the mechanism by which recombinant FVIIa restores hemostasis has not been clearly defined. In conclusion, the TF:FVIIa complex is essential for hemostasis and recombinant FVIIa is an effective hemostatic drug.
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Affiliation(s)
- Nigel Mackman
- Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, NC 27599-7035, USA.
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Affiliation(s)
- R Pawlinski
- Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Maroney SA, Ferrel JP, Collins ML, Mast AE. Tissue factor pathway inhibitor-gamma is an active alternatively spliced form of tissue factor pathway inhibitor present in mice but not in humans. J Thromb Haemost 2008; 6:1344-51. [PMID: 18503630 PMCID: PMC3549614 DOI: 10.1111/j.1538-7836.2008.03033.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Tissue factor pathway inhibitor (TFPI) is a potent inhibitor of tissue factor procoagulant activity produced as two alternatively spliced isoforms, TFPIalpha and TFPIbeta, which differ in domain structure and mechanism for cell surface association. 3' Rapid amplification of cDNA ends was used to search for new TFPI isoforms. TFPIgamma, a new alternatively spliced form of TFPI, was identified and characterized. METHODS The tissue expression, cell surface association and anticoagulant activity of TFPIgamma were characterized and compared to those of TFPIalpha and TFPIbeta through studies of mouse and human tissues and expression of recombinant proteins in Chinese hamster ovary (CHO) cells. RESULTS TFPIgamma is produced by alternative splicing using the same 5'-splice donor site as TFPIbeta and a 3'-splice acceptor site 276 nucleotides beyond the stop codon of TFPIbeta in exon 8. The resulting protein has the first two Kunitz domains connected to an 18 amino acid C-terminal region specific to TFPIgamma. TFPIgamma mRNA is differentially produced in mouse tissues but is not encoded within the human TFPI gene. When expressed in CHO cells, TFPIgamma is secreted into conditioned media and effectively inhibits tissue factor procoagulant activity. CONCLUSIONS TFPIgamma is a third alternatively spliced form of TFPI that is widely expressed in mouse tissues but not made by human tissues. It contains the first two Kunitz domains and is a secreted, rather than a cell surface-associated, protein. It is a functional anticoagulant and may partially explain the resistance of mice to coagulopathy in tissue factor-mediated models of disease.
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Affiliation(s)
- Susan A. Maroney
- Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI
| | | | | | - Alan E. Mast
- Blood Research Institute, Blood Center of Wisconsin, Milwaukee, WI
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI
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Abstract
Thrombosis--localized clotting of the blood--can occur in the arterial or the venous circulation and has a major medical impact. Acute arterial thrombosis is the proximal cause of most cases of myocardial infarction (heart attack) and of about 80% of strokes, collectively the most common cause of death in the developed world. Venous thromboembolism is the third leading cause of cardiovascular-associated death. The pathogenic changes that occur in the blood vessel wall and in the blood itself resulting in thrombosis are not fully understood. Understanding these processes is crucial for developing safer and more effective antithrombotic drugs.
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Affiliation(s)
- Nigel Mackman
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA.
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