1
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Misenheimer TM, Lasarev MR, Kumfer KT, Sheehan JP, Schwartz BS. A novel factor IXa-specific enzyme-linked immunosorbent assay detects factor IXa in human plasma. Res Pract Thromb Haemost 2024; 8:102338. [PMID: 38433974 PMCID: PMC10907220 DOI: 10.1016/j.rpth.2024.102338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/21/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Background Factor (F)IXa activity has been detected in human plasma and may impact thrombotic risk. Current FIXa activity assays are complex and cumbersome. Objectives To develop a reproducible enzyme-linked immunosorbent assay (ELISA) using a novel monoclonal antibody that detects total FIXa in human plasma. Methods A monoclonal antibody was raised against the new N-terminus exposed upon activation of FIX to FIXa by cleavage after R226. This antibody is specific for FIXa protease and does not recognize FIX zymogen or FIXα. The antibody was used to develop a FIXa-specific ELISA capable of quantifying total FIXa (free FIXa and FIXa-antithrombin complex) in human plasma. Total FIXa quantified using the ELISA was compared to that of FIXa-antithrombin quantified using modifications of a previously described ELISA. Results The FIXa-specific ELISA was reproducible and quantified total FIXa in human plasma. Total FIXa levels correlated with FIXa-antithrombin levels. Conclusion A monoclonal antibody was developed that specifically detects human FIXa protease. A FIXa-specific ELISA using the new antibody is capable of reproducibly measuring total FIXa in human plasma (both free FIXa and FIXa-antithrombin). This assay should facilitate the evaluation of total FIXa levels in a variety of clinical circumstances.
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Affiliation(s)
| | - Michael R. Lasarev
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kraig T. Kumfer
- Morgridge Institute for Research, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - John P. Sheehan
- Department of Medicine/Hematology-Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
- University of Wisconsin-Madison Carbone Cancer Center, Madison, Wisconsin, USA
| | - Bradford S. Schwartz
- Morgridge Institute for Research, Madison, Wisconsin, USA
- Departments of Medicine/Hematology-Oncology, and Biomolecular Chemistry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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2
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Ivanciu L, Arruda VR, Camire RM. Factor IXa variants resistant to plasma inhibitors enhance clot formation in vivo. Blood 2023; 141:2022-2032. [PMID: 36724452 PMCID: PMC10163311 DOI: 10.1182/blood.2022018083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/28/2022] [Accepted: 01/13/2023] [Indexed: 02/03/2023] Open
Abstract
Factor IXa (FIXa) plays a pivotal role in coagulation by contributing to FX activation via the intrinsic pathway. Although antithrombin (AT) and other plasma inhibitors are thought to regulate FIXa procoagulant function, the impact of FIXa inhibition on thrombin generation and clot formation in vivo remains unclear. Here, we generated FIXa variants with altered reactivity to plasma inhibitors that target the FIXa active site but maintain procoagulant function when bound to its cofactor, FVIIIa. We found that selected FIXa variants (eg, FIXa-V16L) have a prolonged activity half-life in the plasma due, in part, to AT resistance. Studies using hemophilia B mice have shown that delayed FIXa inhibition has a major impact on reducing the bleeding phenotype and promoting thrombus formation following administration of FIX protein. Overall, these results demonstrate that the regulation of FIXa inhibition contributes in a major way to the spatial and temporal control of coagulation at the site of vascular injury. Our findings provide novel insights into the physiological regulation of FIXa, enhance our understanding of thrombus formation in vivo via the intrinsic pathway, and suggest that altering FIXa inhibition could have therapeutic benefits.
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Affiliation(s)
- Lacramioara Ivanciu
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Valder R. Arruda
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Rodney M. Camire
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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3
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Miyazawa K, Fogelson AL, Leiderman K. Inhibition of platelet-surface-bound proteins during coagulation under flow II: Antithrombin and heparin. Biophys J 2023; 122:230-240. [PMID: 36325617 PMCID: PMC9822793 DOI: 10.1016/j.bpj.2022.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 09/01/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022] Open
Abstract
Blood coagulation is a self-repair process regulated by activated platelet surfaces, clotting factors, and inhibitors. Antithrombin (AT) is one such inhibitor that impedes coagulation by targeting and inactivating several key coagulation enzymes. The effect of AT is greatly enhanced in the presence of heparin, a common anticoagulant drug. When heparin binds to AT, it either bridges with the target enzyme or induces allosteric changes in AT leading to more favorable binding with the target enzyme. AT inhibition of fluid-phase enzymes caused little suppression of thrombin generation in our previous mathematical models of blood coagulation under flow. This is because in that model, flow itself was a greater inhibitor of the fluid-phase enzymes than AT. From clinical observations, it is clear that AT and heparin should have strong inhibitory effects on thrombin generation, and thus we hypothesized that AT could be inhibiting enzymes bound to activated platelet surfaces that are not subject to being washed away by flow. We extended our mathematical model to include the relevant reactions of AT inhibition at the activated platelet surfaces as well as those for unfractionated heparin and a low molecular weight heparin. Our results show that AT alone is only an effective inhibitor at low tissue factor densities, but in the presence of heparin, it can greatly alter, and in some cases shut down, thrombin generation. Additionally, we studied each target enzyme separately and found that inactivation of no single enzyme could substantially suppress thrombin generation.
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Affiliation(s)
- Kenji Miyazawa
- Quantitative Biosciences and Engineering, Colorado School of Mines, Golden, Colorado
| | - Aaron L Fogelson
- Department of Mathematics, University of Utah, Salt Lake City, Utah; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah
| | - Karin Leiderman
- Mathematics Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Computational Medicine Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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4
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Bösch J, Rugg C, Schäfer V, Lichtenberger P, Staier N, Treichl B, Rajsic S, Peer A, Schobersberger W, Fries D, Bachler M. Low-Molecular-Weight Heparin Resistance and Its Viscoelastic Assessment in Critically Ill COVID-19 Patients. Semin Thromb Hemost 2022; 48:850-857. [PMID: 36174602 DOI: 10.1055/s-0042-1756304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Critically ill COVID-19 patients present an inflammatory and procoagulant status with a high rate of relevant macro- and microvascular thrombosis. Furthermore, high rates of heparin resistance have been described; yet, individualized anticoagulation by drug monitoring has not been sufficiently researched. We analyzed data from critically ill COVID-19 patients treated at Innsbruck Medical University Hospital with routinely adapted low-molecular-weight heparin (LMWH) doses according to anti-Xa peak levels, and regularly performed ClotPro analyses (a viscoelastic hemostatic whole blood test). A total of 509 anti-Xa peak measurements in 91 patients were categorized as below (<0.008 IU/mL/mg), within (0.008-0-012 IU/mL/mg) or above (> 0.012 IU/mL/mg) expected ranges with respect to the administered LMWH doses. Besides intergroup comparisons, correlations between anti-Xa levels and ClotPro clotting times (CTs) were performed (226 time points in 84 patients). Anti-Xa peak levels remained below the expected range in the majority of performed measurements (63.7%). Corresponding patients presented with higher C-reactive protein and D-dimer but lower antithrombin levels when compared with patients achieving or exceeding the expected range. Consequently, higher enoxaparin doses were applied in the sub-expected anti-Xa range group. Importantly, 47 (51.6%) patients switched between groups during their intensive care unit (ICU) stay. Anti-Xa levels correlated weakly with IN test CT and moderately with Russell's viper venom (RVV) test CT. Critically ill COVID-19 patients present with a high rate of LMWH resistance but with a variable LMWH response during their ICU stay. Therefore, LMWH-anti-Xa monitoring seems inevitable to achieve adequate target ranges. Furthermore, we propose the use of ClotPro's RVV test to assess the coagulation status during LMWH administration, as it correlates well with anti-Xa levels but more holistically reflects the coagulation cascade than anti-Xa activity alone.
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Affiliation(s)
- Johannes Bösch
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Christopher Rugg
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Volker Schäfer
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Philipp Lichtenberger
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Nikolai Staier
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Benjamin Treichl
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Sasa Rajsic
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Peer
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT - Private University for Health Sciences and Health Technology, Hall i.T., Austria
| | - Dietmar Fries
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Mirjam Bachler
- Department of Anesthesia and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.,Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT - Private University for Health Sciences and Health Technology, Hall i.T., Austria
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5
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Zhu Q, Ye P, Guo F, Zhu Y, Nan W, Chang Z. A heparin-functionalized covered stent prepared by plasma technology. J Biomater Appl 2021; 36:1243-1253. [PMID: 34672223 DOI: 10.1177/08853282211051871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this study, the surface of the covered stent was treated by plasma technology to introduce amino functional groups, and glutaraldehyde and heparin were successfully grafted to prepare a heparin-functionalized covered stent (HPLCS). The preparation parameters such as plasma treatment power, plasma treatment time, concentration of glutaraldehyde and heparin, and pH of heparin solution were studied in detail. The functionalized heparin covered stent can make the titer of heparin reach 1.23 ± 0.03 IU/cm2. In animal experiments, after implantation in pigs for 6 months, the titer of heparin can still reach 0.93 ± 0.05 IU/cm2. This work provides a good method for preparing heparin covered stent.
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Affiliation(s)
- Qing Zhu
- 47863University of Shanghai for Science and Technology, Shanghai, China
| | - Ping Ye
- 47863University of Shanghai for Science and Technology, Shanghai, China
| | - Fang Guo
- 47863University of Shanghai for Science and Technology, Shanghai, China
| | - Yimen Zhu
- 47863University of Shanghai for Science and Technology, Shanghai, China
| | - Wenbin Nan
- 47863University of Shanghai for Science and Technology, Shanghai, China
| | - Zhaohua Chang
- 47863University of Shanghai for Science and Technology, Shanghai, China
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6
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Sheehan JP. Mapping the zymogen to protease transition in FIXa. J Thromb Haemost 2021; 19:1409-1411. [PMID: 34047009 DOI: 10.1111/jth.15286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Affiliation(s)
- John P Sheehan
- Department of Medicine (Hematology/Oncology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, 53792, USA
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7
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Antithrombin and Its Role in Host Defense and Inflammation. Int J Mol Sci 2021; 22:ijms22084283. [PMID: 33924175 PMCID: PMC8074369 DOI: 10.3390/ijms22084283] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 12/12/2022] Open
Abstract
Antithrombin (AT) is a natural anticoagulant that interacts with activated proteases of the coagulation system and with heparan sulfate proteoglycans (HSPG) on the surface of cells. The protein, which is synthesized in the liver, is also essential to confer the effects of therapeutic heparin. However, AT levels drop in systemic inflammatory diseases. The reason for this decline is consumption by the coagulation system but also by immunological processes. Aside from the primarily known anticoagulant effects, AT elicits distinct anti-inflammatory signaling responses. It binds to structures of the glycocalyx (syndecan-4) and further modulates the inflammatory response of endothelial cells and leukocytes by interacting with surface receptors. Additionally, AT exerts direct antimicrobial effects: depending on AT glycosylation it can bind to and perforate bacterial cell walls. Peptide fragments derived from proteolytic degradation of AT exert antibacterial properties. Despite these promising characteristics, therapeutic supplementation in inflammatory conditions has not proven to be effective in randomized control trials. Nevertheless, new insights provided by subgroup analyses and retrospective trials suggest that a recommendation be made to identify the patient population that would benefit most from AT substitution. Recent experiment findings place the role of various AT isoforms in the spotlight. This review provides an overview of new insights into a supposedly well-known molecule.
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8
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Akentieva TN, Ovcharenko EA, Kudryavtseva YA. [Influence of suture material on the development of postoperative complications in vascular surgery and their prevention]. Khirurgiia (Mosk) 2019:75-81. [PMID: 31626243 DOI: 10.17116/hirurgia201910175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Postoperative complications in vascular surgery may be partly provoked by suture material. Analysis of the mechanisms of these complications may be useful for their prevention. Mechanisms of suture-induced thrombosis and neointimal hyperplasia, possible strategies for prevention of postoperative complications including those allowing drug deliveries directly to the vascular anastomosis area are discussed in the article. According to the literature data, heparin is the most optimal drug for modifying suture material and prevention of thrombosis and neointimal hyperplasia. Heparin delivery to the vascular anastomosis site will reduce the risk of thrombosis by inhibiting the activity of thrombin. Complex of heparin and antithrombin III increases inhibitory effect of antithrombin against thrombin. In addition, heparin is able to reduce proliferation of vascular smooth muscle cells through inhibition of the synthesis of extracellular matrix proteases involved in migration and proliferation of cells. Thus, heparin delivery to the vascular injury site may be used to prevent thrombosis and myoproliferative response. Moreover, this strategy prevents complications associated with systemic administration of anticoagulants.
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Affiliation(s)
- T N Akentieva
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - E A Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
| | - Yu A Kudryavtseva
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
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9
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Abstract
Abstract
There is a Blood Commentary on this article in this issue.
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10
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Samelson-Jones BJ, Finn JD, George LA, Camire RM, Arruda VR. Hyperactivity of factor IX Padua (R338L) depends on factor VIIIa cofactor activity. JCI Insight 2019; 5:128683. [PMID: 31219805 DOI: 10.1172/jci.insight.128683] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Adeno-associated-viral (AAV) vector liver-directed gene therapy (GT) for hemophilia B (HB) is limited by a vector-dose-dependent hepatotoxicity. Recently, this obstacle has been partially circumvented by the use of a hyperactive factor IX (FIX) variant, R338L (Padua), which has an eightfold increased specific activity compared to FIX-WT. FIX-R338L has emerged as the standard for HB GT. However, the underlying mechanism of its hyperactivity is undefined; as such, safety concerns of unregulated coagulation and the potential for thrombotic complications have not been fully addressed. To this end, we evaluated the enzymatic and clotting activity as well as the activation, inactivation, and cofactor-dependence of FIX-R338L relative to FIX-WT. We observed that the high-specific-activity of FIX-R338L requires factor VIIIa (FVIIIa) cofactor. In a novel system utilizing emicizumab, a FVIII-mimicking bispecific antibody, the hyperactivity of both recombinant FIX-R338L and AAV-mediated-transgene-expressed FIX-R338L from HB GT subjects is ablated without FVIIIa activity. We conclude that the molecular regulation of activation, inactivation, and cofactor-dependence of FIX-R338L is similar to FIX-WT, but that the FVIIIa-dependent hyperactivity of FIX-R338L is the result of a faster rate of factor X activation. This mechanism helps mitigate safety concerns of unregulated coagulation and supports the expanded use of FIX-R338L in HB therapy.
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Affiliation(s)
- Benjamin J Samelson-Jones
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Philadelphia, Pennsylvania, USA
| | - Jonathan D Finn
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lindsey A George
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Philadelphia, Pennsylvania, USA
| | - Rodney M Camire
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Philadelphia, Pennsylvania, USA
| | - Valder R Arruda
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Philadelphia, Pennsylvania, USA
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11
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Plautz WE, Sekhar Pilli VS, Cooley BC, Chattopadhyay R, Westmark PR, Getz T, Paul D, Bergmeier W, Sheehan JP, Majumder R. Anticoagulant Protein S Targets the Factor IXa Heparin-Binding Exosite to Prevent Thrombosis. Arterioscler Thromb Vasc Biol 2018; 38:816-828. [PMID: 29419409 DOI: 10.1161/atvbaha.117.310588] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/16/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE PS (protein S) is a plasma protein that directly inhibits the coagulation FIXa (factor IXa) in vitro. Because elevated FIXa is associated with increased risk of venous thromboembolism, it is important to establish how PS inhibits FIXa function in vivo. The goal of this study is to confirm direct binding of PS with FIXa in vivo, identify FIXa amino acid residues required for binding PS in vivo, and use an enzymatically active FIXa mutant that is unable to bind PS to measure the significance of PS-FIXa interaction in hemostasis. APPROACH AND RESULTS We demonstrate that PS inhibits FIXa in vivo by associating with the FIXa heparin-binding exosite. We used fluorescence tagging, immunohistochemistry, and protein-protein crosslinking to show in vivo interaction between FIXa and PS. Importantly, platelet colocalization required a direct interaction between the 2 proteins. FIXa and PS also coimmunoprecipitated from plasma, substantiating their interaction in a physiological milieu. PS binding to FIXa and PS inhibition of the intrinsic Xase complex required residues K132, K126, and R170 in the FIXa heparin-binding exosite. A double mutant, K132A/R170A, retained full activity but could not bind to PS. Crucially, Hemophilia B mice infused with FIXa K132A/R170A displayed an accelerated rate of fibrin clot formation compared with wild-type FIXa. CONCLUSIONS Our findings establish PS as an important in vivo inhibitor of FIXa. Disruption of the interaction between PS and FIXa causes an increased rate of thrombus formation in mice. This newly discovered function of PS implies an unexploited target for antithrombotic therapeutics.
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Affiliation(s)
- William E Plautz
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Vijaya Satish Sekhar Pilli
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Brian C Cooley
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Rima Chattopadhyay
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Pamela R Westmark
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Todd Getz
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - David Paul
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Wolfgang Bergmeier
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - John P Sheehan
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.)
| | - Rinku Majumder
- From the Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, New Orleans (W.E.P., V.S.S.P., R.C., R.M.); Department of Biochemistry and Biophysics, University of North Carolina, Chapel Hill (B.C.C., T.G., D.P., W.B.); and Department of Medicine/Hematology-Oncology, University of Wisconsin School of Medicine and Public Health, Madison (P.R.W., J.P.S.).
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12
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Tanratana P, Ellery P, Westmark P, Mast AE, Sheehan JP. Elevated Plasma Factor IXa Activity in Premenopausal Women on Hormonal Contraception. Arterioscler Thromb Vasc Biol 2017; 38:266-274. [PMID: 29097362 DOI: 10.1161/atvbaha.117.309919] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/12/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Combined oral contraceptives induce a reversible hypercoagulable state with an enhanced risk of venous thromboembolism, but the underlying mechanism(s) remain unclear. Subjects on combined oral contraceptives also demonstrate a characteristic resistance to APC (activated protein C) in the thrombin generation assay. Here, we report the potential role of plasma factor IXa (FIXa) as a mechanism for hormone-induced systemic hypercoagulability. APPROACH AND RESULTS A novel assay was used to determine FIXa activity in plasma samples from volunteer blood donors. Plasma from 36 premenopausal females on hormonal contraception and 35 not on hormonal contraception, 35 postmenopausal females, and 10 males were analyzed for FIXa activity, total PS (protein S), total tissue factor pathway inhibitor (TFPI), and TFPI-α antigen. Premenopausal females on hormonal contraception demonstrated significantly increased FIXa activity and decreased TFPI-α compared with the other groups. Remarkably, FIXa values were not normally distributed in the hormonal contraception group, but skewed toward the high end. Plasma FIXa activity inversely correlated with both TFPI-α and total PS antigen. Ex vivo determination of TF-dependent FIX activation in FV-deficient plasma demonstrated that inhibitory anti-TFPI antibodies enhanced FIXa generation by 2- to 3-fold, whereas addition of 75 nmol/L PS reduced FIXa generation by ≈2-fold. Further, increasing FIXa concentration enhanced APC resistance during TF-triggered plasma thrombin generation. CONCLUSIONS Elevation of plasma FIXa activity in association with reductions in TFPI-α and PS is a potential mechanism for systemic hypercoagulability and resistance to APC in premenopausal females on hormonal contraception.
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Affiliation(s)
- Pansakorn Tanratana
- From the Department of Pathology and Laboratory Medicine (P.T.), Department of Medicine/Hematology-Oncology (P.W., J.P.S.), University of Wisconsin School of Medicine and Public Health, Madison; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand (P.T.); Blood Research Institute, Blood Center of Wisconsin, Milwaukee (P.E., A.E.M.); and School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia (P.E.)
| | - Paul Ellery
- From the Department of Pathology and Laboratory Medicine (P.T.), Department of Medicine/Hematology-Oncology (P.W., J.P.S.), University of Wisconsin School of Medicine and Public Health, Madison; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand (P.T.); Blood Research Institute, Blood Center of Wisconsin, Milwaukee (P.E., A.E.M.); and School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia (P.E.)
| | - Pamela Westmark
- From the Department of Pathology and Laboratory Medicine (P.T.), Department of Medicine/Hematology-Oncology (P.W., J.P.S.), University of Wisconsin School of Medicine and Public Health, Madison; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand (P.T.); Blood Research Institute, Blood Center of Wisconsin, Milwaukee (P.E., A.E.M.); and School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia (P.E.)
| | - Alan E Mast
- From the Department of Pathology and Laboratory Medicine (P.T.), Department of Medicine/Hematology-Oncology (P.W., J.P.S.), University of Wisconsin School of Medicine and Public Health, Madison; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand (P.T.); Blood Research Institute, Blood Center of Wisconsin, Milwaukee (P.E., A.E.M.); and School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia (P.E.)
| | - John P Sheehan
- From the Department of Pathology and Laboratory Medicine (P.T.), Department of Medicine/Hematology-Oncology (P.W., J.P.S.), University of Wisconsin School of Medicine and Public Health, Madison; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand (P.T.); Blood Research Institute, Blood Center of Wisconsin, Milwaukee (P.E., A.E.M.); and School of Biomedical Sciences, Curtin University, Perth, Western Australia, Australia (P.E.).
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13
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Protease Inhibitors in the Interstitial Space. Protein Sci 2016. [DOI: 10.1201/9781315374307-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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14
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Abstract
Hemophilia B is an X-linked genetic deficiency of coagulation factor IX (FIX) activity associated with recurrent deep tissue and joint bleeding that may lead to long-term disability. FIX replacement therapy using plasma-derived protein or recombinant protein has significantly reduced bleeding and disability from hemophilia B, particularly when used in a prophylactic fashion. Although modern factor replacement has excellent efficacy and safety, barriers to the broader use of prophylaxis remain, including the need for intravenous (IV) access, frequent dosing, variability in individual pharmacokinetics, and cost. To overcome the requirement for frequent factor dosing, novel forms of recombinant FIX have been developed that possess extended terminal half-lives. Two of these products (FIXFc and rIX-FP) represent fusion proteins with the immunoglobulin G1 (IgG1) Fc domain and albumin, respectively, resulting in proteins that are recycled in vivo by the neonatal Fc receptor. The third product has undergone site-specific PEGylation on the activation peptide of FIX, similarly resulting in a long-lived FIX form. Clinical trials in previously treated hemophilia B patients have demonstrated excellent efficacy and confirmed less-frequent dosing requirements for the extended half-life forms. However, gaps in knowledge remain with regard to the risk of inhibitor formation and allergic reactions in previously untreated patient populations, safety in elderly patients with hemophilia, effects on in vivo FIX distribution, and cost-effectiveness. Additional strategies designed to rebalance hemostasis in hemophilia patients include monoclonal-antibody-mediated inhibition of tissue factor pathway inhibitor activity and siRNA-mediated reduction in antithrombin expression by the liver. Both of these approaches are long acting and potentially involve subcutaneous administration of the drug. In this review, we will discuss the biology of FIX, the evolution of FIX replacement therapy, the emerging FIX products possessing extended half-lives, and novel “rebalancing” approaches to hemophilia therapy.
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Affiliation(s)
- Moniba Nazeef
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John P Sheehan
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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15
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Zang T, Broszczak DA, Broadbent JA, Cuttle L, Lu H, Parker TJ. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects. Expert Rev Proteomics 2015; 13:35-53. [PMID: 26581649 DOI: 10.1586/14789450.2016.1122528] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity.
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Affiliation(s)
- Tuo Zang
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Daniel A Broszczak
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - James A Broadbent
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,c Wound Management Innovation Co-operative Research Centre , West End , Australia
| | - Leila Cuttle
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia.,d Centre for Children's Burns and Trauma Research , Queensland University of Technology, Institute of Health and Biomedical Innovation at the Centre for Children's Health Research , South Brisbane , Australia
| | - Haitao Lu
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
| | - Tony J Parker
- a Tissue Repair and Regeneration Program , Institute of Health and Biomedical Innovation , Kelvin Grove , Australia.,b School of Biomedical Sciences , Queensland University of Technology , Brisbane , Australia
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