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Beck S, Öftering P, Li R, Hemmen K, Nagy M, Wang Y, Zarpellon A, Schuhmann MK, Stoll G, Ruggeri ZM, Heinze KG, Heemskerk JW, Ruf W, Stegner D, Nieswandt B. Platelet glycoprotein V spatio-temporally controls fibrin formation. NATURE CARDIOVASCULAR RESEARCH 2023; 2:368-382. [PMID: 37206993 PMCID: PMC10195106 DOI: 10.1038/s44161-023-00254-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 02/15/2023] [Indexed: 05/21/2023]
Abstract
The activation of platelets and coagulation at vascular injury sites is crucial for haemostasis but can promote thrombosis and inflammation in vascular pathologies. Here, we delineate an unexpected spatio-temporal control mechanism of thrombin activity that is platelet orchestrated and locally limits excessive fibrin formation after initial haemostatic platelet deposition. During platelet activation, the abundant platelet glycoprotein (GP) V is cleaved by thrombin. We demonstrate with genetic and pharmacological approaches that thrombin-mediated shedding of GPV does not primarily regulate platelet activation in thrombus formation, but rather has a distinct function after platelet deposition and specifically limits thrombin-dependent generation of fibrin, a crucial mediator of vascular thrombo-inflammation. Genetic or pharmacologic defects in haemostatic platelet function are unexpectedly attenuated by specific blockade of GPV shedding, indicating that the spatio-temporal control of thrombin-dependent fibrin generation also represents a potential therapeutic target to improve haemostasis.
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Affiliation(s)
- Sarah Beck
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
- University Hospital Würzburg, Institute of Experimental Biomedicine, Würzburg, Germany
| | - Patricia Öftering
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
- University Hospital Würzburg, Institute of Experimental Biomedicine, Würzburg, Germany
| | - Renhao Li
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine; Atlanta, USA
| | - Katherina Hemmen
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
| | - Magdolna Nagy
- Department of Biochemistry, CARIM, Maastricht University; Maastricht, The Netherlands
| | - Yingchun Wang
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine; Atlanta, USA
| | | | | | - Guido Stoll
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | | | - Katrin G. Heinze
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
| | - Johan W.M. Heemskerk
- Department of Biochemistry, CARIM, Maastricht University; Maastricht, The Netherlands
| | - Wolfram Ruf
- Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center Mainz; Mainz, Germany
- Department of Immunology and Microbiology, Scripps Research; La Jolla, CA, USA
| | - David Stegner
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
- University Hospital Würzburg, Institute of Experimental Biomedicine, Würzburg, Germany
| | - Bernhard Nieswandt
- Julius-Maximilians-Universität Würzburg, Rudolf Virchow Center for Integrative and Translational Bioimaging, Würzburg, Germany
- University Hospital Würzburg, Institute of Experimental Biomedicine, Würzburg, Germany
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Choi SJ, Dwyer CN, Rapkin L, Cormier M, Hindmarch CCT, Nesbitt K, Michels A, Hopman W, Swystun LL, Lillicrap D. The mechanistic and structural role of von Willebrand factor in endotoxemia-enhanced deep vein thrombosis in mice. J Thromb Haemost 2023; 21:586-598. [PMID: 36696220 DOI: 10.1016/j.jtha.2022.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Although the concept of immunothrombosis has established a link between inflammation and thrombosis, the role of inflammation in the pathogenesis of deep vein thrombosis remains to be fully elucidated. Further, although various constituents of venous thrombi have been identified, their localizations and cellular and molecular interactions are yet to be combined in a single, multiplexed analysis. OBJECTIVES The objective of this study was to investigate the role of the von Willebrand factor (VWF) in inflammation-associated venous thrombosis. We also performed a proof-of-concept study of imaging mass cytometry to quantitatively and simultaneously analyze the localizations and interactions of 10 venous thrombus constituents. METHODS We combined the murine inferior vena cava stenosis model of deep vein thrombosis with the lipopolysaccharide model of endotoxemia. We also performed a proof-of-concept study of imaging mass cytometry to assess the feasibility of this approach in analyzing the structural composition of thrombi. RESULTS We found that lipopolysaccharide-treated mice had significantly higher incidences of venous thrombosis, an effect that was mitigated when VWF was inhibited using inhibitory αVWF antibodies. Our detailed structural analysis also showed that most thrombus components are localized in the white thrombus regardless of endotoxemia. Moreover, although endotoxemia modulated the relative representation and interactions of VWF with other thrombus constituents, the scaffolding network, comprised VWF, fibrin, and neutrophil extracellular traps, remained largely unaffected. CONCLUSIONS We observe a key role for VWF in the pathogenesis of inflammation-associated venous thrombosis while providing a more comprehensive insight into the molecular interactions that constitute the architecture of venous thrombi.
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Affiliation(s)
- Seon Jae Choi
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Courtney N Dwyer
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Matthew Cormier
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Charles C T Hindmarch
- Queen's Cardiopulmonary Unit, Translational Institute of Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Kate Nesbitt
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Alison Michels
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Wilma Hopman
- Kingston General Hospital Research Institute, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Laura L Swystun
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - David Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.
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3
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Yaoi H, Shida Y, Ogiwara K, Kitazawa T, Shima M, Nogami K. Emicizumab enhances thrombus formation in vitro under high shear flow conditions in whole blood from patients with type 1 and type 3 von Willebrand disease. Haemophilia 2022; 28:694-701. [PMID: 35478475 DOI: 10.1111/hae.14581] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/30/2022] [Accepted: 04/19/2022] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Type 1 and type 3 von Willebrand disease (VWD) are caused by partial and complete, quantitative deficiency of von Willebrand factor (VWF), respectively, and factor (F)VIII/VWF complex concentrates are used for haemostatic treatment. Emicizumab, mimics activated FVIII, reduces bleeding in haemophilia A patients. The effects of emicizumab on haemostasis in both types of VWD remain to be fully established, however. AIM To examine the effects of emicizumab on thrombogenesis in type 1 and type 3 VWD. PATIENTS/METHODS Perfusion chamber experiments under high shear conditions (2500 s-1 ) combined with immunostaining were performed using whole blood samples from patients with type 1 (VWF:Ag 25 U/dl) and type 3 VWD (<1.0 U/dl). RESULTS The addition of FVIII (1 U/ml) to type 1 blood did not affect thrombus formation, whilst supplementation with VWF (1.6 U/ml) or FVIII/VWF (1 U/ml/1.6 U/ml) enhanced thrombogenesis to a similar extent. FVIII/VWF promoted thrombus formation significantly more than VWF alone, however, in type 3 blood. Emicizumab (100 μg/ml) augmented thrombus formation in type 3 blood compared to FVIII, and this potency seemed to be somewhat greater than that of VWF. Surface coverage of formed thrombus in type 3 VWD was less than that in type 1 VWD, but thrombus height was comparable in both. The addition of emicizumab to type 3 blood enhanced thrombin generation and fibrin formation compared to control IgG. CONCLUSION Emicizumab promoted mechanisms of thrombus formation in vitro in type 3 and type 1 VWD, suggesting the possibility of alternative therapeutic protocols in these patients.
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Affiliation(s)
- Hiroaki Yaoi
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Yasuaki Shida
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Kenichi Ogiwara
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Takehisa Kitazawa
- Research Division, Chugai Pharmaceutical Co., Gotemba, Shizuoka, Japan
| | - Midori Shima
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan.,Thrombosis and Hemostasis Research Center, Nara Medical University, Japan
| | - Keiji Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
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Woods AI, Paiva J, Primrose DM, Blanco AN, Sanchez-Luceros A. Von Willebrand disease type 2M: Correlation between genotype and phenotype: Comment from Woods et al. J Thromb Haemost 2022; 20:1022-1023. [PMID: 35307945 DOI: 10.1111/jth.15644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Adriana I Woods
- Hemostasia y Trombosis, IMEX-CONICET-ANM, CABA, Buenos Aires, Argentina
| | - Juvenal Paiva
- Thrombosis and Hemostasis, Institute of Hematological Research, National Academy of Medicine, Buenos Aires, Argentina
| | - Debora M Primrose
- Higher School of Engineering, Informatics and Agri-food Sciences, University of Moron, Moron, Argentina
| | - Alicia N Blanco
- Thrombosis and Hemostasis, Institute of Hematological Research, National Academy of Medicine, Buenos Aires, Argentina
| | - Analia Sanchez-Luceros
- Hemostasia y Trombosis, IMEX-CONICET-ANM, CABA, Buenos Aires, Argentina
- Thrombosis and Hemostasis, Institute of Hematological Research, National Academy of Medicine, Buenos Aires, Argentina
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Maas DPMSM, Atiq F, Blijlevens NMA, Brons P, Krouwel S, Laros‐van Gorkom BAP, Leebeek F, Nieuwenhuizen L, Schoormans SCM, Simons A, Meijer D, van Heerde WL, Schols SEM. Von Willebrand disease type 2M: Correlation between genotype and phenotype. J Thromb Haemost 2022; 20:316-327. [PMID: 34758185 PMCID: PMC9299039 DOI: 10.1111/jth.15586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/21/2021] [Accepted: 11/05/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND An appropriate clinical diagnosis of von Willebrand disease (VWD) can be challenging because of a variable bleeding pattern and laboratory phenotype. Genotyping is a powerful diagnostic tool and may have an essential role in the diagnostic field of VWD. OBJECTIVES To unravel the clinical and laboratory heterogeneity of genetically confirmed VWD type 2M patients and to investigate their relationship. METHODS Patients with a confirmed VWD type 2M genetic variant in the A1 or A3 domain of von Willebrand factor (VWF) and normal or only slightly aberrant VWF multimers were selected from all subjects genotyped at the Radboud university medical center because of a high suspicion of VWD. Bleeding scores and laboratory results were analyzed. RESULTS Fifty patients had a clinically relevant genetic variant in the A1 domain. Median bleeding score was 5. Compared with the nationwide Willebrand in the Netherlands study type 2 cohort, bleeding after surgery or delivery was reported more frequently and mucocutaneous bleedings less frequently. Median VWF activity/VWF antigen (VWF:Act/VWF:Ag) ratio was 0.32, whereas VWF collagen binding activity/VWF antigen (VWF:CB/VWF:Ag) ratio was 0.80. Variants in the A3 domain were only found in two patients with low to normal VWF:Act/VWF:Ag ratios (0.45, 1.03) and low VWF:CB/VWF:Ag ratios (0.45, 0.63). CONCLUSION Genetically confirmed VWD type 2M patients have a relatively mild clinical phenotype, except for bleeding after surgery and delivery. Laboratory phenotype is variable and depends on the underlying genetic variant. Addition of genotyping to the current phenotypic characterization may improve diagnosis and classification of VWD.
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Affiliation(s)
- Dominique P. M. S. M. Maas
- Department of HematologyRadboud university medical centerNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
| | - Ferdows Atiq
- Department of HematologyErasmus University Medical CenterRotterdamthe Netherlands
| | | | - Paul P. T. Brons
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
- Department of Pediatric Hemato‐OncologyRadboud university medical centerNijmegenthe Netherlands
| | - Sandy Krouwel
- Department of Laboratory MedicineLaboratory of HematologyRadboud university medical centerNijmegenthe Netherlands
| | - Britta A. P. Laros‐van Gorkom
- Department of HematologyRadboud university medical centerNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
| | - Frank W. G. Leebeek
- Department of HematologyErasmus University Medical CenterRotterdamthe Netherlands
| | - Laurens Nieuwenhuizen
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
- Department of HematologyMaxima Medical CenterEindhoventhe Netherlands
| | - Selene C. M. Schoormans
- Department of Laboratory MedicineLaboratory of HematologyRadboud university medical centerNijmegenthe Netherlands
| | - Annet Simons
- Department of Human GeneticsRadboud university medical centerNijmegenthe Netherlands
| | - Daniëlle Meijer
- Department of Laboratory MedicineLaboratory of HematologyRadboud university medical centerNijmegenthe Netherlands
| | - Waander L. van Heerde
- Department of HematologyRadboud university medical centerNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
- Enzyre BVNovio Tech CampusNijmegenthe Netherlands
| | - Saskia E. M. Schols
- Department of HematologyRadboud university medical centerNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐Maastrichtthe Netherlands
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Zhao YC, Wang H, Wang Y, Lou J, Ju LA. The N-terminal autoinhibitory module of the A1 domain in von Willebrand factor stabilizes the mechanosensor catch bond. RSC Chem Biol 2022; 3:707-720. [PMID: 35755187 PMCID: PMC9175105 DOI: 10.1039/d2cb00010e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/07/2022] [Indexed: 12/29/2022] Open
Abstract
The N-AIM of VWF-A1 forms a Rotini-like structure, therefore partially autoinhibit VWF-A1–GPIbα interaction. The N-AIM acts as a defending sword to protect and stabilize the VWF-A1 structure under harsh environments.
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Affiliation(s)
- Yunduo Charles Zhao
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, NSW 2008, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Haoqing Wang
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, NSW 2008, Australia
- Heart Research Institute, Newtown, NSW 2042, Australia
| | - Yao Wang
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, NSW 2008, Australia
- Cellular and Genetic Medicine Unit, School of Medical Sciences, University of New South Wales, NSW 2052, Australia
| | - Jizhong Lou
- Key Laboratory of RNA Biology, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Lining Arnold Ju
- School of Biomedical Engineering, Faculty of Engineering, The University of Sydney, Darlington, NSW 2008, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
- Heart Research Institute, Newtown, NSW 2042, Australia
- The University of Sydney Nano Institute (Sydney Nano), The University of Sydney, Camperdown, NSW 2006, Australia
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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7
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Yaoi H, Shida Y, Kitazawa T, Shima M, Nogami K. Emicizumab improves thrombus formation of type 2A von willebrand disease under high shear condition. Haemophilia 2021; 27:e194-e203. [PMID: 33555083 DOI: 10.1111/hae.14272] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Type 2A von Willebrand disease (VWD) is common in type-2 group caused by qualitative deficiency of von Willebrand factor (VWF). Emicizumab is a bispecific antibody that mimics activated factor VIII (FVIIIa) cofactor function, and emicizumab prophylaxis substantially reduces bleeding in patients with haemophilia A. It is unknown whether emicizumab affects thrombus formation in type 2A VWD characterized by not only low FVIII levels but also the impaired platelet adhesion and aggregation. AIM To examine the coagulant potential of emicizumab in type 2A VWD. PATIENTS/METHODS Perfusion chamber experiments combined with immunostaining were performed using whole blood from 5 patients with type 2A VWD under high shear condition (2500 s-1 ). RESULTS The addition of FVIII to type 2A VWD whole blood did not augment thrombus formation, whilst supplementation with VWF or FVIII/VWF enhanced. FVIII appeared to contribute to thrombus height rather than surface coverage. The addition of emicizumab enhanced thrombus formation in type 2A VWD compared with FVIII, but this potency was less than the presence of VWF. The effect on thrombus formation mediated by emicizumab appeared to be more rapid than that by FVIII for non-requirement of activation step of FVIII, whilst that by FVIII showed more impact on thrombus formation at the late phase. CONCLUSION Emicizumab-induced enhancing effects of thrombus formation, independent on VWF, may be useful as an alternative therapy for type 2A VWD patients. These results supported a critical role for the FVIII-VWF complex facilitating thrombus formation under high shear.
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Affiliation(s)
- Hiroaki Yaoi
- Department of Pediatrics, Nara Medical University, Kashihara, Japan
| | - Yasuaki Shida
- Department of Pediatrics, Nara Medical University, Kashihara, Japan
| | | | - Midori Shima
- Department of Pediatrics, Nara Medical University, Kashihara, Japan
| | - Keiji Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Japan
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8
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Yaoi H, Shida Y, Kitazawa T, Shima M, Nogami K. Activated factor VIII-mimicking effect by emicizumab on thrombus formation in type 2N von Willebrand disease under high shear flow conditions. Thromb Res 2020; 198:7-16. [PMID: 33248318 DOI: 10.1016/j.thromres.2020.11.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/24/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Type 2N von Willebrand disease (2NVWD) is characterized by a mild to moderate reduction in plasma levels of factor (F)VIII associated with defective binding of von Willebrand factor (VWF) to FVIII and accelerated proteolysis and clearance of FVIII. The clinical phenotype in 2NVWD is often indistinguishable from mild/moderate hemophilia (H)A. Emicizumab is a bispecific antibody to FIX/FIXa and FX/FXa that mimics FVIIIa cofactor function, and emicizumab prophylaxis significantly reduces bleeding events in patients with severe HA. AIM We investigated the potential benefits of emicizumab in the hemostatic management of 2NVWD. PATIENTS/METHODS Perfusion chamber experiments were performed using whole blood from three 2NVWD patients with different clinical phenotypes (bleeding scores: 0, 6 and 20; mutations: p.R816W, p.R816W, and p.R365X/p.T791M, respectively). Furthermore, the impact of specific FVIII-VWF interactions on thrombus formation was investigated. RESULTS Defective thrombus formation that correlated with bleeding phenotype was evident in these 2NVWD patients. Emicizumab improved surface coverage and thrombus height in all cases. Multi-color immunostaining of thrombi further demonstrated that emicizumab enhanced thrombin generation and fibrin formation. The addition of FVIII alone to 2NVWD whole blood did not augment thrombus formation, while supplementation with FVIII/VWF complex enhanced platelet-fibrin interactions. Furthermore, an anti-FVIII monoclonal antibody known to interrupt the release of FVIIIa from VWF depressed these effects. CONCLUSIONS Emicizumab-induced enhancing effects of thrombus formation, independent on VWF, might be useful as an alternative therapy for 2NVWD patients. The extent of FVIII-VWF interaction should be optimal to deliver and release FVIII/FVIIIa on the activated platelet surface.
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Affiliation(s)
- Hiroaki Yaoi
- Dept. Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Yasuaki Shida
- Dept. Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Takehisa Kitazawa
- Chugai Pharmaceutical Co., Research Division, Gotemba, Shizuoka, Japan
| | - Midori Shima
- Dept. Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Keiji Nogami
- Dept. Pediatrics, Nara Medical University, Kashihara, Nara, Japan.
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9
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Yaoi H, Shida Y, Kitazawa T, Shima M, Nogami K. Emicizumab Augments Thrombus Formation in Whole Blood from Patients with Hemophilia A under High Shear Flow Conditions. Thromb Haemost 2020; 121:279-286. [PMID: 32906155 DOI: 10.1055/s-0040-1716542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Emicizumab is a bispecific antibody to factor (F) IXa and FX that mimics the FVIIIa cofactor function. Emicizumab prophylaxis markedly decreases bleeding episodes in patients with hemophilia A (PwHAs), irrespective of the presence of FVIII inhibitors. However, thrombotic microangiopathy (TMA) was reported when repeated high doses of activated prothrombin complex concentrates (aPCC) were concomitantly used with emicizumab. Although bypassing agents (BPAs) are vital in the hemostatic treatment for PwHAs with inhibitors, the mechanism of emicizumab-related TMA remains unclear. AIM To assess the risk of excessive thrombus formation associated with BPAs and emicizumab under high shear conditions. METHODS Perfusion flow-chamber experiments under high shear conditions were performed using whole blood from PwHAs in the presence of emicizumab without or together with FVIII or BPAs ex vivo. RESULTS Emicizumab (100 μg/mL) added ex vivo to whole blood from PwHAs improved defective thrombus formation in a similar manner to that observed with the addition of recombinant FVIII at the early phase, while FVIII continued to be important at the later stages. aPCC (1.2 U/mL equivalent to 100 U/kg) or recombinant FVIIa (1.1 µg/mL; equivalent to 90 µg/kg) together with emicizumab further promoted platelet interactions and fibrin formation ex vivo but did not induce excessive thrombus formation. CONCLUSION Emicizumab enhanced thrombin generation at local sites and improved defective hemostasis in whole blood from PwHAs under high shear conditions. Simple concomitant use of BPAs with emicizumab did not mediate excessive thrombus formation and remains an option for hemostatic management of emicizumab-treated PwHAs with inhibitors.
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Affiliation(s)
- Hiroaki Yaoi
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Yasuaki Shida
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Takehisa Kitazawa
- Research Division, Chugai Pharmaceutical Co., Kamakura, Kanagawa, Japan
| | - Midori Shima
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Keiji Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
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Motum P, Just S, Zebeljan D, Nicholls C, Kershaw G, Oliver S, Mohammed S, Favaloro EJ. A diagnosis of von Willebrand disease despite normal test results for factor VIII and von Willebrand factor antigen and activity. Am J Hematol 2019; 94:1425-1432. [PMID: 31423628 DOI: 10.1002/ajh.25618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Penelope Motum
- Haematology, NSW Health Pathology Liverpool Hospital New South Wales Australia
| | - Sarah Just
- Haematology, NSW Health Pathology Liverpool Hospital New South Wales Australia
| | - Diane Zebeljan
- Haematology, NSW Health Pathology Liverpool Hospital New South Wales Australia
| | - Catherine Nicholls
- Department of Genetic Pathology SA Pathology Adelaide South Australia Australia
| | - Geoffrey Kershaw
- Haematology, NSW Health Pathology Royal Prince Alfred Hospital New South Wales Australia
| | - Susan Oliver
- Department of Haematology Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital Westmead New South Wales Australia
| | - Soma Mohammed
- Department of Haematology Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital Westmead New South Wales Australia
| | - Emmanuel J. Favaloro
- Department of Haematology Institute of Clinical Pathology and Medical Research (ICPMR), NSW Health Pathology, Westmead Hospital Westmead New South Wales Australia
- Department of Haematology Sydney Centres for Thrombosis and Haemostasis Westmead New South Wales Australia
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11
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Targeting Platelet GPVI Plus rt-PA Administration but Not α2β1-Mediated Collagen Binding Protects against Ischemic Brain Damage in Mice. Int J Mol Sci 2019; 20:ijms20082019. [PMID: 31022936 PMCID: PMC6515069 DOI: 10.3390/ijms20082019] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/16/2022] Open
Abstract
Platelet collagen interactions at sites of vascular injuries predominantly involve glycoprotein VI (GPVI) and the integrin α2β1. Both proteins are primarily expressed on platelets and megakaryocytes whereas GPVI expression is also shown on endothelial and integrin α2β1 expression on epithelial cells. We recently showed that depletion of GPVI improves stroke outcome without increasing the risk of cerebral hemorrhage. Genetic variants associated with higher platelet surface integrin α2 (ITGA2) receptor levels have frequently been found to correlate with an increased risk of ischemic stroke in patients. However until now, no preclinical stroke study has addressed whether platelet integrin α2β1 contributes to the pathophysiology of ischemia/reperfusion (I/R) injury. Focal cerebral ischemia was induced in C57BL/6 and Itga2-/- mice by a 60 min transient middle cerebral artery occlusion (tMCAO). Additionally, wild-type animals were pretreated with anti-GPVI antibody (JAQ1) or Fab fragments of a function blocking antibody against integrin α2β1 (LEN/B). In anti-GPVI treated animals, intravenous (IV) recombinant tissue plasminogen activator (rt-PA) treatment was applied immediately prior to reperfusion. Stroke outcome, including infarct size and neurological scoring was determined on day 1 after tMCAO. We demonstrate that targeting the integrin α2β1 (pharmacologic; genetic) did neither reduce stroke size nor improve functional outcome on day 1 after tMCAO. In contrast, depletion of platelet GPVI prior to stroke was safe and effective, even when combined with rt-PA treatment. Our results underscore that GPVI, but not ITGA2, is a promising and safe target in the setting of ischemic stroke.
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Shida Y, Swystun LL, Brown C, Mewburn J, Nesbitt K, Danisment O, Riches JJ, Hough C, Lillicrap D. Shear stress and platelet-induced tensile forces regulate ADAMTS13-localization within the platelet thrombus. Res Pract Thromb Haemost 2019; 3:254-260. [PMID: 31011709 PMCID: PMC6462754 DOI: 10.1002/rth2.12196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/19/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The multimeric glycoprotein von Willebrand factor (VWF) mediates platelet adhesion and aggregation at the site of vessel injury. The adhesive activity of VWF is influenced by its multimer length which is regulated by the metalloprotease ADAMTS13. The ability of ADAMTS13 to regulate platelet thrombus growth in a shear-dependent manner has been described, however, the mechanistic basis of this action has not been well characterized. METHODS We developed an mCherry-tagged murine ADAMTS13 protein and utilized an ex vivo flow chamber system to visualize the localization of ADAMTS13 within the platelet thrombus under different conditions of shear. Using this system, we also assessed the influence of platelet-mediated tensile force on ADAMTS13 localization within the thrombus using gain-of-function GPIb binding and loss-of-function GPIIbIIIa binding mutants in VWF/ADAMTS13 DKO mice. RESULTS ADAMTS13 was visualized on the growing platelet thrombus under very high shear using ADAMTS13-mcherry. ADAMTS13-mCherry localized particularly at the top portion of the thrombus and reduced thrombus size as it grew to occlusion. At the pathological high shear of 7500 s-1, platelet-mediated tensile force, involving GPIb but not GPIIbIIIa receptors, influenced localization of ADAMTS13 to the thrombus under conditions of shear. CONCLUSIONS Tensile force applied on VWF produced by shear stress and platelet GPIb binding has a crucial role in ADAMTS13 activity at the site of thrombus formation. These results suggest that ADAMTS13 activity at the site of platelet thrombus formation is regulated by a shear stress and platelet-dependent feedback mechanism to prevent vessel occlusion and pathological thrombosis.
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Affiliation(s)
- Yasuaki Shida
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Laura L. Swystun
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Christine Brown
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Jeffrey Mewburn
- Department of MedicineQueen's UniversityKingstonOntarioCanada
| | - Kate Nesbitt
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Ozge Danisment
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Jonathan Jacob Riches
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - Christine Hough
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
| | - David Lillicrap
- Department of Pathology and Molecular MedicineQueen's UniversityKingstonOntarioCanada
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Seang S, Pavasant P, Limjeerajarus CN. Iloprost Induces Dental Pulp Angiogenesis in a Growth Factor-free 3-Dimensional Organ Culture System. J Endod 2018; 44:759-764.e2. [PMID: 29550009 DOI: 10.1016/j.joen.2018.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/15/2018] [Accepted: 02/01/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Angiogenesis is a key determinant in dental pulp regeneration. Iloprost is a synthetic prostacyclin that promotes angiogenesis. A three-dimensional culture that mimics the in vivo condition has been used in tissue engineering. This study investigated the effect of iloprost on promoting dental pulp angiogenesis by using the tooth slice organ culture system. METHODS Tooth slices with intact pulp tissue were cut from molars extracted from 12 patients. Dental pulp tissue viability was determined by live/dead staining. The tooth slices were cultured with iloprost for 1 or 3 days. The microvessel density and expression of vascular endothelial growth factor were determined by immunohistochemical staining. Collagen density was determined by using Masson trichrome and immunofluorescent staining. RESULTS The pulp tissue in the tooth slices remained viable when cultured in serum-free medium. Iloprost increased the microvessel density as shown by a higher number of von Willebrand factor-positive cells. A significant increase in vascular endothelial growth factor expression was observed in the tooth slices cultured with iloprost. Iloprost stimulated collagen deposition, and this effect was abolished after inhibition of protein kinase A activity. CONCLUSIONS Human tooth slices provide a valuable and easy-to-obtain model to investigate the effect of bioactive molecules used in dental pulp regeneration. This study showed for the first time that tooth slices could be kept viable under serum-free conditions for up to 3 days. Iloprost promoted angiogenesis, increased new vessel formation, and induced collagen deposition. This study proposes the clinical value of iloprost as a drug for inducing angiogenesis that can increase the success of pulp regeneration.
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Affiliation(s)
- Sonntana Seang
- Graduate Program in Oral Biology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Prasit Pavasant
- Mineralized Tissue Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Excellence Center in Regenerative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chalida N Limjeerajarus
- Excellence Center in Regenerative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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14
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Misra A, Prakash P, Aggarwal H, Dhankani P, Kumar S, Pandey CP, Pugh N, Bihan D, Barthwal MK, Farndale RW, Dikshit DK, Dikshit M. Anti-thrombotic efficacy of S007-867: Pre-clinical evaluation in experimental models of thrombosis in vivo and in vitro. Biochem Pharmacol 2018; 148:288-297. [DOI: 10.1016/j.bcp.2018.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
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15
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Swystun LL, Georgescu I, Mewburn J, Deforest M, Nesbitt K, Hebert K, Dwyer C, Brown C, Notley C, Lillicrap D. Abnormal von Willebrand factor secretion, factor VIII stabilization and thrombus dynamics in type 2N von Willebrand disease mice. J Thromb Haemost 2017; 15:1607-1619. [PMID: 28581694 DOI: 10.1111/jth.13749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Indexed: 12/20/2022]
Abstract
Essentials Type 2N von Willebrand disease involves impaired von Willebrand factor to factor VIII binding. Type 2N von Willebrand disease mutations exhibit qualitative and mild quantitative deficiencies. Type 2N von Willebrand disease mice exhibit unstable venous hemostatic thrombi. The factor VIII-binding ability of von Willebrand factor regulates arteriole thrombosis dynamics. SUMMARY Background von Willebrand factor (VWF) and factor VIII (FVIII) circulate as a non-covalent complex, with VWF serving as the carrier for FVIII. VWF indirectly influences secondary hemostasis by stabilizing FVIII and transporting it to the site of primary hemostasis. Type 2N von Willebrand disease involves impaired binding of VWF to FVIII, resulting in decreased plasma levels of FVIII. Objectives In these studies, we characterize the impact of three type 2N VWD variants (R763A, R854Q, R816W) on VWF secretion, FVIII stabilization and thrombus formation in a murine model. Methods Type 2N VWD mice were generated by hydrodynamic injections of mutant murine VWF cDNAs and the influence of these variants on VWF secretion and FVIII binding was evaluated. In vivo hemostasis and the dynamics of thrombus formation and embolization were assessed using a murine tail vein transection hemostasis model and an intravital thrombosis model in the cremaster arterioles. Results Type 2N VWD variants were associated with decreased VWF secretion using cell and animal-based models. FVIII-binding to type 2N variants was impaired in vitro and was variably stabilized in vivo by expressed or infused 2N variant VWF protein. Both transgenic type 2N VWD and FVIII knockout (KO) mice demonstrated impaired thrombus formation associated with decreased thrombus stability. Conclusions The type 2N VWD phenotype can be recapitulated in a murine model and is associated with both quantitative and qualitative VWF deficiencies and impaired thrombus formation. Patients with type 2N VWD may have normal primary hemostasis formation but decreased thrombus stability related to ineffective secondary hemostasis.
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Affiliation(s)
- L L Swystun
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - I Georgescu
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - J Mewburn
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - M Deforest
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - K Nesbitt
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - K Hebert
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - C Dwyer
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - C Brown
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - C Notley
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - D Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
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16
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Thrombopoiesis is spatially regulated by the bone marrow vasculature. Nat Commun 2017; 8:127. [PMID: 28743899 PMCID: PMC5527048 DOI: 10.1038/s41467-017-00201-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 06/09/2017] [Indexed: 01/12/2023] Open
Abstract
In mammals, megakaryocytes (MKs) in the bone marrow (BM) produce blood platelets, required for hemostasis and thrombosis. MKs originate from hematopoietic stem cells and are thought to migrate from an endosteal niche towards the vascular sinusoids during their maturation. Through imaging of MKs in the intact BM, here we show that MKs can be found within the entire BM, without a bias towards bone-distant regions. By combining in vivo two-photon microscopy and in situ light-sheet fluorescence microscopy with computational simulations, we reveal surprisingly slow MK migration, limited intervascular space, and a vessel-biased MK pool. These data challenge the current thrombopoiesis model of MK migration and support a modified model, where MKs at sinusoids are replenished by sinusoidal precursors rather than cells from a distant periostic niche. As MKs do not need to migrate to reach the vessel, therapies to increase MK numbers might be sufficient to raise platelet counts.Megakaryocyte maturation is thought to occur as the cells migrate from a vessel-distant (endosteal) niche to the vessel within the bone. Here, the authors show that megakaryocytes represent largely sessile cells in close contact with the vasculature and homogeneously distributed in the bone marrow.
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17
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Yaoi H, Shida Y, Ogiwara K, Hosokawa K, Shima M, Nogami K. Role of red blood cells in the anemia-associated bleeding under high shear conditions. Haemophilia 2017; 23:750-758. [PMID: 28470853 DOI: 10.1111/hae.13252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Red blood cells (RBCs) contribute to hemostasis under blood-flow, and anemia might contribute to a hemorrhagic diathesis. The majority of current laboratory techniques to assess hemostasis do not consider the effects of RBCs. An assay to determine the role of RBCs in hemostasis could be beneficial for clinical management. OBJECTIVES To investigate the influence of RBCs in hemostasis. METHODS Hemostasis was investigated using a novel microchip flow-chamber system (T-TAS® ) in an anemic patient with von Willebrand disease. Subsequently, the effects of RBCs in total thrombus analysis system (T-TAS) were examined using reconstituted whole blood at various hematocrit levels. RESULTS In vivo: When the patient was anemic and demonstrated persisted hemorrhagic symptoms despite the maintained adequate von Willebrand factor ristocetin cofactor activity levels, thrombus formation determined by T-TAS was delayed. However, transfusions of RBCs resolved bleeding symptom and, accordingly, the thrombus formation in T-TAS improved. In vitro: Thrombus formation determined by T-TAS at 1000 s-1 was dose-dependent on hematocrit (the time to reach 10 kPa (T10 ): 10.0 ± 0, 9.5 ± 1.4, 6.7 ± 2.4, 2.8 ± 1.6 min at hematocrits of 0%, 12.5%, 25% and 50%, respectively). Markedly defective thrombus formation (T10 >10 min) was confirmed at a hematocrit <25% at 2000 s-1 . CONCLUSION Red blood cells play an essential role in hemostasis under high shear, and RBC transfusions could be effective for refractory bleeding in patients with anemia. T-TAS measurements appear to reflect the hemostatic consequences of diminished red cell numbers under blood-flow, and could provide a valuable means for monitoring patients.
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Affiliation(s)
- H Yaoi
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - Y Shida
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - K Ogiwara
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - K Hosokawa
- Research Institute, Fujimori Kogyo Co., Ltd., Yokohama, Kanagawa, Japan
| | - M Shima
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
| | - K Nogami
- Department of Pediatrics, Nara Medical University, Kashihara, Nara, Japan
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18
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Swystun LL, James PD. Genetic diagnosis in hemophilia and von Willebrand disease. Blood Rev 2017; 31:47-56. [DOI: 10.1016/j.blre.2016.08.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/08/2016] [Accepted: 08/11/2016] [Indexed: 11/24/2022]
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Semeniak D, Kulawig R, Stegner D, Meyer I, Schwiebert S, Bösing H, Eckes B, Nieswandt B, Schulze H. Proplatelet formation is selectively inhibited by collagen type I through Syk-independent GPVI signaling. J Cell Sci 2016; 129:3473-84. [PMID: 27505889 DOI: 10.1242/jcs.187971] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 07/28/2016] [Indexed: 12/22/2022] Open
Abstract
Collagen receptors GPVI (also known as GP6) and integrin α2β1 are highly expressed on blood platelets and megakaryocytes, their immediate precursors. After vessel injury, subendothelial collagen becomes exposed and induces platelet activation to prevent blood loss. Collagen types I and IV are thought to have opposite effects on platelet biogenesis, directing proplatelet formation (PPF) towards the blood vessels to prevent premature release within the marrow cavity. We used megakaryocytes lacking collagen receptors or treated megakaryocytes with blocking antibodies, and could demonstrate that collagen-I-mediated inhibition of PPF is specifically controlled by GPVI. Other collagen types competed for binding and diminished the inhibitory signal, which was entirely dependent on receptor-proximal Src family kinases, whereas Syk and LAT were dispensable. Adhesion assays indicate that megakaryocyte binding to collagens is mediated by α2β1, and that collagen IV at the vascular niche might displace collagen I from megakaryocytes and thus contribute to prevention of premature platelet release into the marrow cavity and thereby directionally promote PPF at the vasculature.
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Affiliation(s)
- Daniela Semeniak
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Rebecca Kulawig
- Laboratory for Pediatric Molecular Biology, Charité-University Medicine, 13353 Berlin, Germany
| | - David Stegner
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany Rudolf Virchow-Zentrum, University of Würzburg, 97080 Würzburg, Germany
| | - Imke Meyer
- Laboratory for Pediatric Molecular Biology, Charité-University Medicine, 13353 Berlin, Germany
| | - Silke Schwiebert
- Laboratory for Pediatric Molecular Biology, Charité-University Medicine, 13353 Berlin, Germany
| | - Hendrik Bösing
- Laboratory for Pediatric Molecular Biology, Charité-University Medicine, 13353 Berlin, Germany
| | - Beate Eckes
- Department of Dermatology, University of Cologne, 50937 Cologne, Germany
| | - Bernhard Nieswandt
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany Rudolf Virchow-Zentrum, University of Würzburg, 97080 Würzburg, Germany
| | - Harald Schulze
- Institute of Experimental Biomedicine, University Hospital Würzburg, 97080 Würzburg, Germany Laboratory for Pediatric Molecular Biology, Charité-University Medicine, 13353 Berlin, Germany
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A novel role for von Willebrand factor in the pathogenesis of experimental cerebral malaria. Blood 2015; 127:1192-201. [PMID: 26511133 DOI: 10.1182/blood-2015-07-654921] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/19/2015] [Indexed: 01/28/2023] Open
Abstract
Plasmodium falciparum malaria infection is associated with an early marked increase in plasma von Willebrand factor (VWF) levels, together with a pathological accumulation of hyperreactive ultra-large VWF (UL-VWF) multimers. Given the established critical role of platelets in malaria pathogenesis, these increases in plasma VWF raise the intriguing possibility that VWF may play a direct role in modulating malaria pathogenesis. To address this hypothesis, we used an established murine model of experimental cerebral malaria (ECM), in which wild-type (WT) C57BL/6J mice were infected with Plasmodium berghei ANKA. In keeping with findings in children with P falciparum malaria, acute endothelial cell activation was an early and consistent feature in the murine model of cerebral malaria (CM), resulting in significantly increased plasma VWF levels. Despite the fact that murine plasma ADAMTS13 levels were not significantly reduced, pathological UL-VWF multimers were also observed in murine plasma following P berghei infection. To determine whether VWF plays a role in modulating the pathogenesis of CM in vivo, we further investigated P berghei infection in VWF(-/-) C57BL/6J mice. Clinical ECM progression was delayed, and overall survival was significantly prolonged in VWF(-/-) mice compared with WT controls. Despite this protection against ECM, no significant differences in platelet counts or blood parasitemia levels were observed between VWF(-/-) and WT mice. Interestingly, however, the degree of ECM-associated enhanced blood-brain barrier permeability was significantly attenuated in VWF(-/-) mice compared with WT controls. Given the significant morbidity and mortality associated with CM, these novel data may have direct translational significance.
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Marjoram RJ, Li Z, He L, Tollefsen DM, Kunicki TJ, Dickeson SK, Santoro SA, Zutter MM. α2β1 integrin, GPVI receptor, and common FcRγ chain on mouse platelets mediate distinct responses to collagen in models of thrombosis. PLoS One 2014; 9:e114035. [PMID: 25415203 PMCID: PMC4240667 DOI: 10.1371/journal.pone.0114035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 11/03/2014] [Indexed: 12/29/2022] Open
Abstract
Objective Platelets express the α2β1 integrin and the glycoprotein VI (GPVI)/FcRγ complex, both collagen receptors. Understanding platelet-collagen receptor function has been enhanced through use of genetically modified mouse models. Previous studies of GPVI/FcRγ-mediated collagen-induced platelet activation were perfomed with mice in which the FcRγ subunit was genetically deleted (FcRγ−/−) or the complex was depleted. The development of α2β1−/− and GPVI−/− mice permits side-by-side comparison to address contributions of these collagen receptors in vivo and in vitro. Approach and Results To understand the different roles played by the α2β1 integrin, the GPVI receptor or FcRγ subunit in collagen-stimulated hemostasis and thrombosis, we compared α2β1−/−, FcRγ−/−, and GPVI−/− mice in models of endothelial injury and intravascular thrombosis in vivo and their platelets in collagen-stimulated activation in vitro. We demonstrate that both the α2β1 integrin and the GPVI receptor, but not the FcRγ subunit influence carotid artery occlusion in vivo. In contrast, the GPVI receptor and the FcRγ chain, but not the α2β1 integrin, play similar roles in intravascular thrombosis in response to soluble Type I collagen. FcRγ−/− platelets showed less attenuation of tyrosine phosphorylation of several proteins including RhoGDI when compared to GPVI−/− and wild type platelets. The difference between FcRγ−/− and GPVI−/− platelet phosphotyrosine levels correlated with the in vivo thrombosis findings. Conclusion Our data demonstrate that genetic deletion of GPVI receptor, FcRγ chain, or the α2β1 integrin changes the thrombotic potentials of these platelets to collagen dependent on the stimulus mechanism. The data suggest that the FcRγ chain may provide a dominant negative effect through modulating signaling pathways in platelets involving several tyrosine phosphorylated proteins such as RhoGDI. In addition, these findings suggest a more complex signaling network downstream of the platelet collagen receptors than previously appreciated.
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Affiliation(s)
- Robin J. Marjoram
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Zhengzhi Li
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Li He
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Douglas M. Tollefsen
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Thomas J. Kunicki
- Children's Hospital of Orange County, Orange, CA, United States of America
| | - S. Kent Dickeson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Samuel A. Santoro
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Mary M. Zutter
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States of America
- * E-mail:
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