Factor VIII Related Antigen in Normal Blood Platelets and in Platelets of Patients with von Willebrand’s Disease

1975 ◽  
Author(s):  
B. N. Bouma ◽  
J. M. Hordijk-Hos ◽  
S. de Graaf ◽  
J. A. van Mourik ◽  
J. J. Sixma

The presence of Factor VIII-related antigen (F VIIIRA) in haemostatic plugs was demonstrated by immunofluorescent techniques. Immunofluorescent studies of intact washed platelets incubated with rabbit antifactor VIII in suspension showed that most of the platelets did not stain, whereas a positive staining was obtained after disruption of the membranes after air-drying of a drop of the same platelet suspension on a glass slide. This suggested that F VIIIRA was localized inside the platelets. F VIIIRA was detected in the supernatant of washed platelet suspensions that had been lysed by freezing and thawing (4 ×). This platelet F VIIIRA could not be distinguished from plasma factor VIII in immuno diffusion studies and cross-immuno-electrophoresis using antinormal factor VIII and the antisera against the low ionic strength subunits of factor VIII. The concentration of F VIIIRA in normal platelets was about 60 times as high as the concentration in plasma. Normal concentrations of F VIIIRA were detected in blood platelets and in 13 out of 15 patients with Von Willebrand’s Disease. No F VIIIRA was detected in the plasma of these patients with Von Willebrand’s Disease. Blood platelet F VIIIRA of normal platelets and of platelets of patients with Von Willebrand’s Disease supported the Ristocetin aggregation of washed platelets.

1978 ◽  
Vol 40 (02) ◽  
pp. 288-301 ◽  
Author(s):  
P Meucci ◽  
I R Peake ◽  
A L Bloom

SummaryFactor VIII-related activities have been studied in platelet fractions in order to try to reconcile the conflicting findings of other workers, and to extend the studies. In platelets from 16 normal subjects procoagulant factor VIII was not detected. The amount of factor VIII-related antigen (FVIIIR: AG) in the cytosol per mg of protein was about twice that in the membrane fraction and about ten times that in the debris fraction. There was no significant difference between the amount of FVIIIR: AG and ristocetin cofactor (RistCof) activity in each fraction. The findings in haemophilic platelets were similar. In von Willebrand’s disease (vWd) one serverely affected patient had no detectable factor VIII related activities in any platelet fraction. In 5 patients with intermediate vWd results were normal. In a further 5, with more prolonged bleeding times, no FVIIIR: RistCof was detected in platelets, despite a normal amount of FVIIIR: AG in the cytosol and debris. The electrophoretic mobility of cytosol FVIIIR: AG was increased in all normals and patients, while that in the membrane and debris fractions had normal mobility. Cytosol FVIIIR: AG eluted later than normal FVIIIR: AG on gel filtration on Sepharose 2B, and also showed reduced antibody binding in an immunoradiometric assay. Precipitation of FVIIIR: AG by concanavalin A was incomplete in all platelet fractions from normals, and even more reduced in vWd platelet fractions. The results suggest the possibility of two types of platelet FVIIIR: AG.A factor VIII-related antigen was shown to be associated with normal washed platelets by immunofluorescence techniques (Bloom et al. 1973). Since then, several studies have been reported on the localisation of factor VIII related antigen (FVIIIR: AG), factor VIII procoagulant activity (FVIII: C) and factor VIII related ristocetin cofactor activity (FVIIIR: RistCof) within the platelets. Initially, Howard et al. (1974) indicated that FVIIIR: AG was firmly bound to the platelet membrane, and noted that in lysed platelets the level of FVIIIR: AG as measured by electroimmunodiffusion was higher than that in whole platelet suspensions. However, further studies by Nachman and Jaffe (1975) showed that FVIIIR: AG was also present to a considerable extent in the granules, and they detected none in the platelet cytosol. Bouma and colleagues (1975) were, however, able to find FVIIIR: AG and FVIIIR: RistCof in the cytosol upon freezing and thawing platelets. This FVIIIR: AG had an electrophoretic mobility comparable to that of normal plasma. They also noted that platelets which were air dried apparently had a granular FVIIIR:AG localisation by immunfluorescence; however, intact platelets in suspension did not stain by this method.Recently Ruggeri et al. (1977) and Sultan et al. (1977) have also found FVIIIR: AG in the cytosol, and the former authors reported it to have increased electrophoretic mobility when compared to normal plasma FVIIIR:AG. Results concerning the localisation of FVIIIR: AG in normal platelets have thus been conflicting. Similarly, in the few reports available concerning platelet FVIIIR: AG in von Willibrand’s disease variable results have also been obtained (Ruggeri et al. 1977, Howard et al. 1974, Shearn et al. 1974 and Bouma et al. 1975).In this study we report on the localisation of factor VIII-related activities in normal, haemophilic and von Willebrand’s disease platelets using available standard techniques as well as precipitation of FVIIIR: AG with the plant lectin concanavalin A, a procedure which has been shown to detect abnormal forms of FVIIIR:AG in certain types of von Willebrand’s disease (Peake and Bloom 1977).


Nature ◽  
1975 ◽  
Vol 257 (5526) ◽  
pp. 510-512 ◽  
Author(s):  
B. N. BOUMA ◽  
J. M. HORDIJK-HOS ◽  
S. DE GRAAF ◽  
J. J. SIXMA ◽  
J. A. VAN MOURIK

1974 ◽  
Vol 31 (02) ◽  
pp. 328-338
Author(s):  
M. M. P Paulssen ◽  
H. L. M. A Vandenbussche-Scheffers ◽  
P. B Spaan ◽  
T de Jong ◽  
M. C Planje

SummaryFactor VIII occurs in the body in two different forms. In lymph factor VIII is bound to chylomicra. In plasma, factor VIII is bound to a protein.After delipidation of chylomicra we obtained a glycoprotein with a high polysaccharide content and a molecular weight of approx. 160,000.In plasma, factor VIII is attached to a protein which is present in normal concentrations in plasma of patients with haemophilia A and in serum (co-factor VIII).This factor is deficient in both the plasma and the serum of patients with von Willebrand’s disease.The binding between factor VIII and co-factor VIII is reversible.Some properties of these two factors are described.


1979 ◽  
Vol 42 (03) ◽  
pp. 848-854 ◽  
Author(s):  
Paul M Ness ◽  
Herbert A Perkins

SummaryAn enzyme immunoassay (EIA) system has been developed to measure factor VIII- related antigen (VIIIAGN). This assay gives similar results to the commonly used Laurell electroimmunodiffusion (EID) assay for VIIIAGN as shown by comparison of both techniques with samples from healthy controls, patients with hemophilia A, and patients with von Willebrand’s disease. The assay also has a greater precision than the EID technique as demonstrated by multiple assays of aliquots of a single sample. The use of this EIA test for VIIIAGN is simple and employs inexpensive reagents and equipment. The use of expensive antisera is minimized. EIA for VIIIAGN has the advantage of increased sensitivity compared to Laurell EIA.


Blood ◽  
1982 ◽  
Vol 59 (6) ◽  
pp. 1272-1278 ◽  
Author(s):  
ZM Ruggeri ◽  
PM Mannucci ◽  
R Lombardi ◽  
AB Federici ◽  
TS Zimmerman

Abstract We have studied the modifications in the multimeric composition of plasma factor VIII/von Willebrand factor and the bleeding time response following administration of 1-Deamino-[8-D-arginine]-Vasopressin (DDAVP) to patients with different subtypes of von Willebrand's disease. In type I, all multimers were present in plasma in the resting state, though they were decreased in concentration. Administration of DDAVP resulted in an increased concentration of these forms as well as the appearance of larger forms than were previously present. There was concomitant correction of the bleeding time. In type IIA, large multimers were absent in the resting state, and although DDAVP induced an average threefold increase in the plasma concentration of factor VIII/von Willebrand factor, the larger multimers did not appear and the bleeding time, although shortened, was not corrected. In contrast, the larger multimers that were also absent from type IIB plasma in the resting state rapidly appeared following DDAVP administration. However, their appearance was transitory and the bleeding time, as in IIA patients, was shortened but not corrected. The characteristic multimeric composition of platelet factor VIII/von Willebrand factor in given subtypes predicted the alteration in plasma factor VIII/von Willebrand factor induced by DDAVP. These studies provide evidence that the different subtypes of von Willebrand's disease represent distinct abnormalities of factor VIII/von Willebrand factor. They also suggest that complete hemostatic correction following DDAVP can be routinely expected only in type I von Willebrand's disease, and only if factor VIII/von Willebrand factor can be raised to normal levels.


Blood ◽  
1981 ◽  
Vol 57 (1) ◽  
pp. 25-31 ◽  
Author(s):  
PM Mannucci ◽  
ZM Ruggeri ◽  
N Ciavarella ◽  
MD Kazatchkine ◽  
JF Mowbray

Abstract Precipitating antibodies to factor VII/von Willebrand factor can develop in patients with severe homozygous-like von Willebrand's disease following multiple transfusions with blood derivatives. This study of 4 patients treated with cryoprecipitate for 13 different bleeding episodes demonstrates that the occurrence of such antibodies interferes with the management of the disease. The control of mucosal bleeding was poor, whereas more favorable responses were obtained in soft-tissue hemorrhages. These findings probably relate to failure of replacement therapy to shorten the prolonged bleeding time. Immediately after treatment, measurement of plasma factor VIII/von Willebrand factor-related antigen and ristocetin cofactor showed either no increase, or very low values, depending on the pre-infusion antibody titer. Levels of the factor VIII/von Willebrand factor-related procoagulant activity in the circulation were also lower than predicted and usually there was no evidence of the delayed and sustained rise typically observed in uncomplicated von Willebrand's disease. An anamnestic rise in antibody titer appeared 6–15 days after treatment and showed no obvious relationship with the amount of cryoprecipitate infused. Replacement therapy invariably caused severe side effects during, or immediately after, concentrate infusion. The results of in vitro studies support the view that these reactions were due to the appearance of circulating immune complexes.


1977 ◽  
Author(s):  
B.N. Bouma ◽  
S.de Graaf ◽  
T.S. Zimmerman

The location of Factor VIII-Related Antigen (FVIII R:AG) in human blood platelets was evaluated by treating intact platelets with chymotrypsin and observing the effect on the relative distribution of FVIII R:AG in different platelet fractions. Platelets were fractionated using the glycerol gradient technique. In untreated platelets from 12 normal individuals 95.5% of total platelet FVIII R:AG was found in the soluble fraction, 4.5% in the granules and less than 0.01% in the membrane fraction. Treatment of washed platelets with chymotrypsin resulted in the appearance of FVIII R:AG outside the platelets, and the amount of FVIII R:AG in the soluble fraction decreased in parallel. This suggests that at least part of platelet FVIII R:AG is exposed on the surface of the platelets, and that this FVIII R:AG is released from the membranes during homogeniza-tion. FVIII R:AG present in the soluble fraction was analyzed on SDS-polyacrylamide gels in the presence of reducing agents. A PAS-positive band with an apparent mol wt similar to plasma FVIII R:AG was observed. This band was identified as FVIII R:AG by specific removal with insolubilized anti-factor VIII. Granule FVIII R:AG showed crossed immunoelectrophoretic and ultracentrifugational characteristics similar to plasma FVIII R:AG. In contrast studies of FVIII R:AG in the soluble fraction using the same techniques showed a smaller average size than plasma FVIII R:AG. Our results indicate that platelet FVIII R:AG, isolated in the soluble platelet fraction, originates in part from the surface of the platelet and is therefore a glycocalicin-like protein.


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