A Method for Systematic Purification from Bovine Plasma of Six Vitamin K-Dependent Coagulation Factors: Prothrombin, Factor X, Factor IX, Protein S, Protein C, and Protein Z1

1985 ◽  
Vol 97 (5) ◽  
pp. 1347-1355 ◽  
Author(s):  
Nobukazu HASHIMOTO ◽  
Takashi MORITA ◽  
Sadaaki IWANAGA
2018 ◽  
Vol 24 (9_suppl) ◽  
pp. 42S-47S ◽  
Author(s):  
Antonio Girolami ◽  
Silvia Ferrari ◽  
Elisabetta Cosi ◽  
Claudia Santarossa ◽  
Maria Luigia Randi

Vitamin K-dependent clotting factors are commonly divided into prohemorrhagic (FII, FVII, FIX, and FX) and antithrombotic (protein C and protein S). Furthermore, another protein (protein Z) does not seem strictly correlated with blood clotting. As a consequence of this assumption, vitamin K-dependent defects were considered as hemorrhagic or thrombotic disorders. Recent clinical observations, and especially, recent advances in molecular biology investigations, have demonstrated that this was incorrect. In 2009, it was demonstrated that the mutation Arg338Leu in exon 8 of FIX was associated with the appearance of a thrombophilic state and venous thrombosis. The defect was characterized by a 10-fold increased activity in FIX activity, while FIX antigen was only slightly increased (FIX Padua). On the other hand, it was noted on clinical grounds that the thrombosis, mainly venous, was present in about 2% to 3% of patients with FVII deficiency. It was subsequently demonstrated that 2 mutations in FVII, namely, Arg304Gln and Ala294Val, were particularly affected. Both these mutations are type 2 defects, namely, they show low activity but normal or near-normal FVII antigen. More recently, in 2011-2012, it was noted that prothrombin defects due to mutations of Arg596 to Leu, Gln, or Trp in exon 15 cause the appearance of a dysprothrombinemia that shows no bleeding tendency but instead a prothrombotic state with venous thrombosis. On the contrary, no abnormality of protein C or protein S has been shown to be associated with bleeding rather than with thrombosis. These studies have considerably widened the spectrum and significance of blood coagulation studies.


1987 ◽  
Author(s):  
A D'Angelo ◽  
F Gilardoni ◽  
M P Seveso ◽  
P Poli ◽  
R Quintavalle ◽  
...  

Isolated deficiencies of protein C and protein S, two vitamin K-dependent plasma proteins, constitute about 70% of the congenital abnormalities of blood coagulation observed in patients with recurrent venous thrombosis beLow the age of 40. The laboratory diagnosis of congenital deficiency of these proteins represents a major problem since a large proportion of patients are on oral anticoagulation (OA) at the time the deficiencies are suspected.Under these circumstances the availability of a reference interval obtained in patients on stabilized OA has proven useful.Functional (C) and antigenic levels (Ag) of protein C, protein S, factor IX and II were estimated in 136 patients on stabilized OA, subdivided according to the degree of anticoagulation (Internatio nal Normalized Ratio, INR).The results indicate that with increasing anticoagulation the activity levels of all the vitamin K-dependent factors decrease to a greater extent than the corresponding antigenic levels. At variance with the other factors, total protein S antigen levels are only moderately reduced by OA with protein S anticoagulant activi ty comparing well to factor IX clotting activity. These data suggest the possibility of identifying both quantitative and qualita tive deficiencies of protein C and protein S in patients on oral anticoagulant treatment.


1987 ◽  
Author(s):  
M L Wiesel ◽  
R Spaethe ◽  
J-M Freyssinet ◽  
T Tran ◽  
H-J Kolde ◽  
...  

The activation of protein C (PC) by thrombin requires the presence of an endothelial membrane cofactor, thrombomodulin (TM). Activated PC (APC) exerts its anticoagulant activity by degrading factors (F) Va and Villa in the presence of phospholipids and of a vitamin K-dependent cofactor, protein S. Tissue factor (TF) is the essential cofactor of factor Vll/VIIain the activation of factor X. TF is synthetized by several cell lines including endothelial cells. Using a specific TM assay, up to 0.85 units of TM activity could be detected in commercial thromboplastin (TP) preparations from human placenta or rabbit or porcine lung, when the amount of TP was adjusted to contain 1 unit of TF activity. Preparations from brain contained very low amounts, if any, of this activity (< 0.02 TM units). In order to evaluate the effects of the presence of TM activity in some TP preparations, the stability of F V and VIII activities was examined after activation of the coagulation system by these TP in various plasmas. PC deficient plasmas, plasmas lacking F V, VIII or IX and immunoadsorbed PC deficient plasma supplemented with purified human PC (5 Ug/ml) were used. After activation with placenta or lung TP, F V and VIII activities were markedly reduced ( ∼ 90 % reduction) in normal and hemophiliac plasmas, whereas they remained high after activation with brain TP. F V and VIII activities were preserved in protein C deficient plasma after activation by all TP preparations. The same decrease of F V and VIII activities was observed after activation of immunoadsorbed PC deficient plasma supplemented with purified PC with placenta or lung TP only. Preincubation of TP from human placenta with antibodies to human TM raised in laying hens abolished the capacity of this preparation to destroy F V activity of PC containing plasmas. These results establish the presence of TM activity in crude thromboplastin preparations from placenta or from lung. Surprisingly, this anti-coagulant activity seems to be absent from brain. TM from placenta or lung extracts is responsible for the degradation of F V and VIII.


1987 ◽  
Author(s):  
S R Poort ◽  
C Krommenhoek-van Es ◽  
I K van der Linden ◽  
N H van Tilburg ◽  
R M Bertina

Vitamin K-dependent (anti)coagulation factors (factor II, VII, IX, X protein C and S) undergo a conformational transition upon binding of Ca(II), which is a prerequisite for their normal function. Abnormalities in these properties occur during vitamin K deficiency or treatment with anti vitamin K drugs and in some genetic variants of coagulation factors. Immunological assays utilizing antibodies against the Ca(II)-stabilized structure are useful to detect such abnormalities.Starting from specific rabbit antisera antibody populations specific for the Ca(II)-dependent conformation of factor II, VII, IX, X and protein C and S were isolated using immuno-affinity procedures. Subsequently immunoradiometric assays specific for the Ca(II)-dependent (Ca(II)Ag) and Ca(II)-independent (NonCa(II)Ag) conformations of the different proteins were developed. These assays were used for the analysis of plasmas of patients stably treated with oral anticoagulants; Ca(II)Ag, NonCa(II)Ag and their ratio were measured as function of the intensity of the treatment (INR 2.4 to 4.8). The same parameters were measured in plasmas of patients with hereditary coagulation disorders. After treatment with oral anticoagulation with an antivitamin K drug reduced ratios of Ca(II)Ag/-NonCa(II)Ag were observed for factor II, VII, IX, protein C and protein S. However, the actual degree of reduction and its dependence on the intensity of treatment varied for the different vitamin K-dependent proteins. In general Ca(II)Ag levels correspond nicely with the procoagulant activity of the concerning proteins. These data provide indirect evidence for the existence of abnormal (non and/or subcarboxylated) forms of the vitamin K-dependent proteins during oral anticoagulant treatment.Genetic variants with a mutation in one of the sites involved in the formation of the Ca(II)-s tab i1ized structure could be detected for factor IX, factor VII and factor II. However, the extent of reduction of the ratio Ca(II)Ag/-NonCa(II)Ag differed considerably in those variants.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2585-2585
Author(s):  
Carla Vossen ◽  
Peter Callas ◽  
Frits Rosendaal ◽  
Sandra Hasstedt ◽  
Bruce Scott ◽  
...  

Abstract The identification of genes affecting plasma concentrations of biological traits remains difficult, as the loci affecting such traits (termed quantitative trait loci) tend to explain only a fraction of the phenotypic variation. Evidence on inter-relation (i.e. clustering) of coagulation factors in the literature (Van Hylckama Vlieg 2003) suggests the existence of quantitative trait loci, which influence plasma concentrations of several quantitative traits (i.e.have a pleiotropic effect) outside the genes coding for these factors. The aim of the present study was to identify clusters of pro- and anticoagulant factors within a large protein C deficient kindred using principal components analysis. In addition, we wanted to determine how much of the variance within these clusters could be attributed to the genetic variation within a single large pedigree. Levels of the following analytes were measured in family members: prothrombin, factor V, VII, VIII, IX, X, fibrinogen, von Willebrand factor, antithrombin, protein C and protein S. Subjects with the 3363C protein C mutation, a personal history of thrombosis or those using oral anticoagulants, and women pregnant at the time of the blood draw were excluded from the analyses. To identify clusters of haemostatic factors, the principal component method with orthogonal varimax rotation was performed using SPSS. We used a factor loading of &gt;0.40 as a marginal value to include coagulation factors in a cluster. Heritability, the proportion of the phenotypic variance attributed to polygenes, and common household effect, the proportion of the variance attributed to environmental factors shared within a household, were estimated for each principal component score with an eigenvalue (the variance attributable to a particular principal component) greater than or equal to 1 using the variance component method in SOLAR (Almasy & Blangero 1998). The distribution of each score was assumed to be multivariate normal with a variance-covariance matrix following the formula: covariance (one person to another person)=h2K + c2H + e2I, with K derived from the kinship matrix, H from the household matrix and I from the identity matrix. The additive genetic and household components of variance were estimated using maximum likelihood analysis. A total of 87 family members met the inclusion criteria. The principal components analysis identified 3 components which explained 60% of the variance: component 1 included all vitamin K dependent factors (prothrombin, factor VII, factor IX and factor X, protein C and protein S), component 2 consisted of factor V, factor IX, fibrinogen and antithrombin, which all can interact directly with thrombin, and component 3 consisted of factor VIII and its carrier protein von Willebrand factor. The heritability estimates for these 3 components were, respectively, 96% (p=0.002), 87% (p&lt;0.001) and 12% (p=0.33). These findings appear to provide evidence for the existence of genes that regulate the levels of distinct groups of proteins in the coagulation system, thus leading to clustering of levels suggestive of a pleiotropic effect.


1987 ◽  
Vol 57 (01) ◽  
pp. 020-024 ◽  
Author(s):  
A W Broekmans ◽  
J Conard ◽  
R G van Weyenberg ◽  
M H Horellou ◽  
C Kluft ◽  
...  

SummaryFive type I protein C deficient male patients received 5 mg stanozolol b.i.d. during 4 weeks. After four weeks of treatment plasma protein C activity increased from 0.42 to 0.74 U/ml and protein C antigen from 0.49 to 0.75 U/ml. This approximately 1.6 fold increase in plasma protein C was accompanied by an increase in factor II antigen (1.5 fold), factor V activity (1.6 fold), factor X antigen (1.1 fold), antithrombin III antigen (1.3 fold) and heparin cofactor II antigen (1.5 fold), while the concentration of factor VII, factor VIII, and factor IX activity, and of protein S antigen remained unchanged. Prothrombin fragment F1+2, measured in two patients, increased 1.3 fold. In addition to its effect on procoagulant and anticoagulant factors stanozolol had profibrinolytic effects, reflected in an increase in tPA activity and in the concentration of plasminogen. These data indicate that in type I protein C deficient patients stanozolol increases the concentrations of both procoagulant and anticoagulant factors and favours fibrinolysis. The efficacy of stanozolol in preventing thrombotic disease in type I protein C deficient patients, however, remains to be established. During the four weeks of stanozolol treatment no thrombotic manifestations were observed in the protein C deficient patients.


1987 ◽  
Author(s):  
Patrick J O'hara ◽  
Frank A Grant ◽  
A Betty ◽  
J Haldmen ◽  
Mark J Murray

Factor VII is a member of a family of vitamin K-dependent, gamma-carboxylated plasma protein which includes factor IX, factor X, protein C, protein S and prothrombin. Activated factor VII (factor Vila) is a plasma serine protease which participates in a cascade of reactions leading to the coagulation of blood. Two overlapping genomic clones containing sequences encoding human factor VII were isolated and characterized. The complete sequence of the gene was determined and found to span 12.8 kilobases. The mRNA for factor VII as demonstrated by cDNA cloning is polyadenylated at multiple sites but contains only one AAUAAA poly-A signal sequence. The mRNA can undergo alternative splicing forming one transcript containing eight segments as exons and another with an additional exon which encodes a larger pre-pro leader sequence. The portion of the pre-pro leader coded for by the additional exon has no known counterpart in the other vitamin K-dependent proteins. The positions of the introns with respect to the amino acid sequence encoded by the eight essential exons of factor VII are the same as those present in factor IX, factor X, protein C and the first three exons of prothrombin. These exons code for domains generally conserved among members of this gene family, including a pre-pro leader (the essential exon la and alternative exon lb), a gamma-carboxylated domain (exons 2 and 3) a growth factor domain (exons 4 and 5) an activation region (exon 6) and a serine protease (exon 8). The corresponding introns in these genes are dissimilar with respect to size and sequence, with the exception of the third intron in factor VII and protein C. Four introns and a portion of exon 8 in factor VII contain regions made up of tandem repeats of oligonucleotide monomer elements. More than a quarter of the intron sequences and more than a third of the 3' untranslated portion of the mRNA transcript consist of these minisatellite tandem repeats. This type of structure is responsible for polymorphisms due to allelic variation in repeat copy number in other areas of the human genome. Tandem repeats can evolve as a result of random crossover in DNA whose sequence is not maintained by selection. This suggests that much of the sequence information present in the introns and untranslated portion of the message is dispensable.


1987 ◽  
Author(s):  
J M Freyssinet ◽  
A Beretz ◽  
C Klein-Soyer ◽  
J Gauchy ◽  
J Gauchy ◽  
...  

Protein C (PC) activation by thrombin (T) occurs at the endothelial cell (EC) surface in the presence of thrombomodulin (TM). Reconstitution of purified TM into phospholipid (PL) vesicles results in an increased activation of PC but not of Gla-domainless-PC (GD-PC), a chymotryptic derivative of PC lacking the γ-carboxyglutamic acid domain (Gla-domain). We show that several human vitamin K-dependent proteins can interfere in the activation of human PC by the human T-TM complex either in the presence or in the absence of PL. Prothrombin fragment 1 (F1), peptide 1 -4.1, the N-terminal chymotryptic Gla-domain of prothrombin (F II), FI I and factor X (FX) were able to inhibit PC activation. They had no effect on the amidolytic activity of activated PC. Non-competitive inhibition was observed in the presence of 10 yM F1 when PC, at various concentrations, was activated by the 8 μM T-TM complex, at 2 mM Ca2+, with or without PL-reconstituted TM. In any case the apparent Km remained unchanged at 2 μM. In the presence of optimal PL concentrations and in the absence of F1, the Vmax could be enhanced up to 9-fold. When F1 was present, the extents of inhibition with and without PL were comparable and resulted in a 3fold decrease of the Vmax. These effects were independent of Ca2+ between 1 and 5 mM and of T between 10 and 50 nM. At 0.6 μM PC, half maximal inhibition occurred at 8μM F1 and 1 μM peptide 1-41 in the presence or in the absence of PL. Protein S and factors VII and IX had only minimal effect. The inhibition due to F1 and FX was also noticed when PC was activated by T in the presence of cultured human vascular EC. A Ki of 4 μM could be determined for F1 with EC-bound TM. The non-competitive character was confirmed by the observation that F1 could also inhibit the activation of GD-PC by the T-TM complex. Incomplete heat-decarboxylation of F1 and FII, partially abolished their capacity to inhibit PC activation. These results suggest that the Gla domain of PC is involved in two distinct types of interactions. This vitamin K-dependent functional entity is necessary to allow the enhancement of PC activation by anionic PL and also interacts with the T-TM complex.


1987 ◽  
Author(s):  
B Grossman ◽  
A Duncan

Hereditary causes of thrombosis are becoming more evident as assays (and antibodies) for antithrombin III, protein C, and protein S become more widely available. From March 1986 to January 1987, ninety-nine patients with venous thrombosis were referred to our laboratory for evaluation.This included 55 males and 42 females (age ranges:(1- 79 years). In 79 patients protein C antigens and activities were performed and 24 abnormally low values were obtained. Fourteen of these patients had multiple low values of other vitamin K dependent coagulation factors, reflecting warfarin therapy. Ten patients (12.7%) had isolated protein C deficiency with the other vitamin K dependent factors being within our normal ranges. Of 75 free protein S antigens performed there were 32 abnormally low values. Thirteen (17.3%) were isolated deficiencies. Of 62 antithrombin III antigens and activities measured, there were 8 (12.9%) abnormally low values. The prevelance of these hereditary deficiencies are higher in our referral population than previously reported. This may represent a true increase prevelance in our referral population or reflect a selection bias because of our careful screening of the patient́s history prior to performing the test, or an increased availability of the test to the clinicians. These test should be performed routinely in young patients with venous thrombosis and without predisposing risk factors. These results confirm that all patients with thrombosis should have a comprehensive evaluation done. Not only will the etiology be determined but given the cost of these evaluations, it is more efficient to profile rather than to order isolated request for one factor, as has often been the habit in the past


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