Characterization of Fibronectin Assembly by Adherent Platelets Under Flow Conditions: Effect of Shear Stress and Role of β3 Integrins

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5191-5191
Author(s):  
Khon C. Huynh ◽  
Volker R. Stoldt ◽  
Marianna Gyenes ◽  
Rüdiger E. Scharf

Abstract Abstract 5191 Introduction: To fulfill their role in hemostasis, circulating platelets need to irreversibly adhere to the site of vascular injury and to resist to shear stress generated by the flowing blood. We previously reported that there is a relationship between the conformation of fibronectin (Fn) and its role in platelet adhesion and aggregation (Huynh, K. C. et al., ASH Annual Meeting Abstract, 2011. 118(21): p. 2209). In the present study, we examined the effect of shear stress on the assembly of Fn by adherent platelets. Moreover, we studied the role of β3 integrins (αIIbβ3 and αvβ3) in Fn assembly under flow conditions. Methods: Alexa fluor 488-conjugated fibronetin (Fn488) was added to suspensions of washed platelets (108/ml) in HEPES Tyrode buffer. CaCl2 (2 mM) and ADP (10 μM) were added immediately prior to the experiments. The samples (150 μl) were subsequently applied onto plates precoated with 50 μg/ml Fn. A DiaMed Impact-R device was used to generate shear rates of 500 s−1 or 5000 s−1 for 2 min or 10 min. Nonadherent platelets were removed by washing with PBS buffer followed by addition of 150 μl of 2 % DOC lysis buffer. Lysates were collected and total protein concentrations were determined by Bradford assay. The DOC-insoluble pellets containing Fn fibrils were isolated by centrifugation at 13, 500 rpm for 20 min. Pellets were then solubilized with 100 μl of 1 % SDS buffer. Equal amounts of samples based on total protein concentrations were loaded onto wells of 96-well microplates. Fluorescence signals from Fn488 of samples were recorded by a Fluoroskan microplate reader. In some experiments, abciximab (anti-β3, 10 μg/ml) or LM609 (anti-αvβ3, 5 μg/ml) antibody, were added to platelet mixtures before loading onto Fn precoated plates. All data were collected from at least three different experiments and analyzed using GraphPad Quickcals. To test for statistical differences, student's t-test was used. Results: Fn assembly by adherent platelets was strongly affected by the applied shear rate but not by the exposure time to shear. At a shear rate of 500 s−1, there were no insoluble Fn fibrils detectable in samples with adherent platelets after 2 or 10 min. When shear rates increased from 500 s−1 to 5000 s−1, the amount of insoluble Fn detectable on platelets after 2 and 10 min increased significantly (p < 0. 05) suggesting that adherent platelets exposed to high shear rates assemble more Fn fibrils on their surface. However, prolongation of exposure time to shear from 2 to 10 min did not result in significantly more Fn assembled by adherent platelets. By contrast, there were no insoluble fibrils that could be detected with adherent platelets under static conditions for 2 and 10 min. After 2 min at a shear rate of 5000 s−1, platelets blocked with abciximab showed a significant decrease in the amounts of insoluble Fn fibrils in comparison with control experiments (no antibody) (p = 0. 02). Similar inhibitory effects could be seen with platelets treated with LM609. In parallel experiments in which 10 min at 5000 s−1 were applied, both abciximab and LM609 had an inhibitory effect on Fn fibrillogenesis with a stronger effect by abciximab. Taken together, these data show that αvβ3 even at the low expression on platelets plays a major role in initiating the fibrillogenesis of Fn under high shear rate conditions, whereas αIIbβ3 contributes to the progression of Fn fibrils formation subsequently. Conclusion: Our observations document that the assembly of Fn on the surface of adherent platelets is strongly affected by shear rate conditions. In addition, our data imply that, despite its lower expression on platelet surface, αvβ3 provides a significant contribution in initiating the Fn assembly under high flow conditions, as compared with αIIbβ3. By contrast, αIIbβ3 with its abundant amount on the platelet surface probably exerts its effect in the later phase of Fn fibrillogenesis. The present findings support the contention that not a single integrin or Fn binding domain, but multiple interaction steps including different molecules and Fn domains may be involved in assembling Fn. Disclosures: No relevant conflicts of interest to declare.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2167-2167
Author(s):  
Marianna Gyenes ◽  
Volker R. Stoldt ◽  
Khon C. Huynh ◽  
Rüdiger E. Scharf

Abstract Abstract 2167 Objectives: Shear stress can activate platelets resulting in subsequent platelet aggregation. The so-called “shear-induced platelet aggregation” (SIPA) contributes to various vascular diseases (Speich et al., Am J Physiol Cell Physiol 2008). Several signaling pathways were proposed to be involved in this process, e.g., αIIbβ3-mediated signaling (Feng et al., Am J Physiol Cell Physiol 2006). We investigated the impact of shear stress on the αIIbβ3–ligand interaction in human platelets adherent onto fibrinogen. Platelets on immobilized fibrinogen were exposed to various shear rates and signaling of Src and FAK tyrosine kinases, both essential in the integrin downstream signaling pathways, were examined. Specifically, we analyzed the role of αIIbβ3 in shear-induced platelet signaling (i) by comparing the Src Y418 and FAK Y397 phosphorylation activities between platelets on immobilized fibrinogen and platelets on BSA matrix in response to shear stress, and (ii) by performing experiments in the presence of the αIIbβ3 antagonist abciximab. Methods: Human washed platelets were incubated on immobilized fibrinogen 100 μg/ml or 1% BSA either under static conditions or exposed to shear rates of 500 s−1 or 5000 s−1, respectively. Specific phosphorylation of Src (pY418) and FAK (pY397) was determined by Western blot and quantified densitometrically. Experiments under flow conditions were performed in a cone-plate viscometer. Results: Both Src and FAK exhibited phosphorylation under static conditions on immobilized fibrinogen after 2 min of adhesion. A shear rates of 500 s−1 did not increase the phosphorylation activities. By contrast, high shear rates (5000 s−1) significantly enhanced both Src and FAK phosphorylations in fibrinogen-adherent platelets (3-fold increase each, p<0.05). In the absence of immobilized fibrinogen, platelets incubated with BSA matrix did not show any Src activation under static conditions and only a very low Y418 phosphorylation activity in response to a shear rate of 500 s−1. A shear rate of 5000 s−1 considerably induced Src pY418 activity compared to platelets exposed to physiological shear stress (10-fold increase, p< 0.01). In response to shear rates of 500 s−1 or 5000 s−1, we detected a significantly higher Src activation in platelets adherent onto fibrinogen (500 s−1: 10-fold higher, p<0.01; 5000 s−1: 2-fold higher, p<0.05) than in platelets incubated over a BSA matrix indicating a ligand-dependent signaling. When platelets over BSA were exposed to a shear rate of 5000 s−1, FAK also exhibited a significant elevation of pY397 activity (9-fold increase, p<0.05). By contrast to Src, in platelets exposed to a shear rate of 500 s−1 or 5000 s−1, we observed approximately equal FAK pY397 activation, independent of the presence or absence of immobilized fibrinogen. In platelets incubated for 10 min on a fibrinogen matrix under static conditions, we did not detect any change in the Src activation compared to 2 min incubation. The activity of FAK pY397, however, was time-dependent and showed a 3-fold higher phosphorylation extent after 10 min than after 2 min adhesion (p<0.05). In response to a shear rate of 500 s−1 both Src Y418 and FAK Y397 phosphorylations exhibited a considerable time-dependent enhancement (comparing the phosphorylation activities after incubation for 2 or 10 min). This enhancement could be seen both in platelets adherent onto fibrinogen and in platelets over BSA (3 to 6-fold increase, p<0.05). In platelets exposed to a shear rate of 5000 s−1 for 10 min, the Src and FAK phosphorylation activities were similar to platelets after 2 min. Abciximab inhibited the Src and FAK signaling in platelets exposed to 5000 s−1 on immobilized fibrinogen. The same inhibition was seen in platelets exposed to 5000 s−1 over BSA (p<0.05). Conclusions: Exposure of platelets to high shear rates induces a significant increase of both Src and FAK signaling compared to platelets under static conditions. Whereas Src activation remains predominantly ligand-dependent in fibrinogen-adherent platelets even under shear stress, FAK signaling appears to be shear-induced. The finding that, abciximab inhibits the activation of both Src and FAK in the absence of fibrinogen, emphasizes the role of integrin αIIβ3 in the shear-induced platelet signaling. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1079-1079
Author(s):  
Agata Anna Nowak ◽  
Michael Laffan ◽  
Thomas A J McKinnon

Abstract Abstract 1079 Sialic acids (SA) are negatively charged monosaccharides present on the terminus of N- and O-linked glycans. They carry out diverse functions such as protection from proteolytic degradation and modulation of protein clearance. Both the N- and O-linked glycans of VWF are decorated with SA residues, which have been shown to block recognition and clearance of VWF via the asialoglycoprotein receptor (ASGPR). It has been previously shown that VWF devoid of SA residues exhibits increased platelet binding and decreased susceptibility to ADAMTS13 proteolysis, however this has only been shown under static conditions. In this study we have investigated the role of VWF SA under the physiological conditions of shear stress. Firstly, using a plate-based ELISA assay we confirmed that desialylated (ds)VWF demonstrated enhanced sensitivity to ristocetin-mediated binding to GPIbα Interestingly, this effect was attributed to α 2–3 linked SA which are present primarily on O-linked glycans. For analysis under flow conditions, a recombinant VWF fragment spanning the D'-A3 domains was immobilised on Ibidi flow slides and perfused with washed, labelled platelets and red blood cells at a range of shear rates. This fragment contains the majority of the O-linked glycans on VWF which are clustered either side of the A1 domain. At low shear rates (400–600s−1), dsD'A3 captured more platelets than wild type (wt) D'A3; whilst a similar number of platelets was captured to both proteins at high shear rates (1000–2000s−1). Platelet translocation velocity over dsD'A3 was decreased at all shear rates (400–2000s−1) when compared to wtD'A3: however the dissociation rate constant was unaltered. Interestingly, when perfused over a collagen type III coated surface in reconstituted blood, dsVWF and VWF devoid of only α 2–3 linked sialic acid residues (α 2–3dsVWF), both mediated platelet capture to a similar extent as wtVWF. In the absence of VWF, no platelet capture was detected, confirming that platelet capture under the shear rate applied (1500s−1) was VWF dependent. Subsequently, to assess susceptibility of ds- and α 2–3ds VWF to ADAMTS13 proteolysis under shear, recombinant ADAMTS13 was added to plasma free blood supplemented with VWF and perfused over collagen. In control experiments, the presence of ADAMTS13, but not the inactive ADAMTS13 variant (M225Q), diminished platelet capture demonstrating the assay was sensitive to ADAMTS13 proteolysis of VWF. Interestingly, the decrease in platelet capture in the presence of ADAMTS13 was significantly less with dsVWF and α 2–3dsVWF than with control VWF, demonstrating that dsVWF and α 2–3dsVWF are proteolysed slower by ADAMTS13 under shear stress and confirming the relevance of the results from static assays. Furthermore, these data suggest that it is the α 2–3 linked sialic acid residues capping mainly O-linked oligosaccharides which modulate VWF sensitivity to ADAMTS13 cleavage under high shear stress. In summary, these data demonstrate that sialylation of VWF increases its susceptibility to ADAMTS13 cleavage under flow but does not otherwise affect VWF mediated platelet capture to collagen. ADAMTS13 is crucial for regulating haemostasis, as it controls the size of newly secreted ultra large VWF multimers and can cleave VWF at sites of haemostatic plug formation. It has been previously shown that sialyltransferase expression levels vary between different tissues, and sialic acid expression can change in different pathological conditions, it is therefore important to characterise how the differences in VWF sialylation status affect its key properties such as platelets binding and susceptibility to proteolysis. Disclosures: No relevant conflicts of interest to declare.


1989 ◽  
Vol 61 (03) ◽  
pp. 485-489 ◽  
Author(s):  
Eva Bastida ◽  
Lourdes Almirall ◽  
Antonio Ordinas

SummaryBlood platelets are thought to be involved in certain aspects of malignant dissemination. To study the role of platelets in tumor cell adherence to vascular endothelium we performed studies under static and flow conditions, measuring tumor cell adhesion in the absence or presence of platelets. We used highly metastatic human adenocarcinoma cells of the lung, cultured human umbilical vein endothelial cells (ECs) and extracellular matrices (ECM) prepared from confluent EC monolayers. Our results indicated that under static conditions platelets do not significantly increase tumor cell adhesion to either intact ECs or to exposed ECM. Conversely, the studies performed under flow conditions using the flat chamber perfusion system indicated that the presence of 2 × 105 pl/μl in the perfusate significantly increased the number of tumor cells adhered to ECM, and that this effect was shear rate dependent. The maximal values of tumor cell adhesion were obtained, in presence of platelets, at a shear rate of 1,300 sec-1. Furthermore, our results with ASA-treated platelets suggest that the role of platelets in enhancing tumor cell adhesion to ECM is independent of the activation of the platelet cyclooxygenase pathway.


Blood ◽  
1987 ◽  
Vol 70 (4) ◽  
pp. 1214-1217
Author(s):  
E Fressinaud ◽  
D Baruch ◽  
C Rothschild ◽  
HR Baumgartner ◽  
D Meyer

Although it is well established that plasma von Willebrand Factor (vWF) is essential to platelet adhesion to subendothelium at high shear rates, the role of platelet vWF is less clear. We studied the respective role of both plasma and platelet vWF in mediating platelet adhesion to fibrillar collagen in a parallel-plate perfusion chamber. Reconstituted blood containing RBCs, various mixtures of labeled washed platelets and plasma from controls or five patients with severe von Willebrand disease (vWD), was perfused through the chamber for five minutes at a shear rate of 1,600 s-1. Platelet-collagen interactions were estimated by counting the radioactivity in deposited platelets and by quantitative morphometry. When the perfusate consisted of normal platelets suspended in normal plasma, platelet deposition on the collagen was 24.7 +/- 3.6 X 10(6)/cm2 (mean +/- SEM, n = 6). Significantly less deposition (16 +/- 2.3) was observed when vWD platelets were substituted for normal platelets. In mixtures containing vWD plasma, significantly greater deposition (9 +/- 2.2) was obtained with normal than with vWD platelets (1 +/- 0.4) demonstrating a role for platelet vWF in mediating the deposition of platelets on collagen. Morphometric analysis confirmed these data. Our findings indicate that platelet, as well as plasma, vWF mediates platelet-collagen interactions at a high shear rate.


2004 ◽  
Vol 70 (12) ◽  
pp. 7426-7435 ◽  
Author(s):  
Alexander H. Rickard ◽  
Andrew J. McBain ◽  
Amy T. Stead ◽  
Peter Gilbert

ABSTRACT The development of freshwater multispecies biofilms at solid-liquid interfaces occurs both in quiescent waters and under conditions of high shear rates. However, the influence of hydrodynamic shear rates on bacterial biofilm diversity is poorly understood. We hypothesized that different shear rates would significantly influence biofilm diversity and alter the relative proportions of coaggregating and autoaggregating community isolates. In order to study this hypothesis, freshwater biofilms were developed at five shear rates (<0.1 to 305 S−1) in a rotating concentric cylinder reactor fed with untreated potable water. Eubacterial diversity was assessed by denaturing gradient gel electrophoresis (DGGE) and culturing on R2A agar. Fifty morphologically distinct biofilm strains and 16 planktonic strains were isolated by culturing and identified by partial 16S rRNA gene sequencing, and their relatedness was determined by the construction of a neighbor-joining phylogenetic tree. Phylogenetic and DGGE analyses showed an inverse relationship between shear rate and bacterial diversity. An in vitro aggregation assay was used to assess the relative proportions of coaggregating and autoaggregating species from each biofilm. The highest proportion of autoaggregating bacteria was present at high shear rates (198 to 305 S−1). The intermediate shear rate (122 S−1) selected for the highest proportion of coaggregating bacteria (47%, or 17 of a possible 36 coaggregation interactions). Under static conditions (<0.1 S−1), 41 (33%) of a possible 125 coaggregation interactions were positive. Few coaggregation (3.3%) or autoaggregation (25%) interactions occurred between the 16 planktonic strains. In conclusion, these data show that shear rates affect biofilm diversity as well as the relative proportions of aggregating bacteria.


Blood ◽  
1995 ◽  
Vol 85 (3) ◽  
pp. 705-711 ◽  
Author(s):  
J Harsfalvi ◽  
JM Stassen ◽  
MF Hoylaerts ◽  
E Van Houtte ◽  
RT Sawyer ◽  
...  

Calin from the saliva of the medicinal leech, Hirudo medicinalis, is a potent inhibitor of collagen mediated platelet adhesion and activation. In addition to inhibition of the direct platelet-collagen interaction, we presently demonstrate that binding of von Willebrand to coated collagen can be prevented by Calin, both under static and flow conditions in agreement with the occurrence of binding of Calin to collagen, confirmed by Biospecific Interaction Analysis. To define whether Calin acted by inhibiting the platelet-collagen or the platelet- von Willebrand factor (vWF)-collagen-mediated thrombus formation, platelet adhesion to different types of collagens was studied in a parallel-plate flow chamber perfused with whole blood at different shear rates. Calin dose-dependently prevented platelet adhesion to the different collagens tested both at high- and low-shear stress. The concentration of Calin needed to cause 50% inhibition of platelet adhesion at high-shear stress was some fivefold lower than that needed for inhibition of vWF-binding under similar conditions, implying that at high-shear stress, the effect of Calin on the direct platelet- collagen interactions, suffices to prevent thrombus formation. Platelet adhesion to extracellular matrix (ECM) of cultured human umbilical vein endothelial cells was only partially prevented by Calin, and even less so at a high-shear rather than a low-shear rate, whereas the platelet binding to coated vWF and fibrinogen were minimally affected at both shear rates. Thus, Calin interferes with both the direct platelet- collagen interaction and the vWF-collagen binding. Both effects may contribute to the inhibition of platelet adhesion in flowing conditions, although the former seems to predominate.


Blood ◽  
1987 ◽  
Vol 70 (4) ◽  
pp. 1214-1217 ◽  
Author(s):  
E Fressinaud ◽  
D Baruch ◽  
C Rothschild ◽  
HR Baumgartner ◽  
D Meyer

Abstract Although it is well established that plasma von Willebrand Factor (vWF) is essential to platelet adhesion to subendothelium at high shear rates, the role of platelet vWF is less clear. We studied the respective role of both plasma and platelet vWF in mediating platelet adhesion to fibrillar collagen in a parallel-plate perfusion chamber. Reconstituted blood containing RBCs, various mixtures of labeled washed platelets and plasma from controls or five patients with severe von Willebrand disease (vWD), was perfused through the chamber for five minutes at a shear rate of 1,600 s-1. Platelet-collagen interactions were estimated by counting the radioactivity in deposited platelets and by quantitative morphometry. When the perfusate consisted of normal platelets suspended in normal plasma, platelet deposition on the collagen was 24.7 +/- 3.6 X 10(6)/cm2 (mean +/- SEM, n = 6). Significantly less deposition (16 +/- 2.3) was observed when vWD platelets were substituted for normal platelets. In mixtures containing vWD plasma, significantly greater deposition (9 +/- 2.2) was obtained with normal than with vWD platelets (1 +/- 0.4) demonstrating a role for platelet vWF in mediating the deposition of platelets on collagen. Morphometric analysis confirmed these data. Our findings indicate that platelet, as well as plasma, vWF mediates platelet-collagen interactions at a high shear rate.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2199-2199 ◽  
Author(s):  
Marianna Gyenes ◽  
Markus Hasse ◽  
Volker R. Stoldt ◽  
Abdelouahid El-Khattouti ◽  
Khon C. Huynh ◽  
...  

Abstract Abstract 2199 Objectives: Platelet integrin αIIbβ3 is polymorphic at residue 33 (Leu33/HPA-1a or Pro33/HPA-1b). In patients with coronary artery disease, the Pro33 isoform is associated with premature manifestation of myocardial infarction (Zotz et al., JTH 2005). Based on this finding, it has been postulated that the Pro33 variant of αIIbβ3 has a prothrombotic phenotype. Moreover, several studies have shown that elevated shear stress can activate platelets leading to shear-induced platelet aggregation contributing to acute myocardial infarction. Thus, it has been reported that pathological shear stress directly regulates αIIbβ3 (Feng et al., Am J Physiol Cell Physiol 2006). We have shown that adherent Pro33 platelets have a higher resistance than Leu33 platelets upon exposure to high shear rates (Loncar et al, Thromb J 2007). We now studied the impact of the Leu33/Pro33 polymorphism on αIIbβ3-mediated outside-in signaling under static and flow dynamic conditions in the presence or absence of Mn2+, analyzing the Src pY418 and FAK pY397 activities. Methods: Adhesion assays were performed with 10 or 100 μg/ml of immobilized fibrinogen for different incubation times with washed human platelets in the presence or absence of Mn2+ (0.5 mM). Mn2+ induces the active conformation of αIIbβ3. Src pY418 and FAK pY397 activities were determined by Western blotting and quantified densitometrically. Control experiments were performed with 1% BSA. Adhesion experiments under flow conditions were carried out with a cone-plate viscometer. Results: Under static conditions, Pro33 platelets adherent onto fibrinogen exhibited a 2.5-fold higher Src pY418 activity than Leu33 platelets after incubation for 20 min (p<0.01). Presence of Mn2+ (0.5 mM) in suspended Leu33 platelets stimulated their Src pY418 activity in an extent comparable to that of platelets adherent onto fibrinogen, while addition of Mn2+ (0.5 mM) to platelets adherent onto fibrinogen yielded a 3.5-fold increase in Src pY418 activity (p<0.05). Increase of the Mn2+ concentration (2 mM) raised the Src pY418 activity 1.5-fold, as compared to 0.5 mM Mn2+ (p<0.05). In parallel experiments with both HPA-1 isoforms of αIIbβ3, Pro33 platelets adherent onto fibrinogen in the presence of 0.5 mM Mn2+ revealed a 2.5-fold higher Src pY418 activity than Leu33 platelets after 5 min (p<0.05). This difference further increased upon prolonged adhesion for 10 or 20 min with a 5-fold increase after 40 min (p<0.01). The concentration of immobilized fibrinogen (10 or 100 μg/ml) had no influence on this effect. Addition of abciximab completely abolished the Src pY418 activation. Upon exposure to abnormal (5000 s−1) but not physiological (500 s−1) shear rates for 2 or 5 min, Pro33 platelets adherent onto 100 μg/ml fibrinogen exhibited a 2- or 2.5-fold higher Src pY418 activity than under static conditions (p<0.05 or 0.02, respectively). Under the same conditions, the Src pY418 activity of Pro33 platelets was 2-fold higher than that of Leu33 platelets (p<0.05). Again, different concentrations of fibrinogen (10 μg/ml and 100 μg/ml) did not affect these results. In comparison to Src (pY418), phosphorylation of FAK (pY397) increased slower both in Leu33 and Pro33 platelets adherent onto fibrinogen, when exposed to a shear rate of 5000 s−1 for 10min. Both isoforms (Leu33 or Pro33) exhibited a significantly higher FAK pY397 activity than under static conditions (3-fold increase, p<0.05). The Pro33 variant of αIIbβ3 showed a higher FAK pY397 activation than the Leu33 isoform (p<0.05). Again, abciximab completely blocked both the Src and FAK activation not only under static conditions but also upon exposure to shear. Conclusion: Our observations indicate that the HPA-1 polymorphism of αIIbβ3 has a considerable impact on the integrin-mediated outside-in signaling. The significantly higher Src (pY418) and FAK (pY397) activities of Pro33 platelets adherent onto fibrinogen under static and flow conditions are in agreement with the contention that the Pro33 (HPA-1b) isoform of αIIbβ3 is indeed a prothrombotic integrin variant. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 83-83
Author(s):  
Hiroaki Yaoi ◽  
Yasuaki Shida ◽  
Takehisa Kitazawa ◽  
Kunihiro Hattori ◽  
Midori Shima ◽  
...  

Abstract Background : Factor VIII (FVIII) is protected by binding to its carrier protein, von Willebrand factor (VWF) in the circulation. VWF contributes to hemostasis particularly under high shear flow condition by extending its multimeric configuration. By contrast, coagulation factors including FVIII are thought to play a dominant role under low shear. Since FVIII binds to VWF unlike other coagulation factors, FVIII may contribute to thrombus formation even under high shear conditions. FVIII has to be released from VWF and activated to exert its coagulation function. However, the role of interaction between FVIII and VWF on hemostasis under flow conditions needs to be explored in addition to the protective function of VWF. Aims: To analyze the mechanism and role of FVIII and VWF interaction on hemostasis under flow conditions. Methods: Whole blood samples were obtained from patients with type 2A von Willebrand disease (VWD). FVIII, VWF, FVIII/VWF (final concentration; f.c. 1U/mL), FVIII plus ESH8 (f.c. 1 µM), and emicizumab (ACE910; f.c. 100 µg/mL) were added to the blood followed by perfusion into the collagen-coated flow chamber under controlled high (2,500s-1) and low (50s-1) shear conditions. ESH8 is an anti-FVIII antibody that interrupts the release of FVIII from VWF, and emicizumab is a bispecific antibody mimicking activated FVIII (FVIIIa). The concentration of emicizumab was chosen, as it was the highest dose in clinical study. After the perfusion, formed thrombus was fixed and immunostaining was performed to visualize platelets, VWF, thrombin, and FVIII. Thrombi were observed by using confocal laser scanning microscopy and the obtained images were analyzed by Image Pro Premier 3D. Initial thrombus formation was measured as surface coverage (SC) and thrombus development was measured as thrombus volume (TV). Results: SC and TV were impaired in VWD particularly under high shear (high: SC 8.3%, TV 3.9x103μm3, low: SC 2.7%, TV 2.9x103μm3). Addition of FVIII/VWF improved thrombus formation to normal level under both shear conditions (high: SC 37.3%, TV 2.4x104μm3, low SC 4.3%, TV 4.1x103μm3). Addition of VWF improved SC and TV under both shear conditions (high: 40.9%, 1.7x104μm3, low: SC 3.0%, TV 3.3x103μm3), suggesting that the VWF function was crucial under both shear. By contrast, addition of FVIII alone did not improve SC and TV under both shears (high: SC 9.9%, TV 5.0x103μm3, low: SC 2.4%, TV 3.1x103μm3). Since FVIII/VWF had a greater effect on TV than VWF alone, FVIII enhanced thrombus development under high shears, however, this effect required the presence of VWF. FVIII immunostaining demonstrated the binding of FVIII on platelet surface in the FVIII-added experiment and, therefore, FVIII binding alone was not sufficient to initiate coagulation. Since FVIII may need to be activated on the platelet surface in a timely fashion, it was speculated that the optimal delivery from VWF and activation of FVIII on platelets was required for hemostasis. To analyze the role of FVIII and VWF interaction on hemostasis under flow condition, ESH8 was used to modify FVIII/VWF binding by blocking FVIII release. Treatment of FVIII/VWF with ESH8 did not change SC but slightly impaired TV under high shear (high: SC 41.8%, TV 1.8 x104μm3). Thus, the presence of FVIII at thrombus was not enough and the release of FVIII from VWF and presumably activation of FVIII on the platelet surface might be essential for thrombus formation under high shear. Under low shear, both SC and TV were interrupted by ESH8 (SC 2.6%, TV 3.1x103μm3), suggesting the important role of FVIII and coagulation under low shear. Lastly, to analyze the impact of activated FVIII on thrombus formation under flow conditions, emicizumab was evaluated in this system. In contrast to FVIII, emicizumab alone improved thrombus formation (high: SC 26.0%, TV 1.1 x104μm3, low: SC 3.5%, TV 4.2 x103μm3). The rate of improvement in SC and TV was better under low shear than high shear, which implicated the coagulative role of emicizumab. Even under high shear, however, emicizumab enhanced thrombus formation. Therefore, the role of emicizumab in substituting for the activated form of FVIII might be able to rapidly initiate coagulation even under high shear. Conclusion: VWF delivers and releases FVIII in a timely fashion on platelet surface. FVIII has to become active on platelets for hemostasis and FVIIIa can accelerate thrombus formation even under high shear condition. Disclosures Yaoi: Chugai Pharmaceutical Co., Ltd.: Research Funding. Shida:Chugai Pharmaceutical Co., Ltd.: Research Funding. Kitazawa:Chugai Pharmaceutical Co.: Employment, Equity Ownership, Patents & Royalties; Sysmex Corporation: Patents & Royalties. Hattori:Chugai Pharmaceutical Co.: Employment, Equity Ownership, Patents & Royalties. Shima:Sysmex Corporation: Patents & Royalties, Research Funding; Chugai Pharmaceutical Co., Ltd.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding; F. Hoffmann-La Roche Ltd.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Nogami:F. Hoffmann-La Roche Ltd.: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sysmex Corporation: Patents & Royalties, Research Funding; Chugai Pharmaceutical Co., Ltd.: Honoraria, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding.


2021 ◽  
Vol 5 (17) ◽  
pp. 3468-3477
Author(s):  
Fraser L. Macrae ◽  
Frauke Swieringa ◽  
Johan W. M. Heemskerk ◽  
Robert A. S. Ariëns

Abstract Fibrinogen γ' accounts for 3% to 40% of plasma fibrinogen. Earlier studies indicated that fibrinogen γ' forms altered fibrin clots under static conditions, whereas clinically, altered plasma γ' levels are associated with arterial and venous thrombosis. However, the effects of static vs flow conditions on the role of γ′ throughout the pathophysiological range is unknown. This study explores the effects of γ' levels on clot formation and structure in static and flow conditions. Coagulation of plasma samples with low (n = 41; 3%), normal (n = 45; 10%), or high (n = 33; 30%) γ′ levels were compared with that of purified fibrinogen mixtures with increasing ratios of γ′ (3%, 10%, 30%). Clots were analyzed by confocal microscopy, permeation, turbidity, and lysis techniques. In a novel 2-step flow-perfusion model, fibrinogen-deficient plasma repleted with increasing ratios of γ′ (3%, 10%, 30%) or plasmas with low (n = 5, 3%) or high (n = 5, 30%) γ′ were flowed over preformed platelet aggregates at arterial (500 s−1) and venous (150 s−1) shear rates. Increasing γ′ percentages within the pathophysiological range (3%-30%) did not result in any change in clot-formation rates; however, it led to significantly higher clot density, thinner fibers, and slower lysis in static conditions. Under flow at arterial shear, high γ′ (30%) led to faster (+44.1%-75.3%) and increased (+104%-123%) fibrin deposition, with clots exhibiting a larger volume (+253%-655%) and height (+130%-146%). These trends were magnified at venous shear. Overall, our findings demonstrate the significant impact of pathophysiological fibrinogen γ′ levels on clot structure and provide new flow-dependent mechanisms to explain how γ′ increases thrombosis risk.


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