The Findings Suggest a Possible Novel Target for the Treatment of Hemophilia A
La Jolla, CA – January 31, 2011 – A scientist from The Scripps
Research Institute has identified a new role for a natural signaling
molecule in preventing blood clot formation. The molecule could become a
target for the development of novel and cost-effective treatments for
blood clotting diseases such as Hemophilia A.
The findings, from a
study by Scripps Research Assistant Professor Laurent O. Mosnier, were
published in a recent edition of Journal of Biological Chemistry.
The
study focused on Platelet Factor 4 – a small cytokine (intracellular
signaling molecule) released during platelet aggregation.
Based
on Platelet Factor 4 effects on another coagulation protein, it was
thought that Platelet Factor 4 could potentially stimulate activation of
thrombin-activatable fibrinolysis inhibitor (TAFI) – an enzyme (soluble
protein) that protects clot longevity, making clots last longer and
preventing excess bleeding; TAFI is like a hardener that is added to the
mortar used between the bricks in a brick wall, without which the
mortar would never completely solidify, and the wall would never be
solid.
The new study, however, found exactly the opposite role for Platelet Factor 4—inhibition of TAFI activation.
For
Mosnier, this finding led to a radical idea—sequestering Platelet
Factor 4 using such molecules as heparin derivatives could improve clot
stability. Heparin - a highly sulfated or negatively charged
glucoseaminoglycan (polysaccharide or sugar derivative) – is a commonly
used anticoagulant. Mosnier, however, was able to modify the compound to
have the reverse effect and aid in blood clotting in laboratory tests.
“The
idea of using heparin to prevent bleeding in kids [who have bleeding
tendencies] would be outrageous because that would just greatly
accelerate bleeding,” said Mosnier, “Our trick, however, was to modulate
heparin’s anticoagulant properties. This opens up new possibilities.”
Converting Heparin from an Anticoagulant into a Non-Anticoagulant
Heparin’s
anticoagulant activity is derived from a specific pattern of nitrogen-
and oxygen-linked sulfation (or simply negative charges) that is
recognized by anti-thrombin – the inactivator of coagulation. However,
in addition to binding to anti-thrombin heparin also binds to Platelet
Factor 4, which is glittered with positive charge, and they attract one
another like magnets.
Mosnier found heparin’s anticoagulant
activity could be prevented, and its Platelet Factor 4 binding selected
for, by selectively removing the N-linked sulfations (and further
acetylation). This effectively prevented heparin from being recognized
by anti-thrombin and allowed it to instead take the Platelet Factor 4
out of the equation. This resulted in prevention of clot breakdown
(fibrinolysis), by allowing TAFI to do its job.
To test the
effectiveness of the modified heparin derivatives in enhancing clot
stability, Mosnier employed a functional assay called a “clot lysis
assay.” Using a light scattering technique, plasma was used to generate a
clot, which was degraded. Further modulation of the conditions allowed
measurement of clot stability via TAFI activation. Mosnier found that,
indeed, the modified-version heparin promoted clot stability.
Toward a Cheaper, Cost-Effective Treatment for Hemophilia A
An
optimistic Mosnier admits his new discovery is in its infancy, but
hopes it may one day provide an alternative treatment for bleeding
conditions such as Hemophilia A.
Hemophilia A, which affects 1
in 5,000 males, is an X-linked genetic bleeding disorder whereby there
is a reduced amount or activity of factor VIII. This results in the
unstable clots, lacking fibrin – a fibrous clot-forming protein.
Currently, the treatment for Hemophilia A is prophylactically taking
factor VIII as a medicine to improve clotting. Unfortunately, immunity
against factor VIII is a significant side effect.
Mosnier hopes
that modification of heparin – which is cheaper than factor VIII and
already used clinically – could one day stabilize clots in these
patients.
“The next step is to see if the modified compound will
improve bleeding complications in the Hemophilia mouse,” said Mosnier.
“We are still a long way from claiming anything clinically.”
His optimism is contagious, however, and it is an exciting time for science in the Mosnier lab.
Professor
Laurent O. Mosnier of the Scripps Research Institute was sole author of
the study, “Platelet Factor 4 Inhibits Thrombomodulin-dependent
Activation of Thrombin-activatable Fibrinolysis Inhibitor (TAFI) by
Thrombin.” For more information, see http://www.jbc.org/content/286/1/502.full?sid=7795e622-9966-4a9a-b999-0eb4d69e474a.
This
research was funded by a “Pathway to Independence Grant,” which enabled
the establishment of the Mosnier Lab, from the National Institute of
Health (NHLBI Grant HL087618).
For more information contact:
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La Jolla, California 92037
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