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Prepublished online as a Blood First Edition Paper on July 25, 2002; DOI 10.1182/blood-2002-05-1401.
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Blood, 1 December 2002, Vol. 100, No. 12, pp. 4033-4039
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
ADAMTS-13 rapidly cleaves newly secreted ultralarge von
Willebrand factor multimers on the endothelial surface under
flowing conditions
Jing-fei Dong,
Joel L. Moake,
Leticia Nolasco,
Aubrey Bernardo,
Wendy Arceneaux,
Corie N. Shrimpton,
Alicia J. Schade,
Larry V. McIntire,
Kazuo Fujikawa, and
José A. López
From the Thrombosis Research Section, Department of
Medicine, and Department of Molecular and Human Genetics, Baylor
College of Medicine, Houston, TX; Department of Biochemistry,
University of Washington, Seattle; and the Cox Laboratory for
Bioengineering, Rice University, Houston, TX.
Thrombotic thrombocytopenic purpura (TTP) is a devastating
thrombotic disorder caused by widespread microvascular thrombi composed
of platelets and von Willebrand factor (VWF). The disorder is
associated with a deficiency of the VWF-cleaving metalloprotease, ADAMTS-13, with consequent accumulation of ultralarge (UL) VWF multimers in the plasma. ULVWF multimers, unlike plasma forms of VWF,
attach spontaneously to platelet GP Ib , a component of the GP
Ib-IX-V complex. We have found that ULVWF multimers secreted from
stimulated endothelial cells (ECs) remained anchored to the endothelial
surface where platelets and Chinese hamster ovary cells expressing the
GP Ib-IX-V complex attached to form long beads-on-a-string structures
in the presence of fluid shear stresses in both the venous (2.5 dyne/cm2) and arterial (20 and 50 dyne/cm2)
ranges. Although measurement of the activity of the ADAMTS-13 VWF-cleaving metalloprotease in vitro requires prolonged incubation of
the enzyme with VWF under nonphysiologic conditions, EC-derived ULVWF
strings with attached platelets were cleaved within seconds to minutes
in the presence of normal plasma (containing approximately 100%
ADAMTS-13 activity) or in the presence of partially purified ADAMTS-13. By contrast, the strings persisted for the entire period of
perfusion (10 minutes) in the presence of plasma from patients with TTP
containing 0% to 10% ADAMTS-13 activity. These results suggest
that cleavage of EC-derived ULVWF multimers by ADAMTS-13 is a
rapid physiologic process that occurs on endothelial cell surfaces.

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