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Physiologic cleavage of von Willebrand factor by a plasma protease is dependent on its conformation and requires calcium ion

HM Tsai

Division of Hematology, Montefiore Medical Center, Bronx, NY 10467, USA.

von Willebrand factor (vWF) in the circulation is subjected to proteolysis. In a recent study, we reported that normal plasma contains a protease activity that cleaves vWF in a shear-dependent manner, causing a decrease in its multimer size while generating dimers of the 140-kD and the 176-kD fragments indistinguishable from those found in normal plasma. In this study, the plasma protease has been partially purified and characterized and the role of vWF conformation in its cleavage by the protease has been further investigated. Guanidine HCl caused unfolding of vWF in a concentration-dependent manner, resulting in a shift in its fluorescence emission maxima to longer wavelengths. A dramatic increase in its proteolytic susceptibility was seen at 1.1 to 1.2 mol/L guanidine HCl, a concentration causing only a 3- to 4-nm shift in vWF emission maxima. Although vWF molecules refolded as guanidine HCl was removed by dialysis, the refolding was accompanied only by a partial recovery of the proteolytic resistance. The plasma protease, partially purified by approximately 900 folds by Sephacryl S- 300 HR gel filtration, Matrex gel orange A dye affinity chromatography, and Q Sepharose anion exchange, had a molecular mass of approximately 200 kD and was inhibited by EDTA, EGTA, or 1,10-phenanthroline. The inhibition by EGTA or EDTA could be reversed by Ca2+ but not by mg2+. It was not inhibited by a panel of synthetic and natural protease inhibitors or adsorbed by gelatin-agarose, and it was present in plasmas deficient in proteins involved in coagulation and anticoagulation. The vWF fragments generated by the protease, as mapped by peptide-specific antibodies VP-1 and LJ-7745, were in distinguishable from the natural fragments but distinct from those produced by plasmin. High molecular weight endothelial vWF, after exposure to guanidine HCLI or high shear stress, was cleaved by the protease to smaller forms. These results support the model that endothelial secreted vWF is converted to multimers by a novel plasma metalloproteinase. Although native vWF exists in a conformation relatively resistant to cleavage, an alteration in the conformation by shear stress can lead to enhanced proteolytic susceptibility. This model may explain the decrease in vWF multimer sizes in various clinical conditions.

Volume 87, Issue 10, pp. 4235-4244, 05/15/1996
Copyright © 1996 by The American Society of Hematology


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K. Kokame, M. Matsumoto, K. Soejima, H. Yagi, H. Ishizashi, M. Funato, H. Tamai, M. Konno, K. Kamide, Y. Kawano, et al.
Mutations and common polymorphisms in ADAMTS13 gene responsible for von Willebrand factor-cleaving protease activity
PNAS, September 3, 2002; 99(18): 11902 - 11907.
[Abstract] [Full Text] [PDF]


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NEJMHome page
J. L. Moake
Thrombotic Microangiopathies
N. Engl. J. Med., August 22, 2002; 347(8): 589 - 600.
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BloodHome page
G. Remuzzi, M. Galbusera, M. Noris, M. T. Canciani, E. Daina, E. Bresin, S. Contaretti, J. Caprioli, S. Gamba, P. Ruggenenti, et al.
von Willebrand factor cleaving protease (ADAMTS13) is deficient in recurrent and familial thrombotic thrombocytopenic purpura and hemolytic uremic syndrome
Blood, July 18, 2002; 100(3): 778 - 785.
[Abstract] [Full Text] [PDF]


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BloodHome page
V. Bianchi, R. Robles, L. Alberio, M. Furlan, and B. Lammle
Von Willebrand factor-cleaving protease (ADAMTS13) in thrombocytopenic disorders: a severely deficient activity is specific for thrombotic thrombocytopenic purpura
Blood, June 28, 2002; 100(2): 710 - 713.
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ASH Education BookHome page
J. N. George, J. E. Sadler, and B. Lammle
Platelets: Thrombotic Thrombocytopenic Purpura
Hematology, January 1, 2002; 2002(1): 315 - 334.
[Abstract] [Full Text]


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BloodHome page
P. M. Mannucci, M. T. Canciani, I. Forza, F. Lussana, A. Lattuada, and E. Rossi
Changes in health and disease of the metalloprotease that cleaves von Willebrand factor
Blood, November 1, 2001; 98(9): 2730 - 2735.
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BloodHome page
H. E. Gerritsen, R. Robles, B. Lammle, and M. Furlan
Partial amino acid sequence of purified von Willebrand factor-cleaving protease
Blood, September 15, 2001; 98(6): 1654 - 1661.
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BloodHome page
K. Fujikawa, H. Suzuki, B. McMullen, and D. Chung
Purification of human von Willebrand factor-cleaving protease and its identification as a new member of the metalloproteinase family
Blood, September 15, 2001; 98(6): 1662 - 1666.
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BloodHome page
A. Veyradier, B. Obert, A. Houllier, D. Meyer, and J.-P. Girma
Specific von Willebrand factor-cleaving protease in thrombotic microangiopathies: a study of 111 cases
Blood, September 15, 2001; 98(6): 1765 - 1772.
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BloodHome page
J. C. Moore, C. P. M. Hayward, T. E. Warkentin, and J. G. Kelton
Decreased von Willebrand factor protease activity associated with thrombocytopenic disorders
Blood, September 15, 2001; 98(6): 1842 - 1846.
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ASH Education BookHome page
K. R. McCrae, J. B. Bussel, P. M. Mannucci, G. Remuzzi, and D. B. Cines
Platelets: An Update on Diagnosis and Management of Thrombocytopenic Disorders
Hematology, January 1, 2001; 2001(1): 282 - 305.
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BloodHome page
N. Mistry, S. L. Cranmer, Y. Yuan, P. Mangin, S. M. Dopheide, I. Harper, S. Giuliano, D. E. Dunstan, F. Lanza, H. H. Salem, et al.
Cytoskeletal regulation of the platelet glycoprotein Ib/V/IX-von Willebrand factor interaction
Blood, November 15, 2000; 96(10): 3480 - 3489.
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CirculationHome page
F. I. Pareti, A. Lattuada, C. Bressi, M. Zanobini, A. Sala, A. Steffan, and Z. M. Ruggeri
Proteolysis of von Willebrand Factor and Shear Stress-Induced Platelet Aggregation in Patients With Aortic Valve Stenosis
Circulation, September 12, 2000; 102(11): 1290 - 1295.
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Nephrol Dial TransplantHome page
M. Furlan and B. Lammle
Haemolytic-uraemic syndrome and thrombotic thrombocytopenic purpura--new insights into underlying biochemical mechanisms
Nephrol. Dial. Transplant., August 1, 2000; 15(8): 1112 - 1114.
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J. Clin. Pathol.Home page
S L Allford and S J Machin
Current understanding of the pathophysiology of thrombotic thrombocytopenic purpura
J. Clin. Pathol., July 1, 2000; 53(7): 497 - 501.
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ANN INTERN MEDHome page
H.-M. Tsai, L. Rice, R. Sarode, T. W. Chow, and J. L. Moake
Antibody Inhibitors to von Willebrand Factor Metalloproteinase and Increased Binding of von Willebrand Factor to Platelets in Ticlopidine-Associated Thrombotic Thrombocytopenic Purpura
Ann Intern Med, May 16, 2000; 132(10): 794 - 799.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
A. Nandi, P. Estess, and M. H. Siegelman
Hyaluronan Anchoring and Regulation on the Surface of Vascular Endothelial Cells Is Mediated through the Functionally Active Form of CD44
J. Biol. Chem., May 12, 2000; 275(20): 14939 - 14948.
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BloodHome page
P.L. Turecek, L. Pichler, W. Auer, G. Eder, K. Varadi, A. Mitterer, W. Mundt, U. Schlokat, F. Dorner, L.O. Drouet, et al.
Evidence for Extracellular Processing of Pro-von Willebrand Factor After Infusion in Animals With and Without Severe von Willebrand Disease
Blood, September 1, 1999; 94(5): 1637 - 1647.
[Abstract] [Full Text] [PDF]


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Cancer Res.Home page
L. Oleksowicz, N. Bhagwati, and M. DeLeon-Fernandez
Deficient Activity of von Willebrand's Factor-cleaving Protease in Patients with Disseminated Malignancies
Cancer Res., May 1, 1999; 59(9): 2244 - 2250.
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NEJMHome page
M. Furlan, R. Robles, M. Galbusera, G. Remuzzi, P. A. Kyrle, B. Brenner, M. Krause, I. Scharrer, V. Aumann, U. Mittler, et al.
von Willebrand Factor-Cleaving Protease in Thrombotic Thrombocytopenic Purpura and the Hemolytic-Uremic Syndrome
N. Engl. J. Med., November 26, 1998; 339(22): 1578 - 1584.
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NEJMHome page
H.-M. Tsai and E. C.-Y. Lian
Antibodies to von Willebrand Factor-Cleaving Protease in Acute Thrombotic Thrombocytopenic Purpura
N. Engl. J. Med., November 26, 1998; 339(22): 1585 - 1594.
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NEJMHome page
J. L. Moake
Moschcowitz, Multimers, and Metalloprotease
N. Engl. J. Med., November 26, 1998; 339(22): 1629 - 1631.
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BloodHome page
M. Furlan, R. Robles, M. Solenthaler, and B. Lammle
Acquired Deficiency of von Willebrand Factor-Cleaving Protease in a Patient With Thrombotic Thrombocytopenic Purpura
Blood, April 15, 1998; 91(8): 2839 - 2846.
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BloodHome page
P. V. Jenkins, K. J. Pasi, and S. J. Perkins
Molecular Modeling of Ligand and Mutation Sites of the Type A Domains of Human von Willebrand Factor and Their Relevance to von Willebrand's Disease
Blood, March 15, 1998; 91(6): 2032 - 2044.
[Abstract] [Full Text] [PDF]


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BloodHome page
P. L. Turecek, H. Gritsch, L. Pichler, W. Auer, B. Fischer, A. Mitterer, W. Mundt, U. Schlokat, F. Dorner, H. J. M. Brinkman, et al.
In Vivo Characterization of Recombinant von Willebrand Factor in Dogs With von Willebrand Disease
Blood, November 1, 1997; 90(9): 3555 - 3567.
[Abstract] [Full Text] [PDF]


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BloodHome page
M. Furlan, R. Robles, M. Solenthaler, M. Wassmer, P. Sandoz, and B. Lammle
Deficient Activity of von Willebrand Factor-Cleaving Protease in Chronic Relapsing Thrombotic Thrombocytopenic Purpura
Blood, May 1, 1997; 89(9): 3097 - 3103.
[Abstract] [Full Text] [PDF]


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BloodHome page
H.-M. Tsai, I. I. Sussman, D. Ginsburg, H. Lankhof, J. J. Sixma, and R. L. Nagel
Proteolytic Cleavage of Recombinant Type 2A von Willebrand Factor Mutants R834W and R834Q: Inhibition by Doxycycline and by Monoclonal Antibody VP-1
Blood, March 15, 1997; 89(6): 1954 - 1962.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
X. Zheng, D. Chung, T. K. Takayama, E. M. Majerus, J. E. Sadler, and K. Fujikawa
Structure of von Willebrand Factor-cleaving Protease (ADAMTS13), a Metalloprotease Involved in Thrombotic Thrombocytopenic Purpura
J. Biol. Chem., October 26, 2001; 276(44): 41059 - 41063.
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