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Rapid Activation of Protein C by Factor Xa and Thrombin in the
Presence of Polyanionic Compounds
Alireza R. Rezaie
From the Cardiovascular Biology Research Program, Oklahoma Medical
Research Foundation, Oklahoma City, OK.
A recent study indicated that negatively charged substances such as
heparin and dextran sulfate accelerate thrombin activation of
coagulation factor XI by a template mechanism. Because the serine
proteinase of the natural anticoagulant pathway, activated protein C,
can bind heparin, it was reasonable to think that these compounds may
also bind protein C (PC) and accelerate its activation by thrombin or
other heparin binding plasma serine proteinases by a similar mechanism.
To test this, PC activation by thrombin and factor Xa (fXa) was studied
in the presence of these polysaccharides. With thrombin in the absence
of thrombomodulin (TM), these polysaccharides markedly reduced the
Km for PC and Gla-domainless PC (GDPC) activation in the
presence of Ca2+. With TM containing chondroitin sulfate,
heparin did not influence PC activation by thrombin, but with TM
lacking chondroitin sulfate, the characteristic high-affinity PC
interaction at low Ca2+ (~50 to 100 µmol/L) was
largely eliminated by heparin. In EDTA, heparin enhanced thrombin
activation of GDPC by reducing the Km, but it inhibited PC
activation by increasing the Km. PC activation in EDTA was
insensitive to the presence of heparin if the exosite 2 mutant,
R93,97,101A thrombin, was used for activation. These results suggest
that, when the Gla-domain of PC is not fully stabilized by
Ca2+, it interacts with the anion binding exosite 2 of
thrombin and that heparin binding to this site prevents this
interaction. Additional studies indicated that, in the presence of
phospholipid vesicles, heparin and dextran sulfate dramatically
accelerate PC activation by fXa by also reducing the Km.
Interestingly, on phospholipids containing 40%
phosphatidylethanolamine, the activation rate of near physiological PC
concentrations (~80 nmol/L) by fXa in the presence of dextran sulfate
was nearly comparable to that observed by the thrombin-TM complex. The
biochemical and potential therapeutical ramifications of these findings
are discussed.
Blood, Vol. 91 No. 12 (June 15), 1998:
pp. 4572-4580
© 1998 by The American Society of Hematology.

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