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Blood, 15 May 2002, Vol. 99, No. 10, pp. 3613-3622
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
Platelet factor 4 binds to low-density lipoprotein receptors and
disrupts the endocytic itinerary, resulting in retention of low-density
lipoprotein on the cell surface
Bruce S. Sachais,
Alice Kuo,
Taher Nassar,
Jeanelle Morgan,
Katalin Kariko,
Kevin Jon Williams,
Michael Feldman,
Michael Aviram,
Neelima Shah,
Leonard Jarett,
Mortimer Poncz,
Douglas B. Cines, and
Abd Al-Roof Higazi
From the Departments of Pathology and Laboratory
Medicine, Neurosurgery, and Pediatrics, University of Pennsylvania,
Philadelphia; the Department of Medicine, Jefferson Medical College of
Thomas Jefferson University, Philadelphia, PA; Lipid Research
Laboratory, Rambam Medical Center and Rappaport Institute for Research
in the Medical Sciences, Haifa, Israel, and the Department of Clinical
Biochemistry, Hadassah Medical Organization, Jerusalem, Israel.
The influence of platelets on the cellular metabolism of
atherogenic lipoproteins has not been characterized in detail.
Therefore, we investigated the effect of platelet factor 4 (PF4), a
cationic protein released in high concentration by activated platelets, on the uptake and degradation of low-density lipoprotein (LDL) via the
LDL receptor (LDL-R). LDL-R-dependent binding, internalization, and
degradation of LDL by cultured cells were inhibited 50%, 80%, and
80%, respectively, on addition of PF4. PF4 bound specifically to the
ligand-binding domain of recombinant soluble LDL-R (half-maximal binding 0.5 µg/mL PF4) and partially (approximately 50%) inhibited the binding of LDL. Inhibition of internalization and degradation by
PF4 required the presence of cell-associated proteoglycans, primarily
those rich in chondroitin sulfate. PF4 variants with impaired heparin
binding lacked the capacity to inhibit LDL. PF4, soluble LDL-R, and LDL
formed ternary complexes with cell-surface proteoglycans. PF4 induced
the retention of LDL/LDL-R complexes on the surface of human
fibroblasts in multimolecular clusters unassociated with coated pits,
as assessed by immuno-electron microscopy. These studies demonstrate
that PF4 inhibits the catabolism of LDL in vitro in part by competing
for binding to LDL-R, by promoting interactions with cell-associated
chondroitin sulfate proteoglycans, and by disrupting the normal
endocytic trafficking of LDL/LDL-R complexes. Retention of LDL on cell
surfaces may facilitate proatherogenic modifications and support an
expanded role for platelets in the pathogenesis of atherosclerosis.

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