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Prepublished online as a Blood First Edition Paper on June 14, 2002; DOI 10.1182/blood-2002-02-0354.
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
From the W. K. Warren Medical Research Institute,
Department of Medicine, University of Oklahoma Health Sciences Center,
Oklahoma City, OK.
Activation of platelets with 2 agonists, collagen and thrombin,
reveals a subpopulation of cells referred to as COAT-platelets (collagen and thrombin activated).
These cells are enriched in several membrane-bound, procoagulant
proteins, including fibrinogen, thrombospondin, factor V, von
Willebrand factor, and fibronectin. Platelets perform a critical role in hemostasis by
providing a surface both for catalyzing thrombin generation and for
binding adhesive proteins.1,2 The various proteins bound
to activated platelets interact via integrins,3 exposed
phosphatidylserine,4 or one of several other
well-characterized membrane receptors.5 It was, therefore,
unexpected to observe procoagulant protein interactions with activated
platelets, which were stabilized by a supplementary mechanism.
Specifically, platelets activated simultaneously with 2 agonists,
collagen and thrombin, demonstrated retention of procoagulant proteins
on a subfraction of the total platelets; this subpopulation, referred
to as COAT-platelets (collagen and thrombin activated), was enriched in surface-bound factor
V, fibrinogen, fibronectin, von Willebrand factor, thrombospondin, and
Human fibrinogen, bovine serum albumin (BSA), bovine thrombin,
Buffers
Synthesis of b-BSA-(5-HT)6, HRP-HT, and photo
cross-linking reagents
Preparation of human platelets Informed consent was obtained in accordance with local institution review board guidelines. Ten milliliters of whole blood was drawn from the antecubital vein into a plastic syringe containing 1.0 mL ACD. After 1:2 dilution with room temperature (RT) BSGC, pH 7.3, platelet-rich plasma (PRP) was prepared immediately in plastic tubes at 170g (maximum) for 8 minutes at RT. Gel filtration was performed on a column of Sepharose CL-2B, and purified platelets were normalized to a concentration of 4 × 104/µL in BSGC.Platelet activation for flow experiments Reactions were 100 µL total volume containing 10 mM HEPES, pH 7.5, 1 mg/mL BSA, 2 mM CaCl2, 1 mM MgCl2, 140 mM NaCl, 4 × 105 platelets and agonist, 500 ng/mL convulxin, and 0.5 U/mL thrombin.6 After 10 minutes at 37°C, the reaction was stopped with 200 µL 1.5% (wt/vol) formalin in HEPES/saline and fixed for 20 minutes at RT. After fixation, 3.5 mL PBS containing 1 mg/mL BSA (PBS/BSA) was added, and the sample was centrifuged at 1500g for 15 minutes. The pellet was resuspended in 200 µL PBS/BSA along with the appropriate detection system. After 25 minutes at RT, platelets were washed as before and resuspended for flow cytometry.Chymotrypsin treatment of the platelets Chymotrypsin was dissolved in PBS containing 0.5 mg/mL BSA, and digestion was performed either before or during platelet activation. Before activation, 1 µg/mL (final concentration) of chymotrypsin was added to the platelet suspension for 4 minutes at 37°C, and the proteolytic digestion was stopped by the addition of 50 µg/mL (final concentration) trypsin-chymotrypsin inhibitor. For chymotrypsin digestion during activation, chymotrypsin was added after 3 minutes of activation and stopped at 7 minutes as outlined above. When a monoclonal antibody (mAb) or biotinylated BSA (b-BSA)-HT was required during the assay, it was added only after chymotrypsin was inhibited.Photoreactive cross-linking of b-BSA-(5-HT)6 to platelets Ten micrograms per milliliter b-BSA-(5-HT)6 derivatized with azidotetrafluorobenzoic acid was coincubated with platelets activated in 2 mM CaCl2, 1 mM MgCl2, 150 mM NaCl, 10 mM HEPES, pH 7.5, with 1 µM A23187 and 0.5 U/mL thrombin to obtain maximal COAT-platelet production.7 After 10 minutes at 37°C, the samples were placed on ice and cross-linked for 2 minutes at about 10 cm from a UV lamp (UV Crosslinker, FB-UVXL-1000; Fisher Scientific, Pittsburgh, PA). Before lysing, platelets were treated with 1 µg/mL chymotrypsin for 30 minutes at 37°C. Cells were then lysed with 0.5% Triton X-100 in 1 M NaCl and 50 µg/mL BSA-(5-HT)6. Microtiter plates were coated with antibodies (10 µg/mL) and blocked with 2 mg/mL BSA. Polyclonal antibodies against fibrinogen, thrombospondin, fibronectin, von Willebrand factor, and 2-antiplasmin
were utilized in addition to HFV237 monoclonal anti-FV. One
hundred-microliter aliquots of platelet lysate were added to the wells
for 90 minutes at RT. Bound b-BSA-(5-HT)6 was detected with
streptavidin-peroxidase.
Solid phase binding assays Ninety-six-well microtiter plates were coated with 100 µL of 10 µg/mL thrombospondin (Tsp), fibrinogen (Fbg), fragment D, or fragment E in PBS containing 0.5 mM ethylenediaminetetraacetic acid (PBS/EDTA) for 2 hours at RT. Wells were then blocked with 2 mg/mL BSA in PBS/EDTA for 3 hours and then washed with 0.05% (wt/vol) Tween 20 in PBS. Increasing concentrations of b-BSA-(5-HT)6 in PBS/EDTA/Tween 20 (PBS with 0.5 mM EDTA and 0.02% Tween 20) were added for 90 minutes at RT. After washing, bound b-BSA-(5-HT)6 was detected with streptavidin-peroxidase by standard techniques.Kinetic assay for FITC-BSA-(5-HT)6 binding to fibrinogen One hundred microliters of 6.2 µm latex beads (10% suspension; 7 × 108 beads per milliliter) was incubated with 1.5 mL 3 mg/mL fibrinogen in HEPES/saline overnight at 4°C with rocking. Beads were then washed 2 times with saline and resuspended at 2 × 106 /mL in HEPES/saline/BSA. For binding experiments, 120 µL of bead suspension was incubated with shaking in 330 µL HEPES/saline/BSA with graded doses of N-acetyl serotonin (500 mM stock in dimethyl sulfoxide [DMSO]) and 4.4 µg/mL FITC-BSA-(5-HT)6. Fifty-microliter aliquots were removed at various times, diluted into 0.4 mL HEPES/saline/BSA, and immediately analyzed for bound FITC by flow cytometry.
Chymotrypsin treatment of COAT-platelets Previous experiments7 demonstrated that biotin-albumin-(serotonin)6 (b-BSA-(5-HT)6) binds to COAT-platelets in a manner similar to -granule procoagulant
proteins (Figure
1A). Therefore, b-BSA-(5-HT)6 binding was used as a probe to investigate
parameters that affect retention of serotonin conjugates on
COAT-platelets. Figure 1C demonstrates that a brief treatment of
activated COAT-platelets with 1 µg/mL chymotrypsin eliminates
b-BSA-(5-HT)6 binding; however, chymotrypsin treatment of
platelets prior to activation does not significantly impede
b-BSA-(5-HT)6 binding upon subsequent activation (Figure
1B). These observations suggest that the serotonin binding site on
COAT-platelets is a protein that is exposed on the cell surface only
after activation, making -granule proteins likely candidates.
Identification of serotonin binding sites by photo cross-linking Biotin-BSA-(5-HT)6, derivatized with a photoreactive probe, 4-azido-2,3,5,6-tetrafluorobenzoic acid,10 was coincubated with platelets during activation with ionophore A23187 and thrombin to maximize the number of COAT-platelets produced.7 After activation, cells were irradiated with ultraviolet light for 2 minutes and then lysed for analysis. Preliminary experiments indicated that photo cross-linking resulted in large macromolecular complexes that were refractory to examination; however, partial digestion with chymotrypsin did allow subsequent analysis by enzyme-linked immunosorbent assay (ELISA). Therefore, partially digested samples were applied to microtiter plates coated with polyclonal antibodies against several -granule proteins,
including fibrinogen (Fbg), thrombospondin (Tsp), fibronectin, von
Willebrand factor, and 2-antiplasmin; a monoclonal
antibody against factor V was also utilized. Biotin-BSA-(5-HT) was
coupled almost exclusively to Fbg and Tsp (Figure
2A). Further examination demonstrated
that photo cross-linking and dual-agonist activation were both required for significant cross-linking of the serotonin probe to occur (Figure
2B), although thrombin activation alone resulted in a modest
retention of the biotin probe. Similar results were obtained with
horseradish peroxidase derivatized with 5-HT and
4-azido-2,3,5,6-tetrafluorobenzoic acid (data not shown).
Thrombospondin and fibrinogen bind serotonin conjugates Tsp, Fbg, and Fbg fragments D and E11 were adsorbed onto microtiter plates, and the binding of graded concentrations of b-BSA-(5-HT)6 was determined. Fbg and Fbg fragment D both bound b-BSA-(5-HT)6 while fragment E did not (Figure 3A); Tsp also bound b-BSA-(5-HT)6 (Figure 3B). The apparent median effective concentration (EC50) values for b-BSA-(5-HT)6 binding to Fbg, fragment D, and Tsp were 2.2, 8.2, and 2.3 nM, respectively. Although this appears to be a relatively strong interaction, it is likely to represent the product of multiple binding interactions rather than a high affinity of Fbg or Tsp for 5-HT. This is supported by the observation that the reverse ELISA experiment, binding of solution phase Fbg and fragment D to immobilized b-BSA-(5-HT)6, demonstrated that intact Fbg was retained while fragment D bound poorly (Figure 3C). This suggests that the 2 binding sites of intact Fbg were sufficient to stabilize it on the immobilized b-BSA-(5-HT)6 while the single binding site on fragment D was not. Finally, the binding of b-BSA-(5-HT)6 to immobilized Tsp was found to be sensitive to chymotrypsin (Figure 3D), suggesting that Tsp may be responsible for the chymotrypsin sensitivity observed in Figure 1. Binding of b-BSA-(5-HT)6 to immobilized Fbg is only modestly affected by chymotrypsin (data not shown).
A kinetic assay for monitoring binding of FITC-BSA-(5-HT)6
to immobilized Fbg was also established. Specifically, Fbg was bound to
6-µm nylon beads, and the time-dependent binding of
FITC-BSA-(5-HT)6 was monitored by flow cytometry. A typical
experiment is shown in Figure 4A, where
the binding of 4.4 µg/mL FITC-BSA-(5-HT)6 was
followed in the presence of graded doses of an inhibitor, N-acetyl
serotonin. Figure 4B presents cumulative data on the effect of N-acetyl
serotonin and indicates a concentration-dependent inhibition of
FITC-BSA-(5-HT)6 binding. Additional experiments showed
that neither serotonin nor 5-hydroxyindoleacetic acid were effective inhibitors of FITC-BSA- (5-HT)6 binding to
immobilized Fbg (data not shown). It is likely that the
positive charge of serotonin and the negative charge of
5-hydroxyindoleacetic acid prevent them from being effective mimetics
of the uncharged, conjugated serotonin on FITC-BSA-(5-HT)6.
COAT-platelets are a recently described subpopulation of dual-agonist-stimulated cells characterized by high levels of membrane-bound, strongly retained, procoagulant proteins.6,7 We previously postulated7 that COAT-platelet production involves a transglutaminase-mediated conjugation of serotonin to several of these procoagulant proteins and stabilization of the serotonin-derivatized proteins on the platelet surface by an unidentified serotonin binding protein in addition to the specific known receptors (eg, glycoprotein [GP] IIb/IIIa for Fbg, phosphatidylserine [PS] for factor Va). This report demonstrates that thrombospondin (Tsp) and fibrinogen (Fbg) provide the serotonin binding sites necessary for COAT-platelet formation. The binding of serotonin conjugates to Fbg is likely to represent a relatively low-affinity interaction, as indicated by the poor binding of soluble fragment D compared with soluble, intact Fbg (Figure 3C). This does not indicate, however, that the physiologic importance of this interaction is diminished. The inherent stability of multiple, low-affinity interactions has been well documented with polyvalent antibodies,12,13 and the avidity produced by even bivalent interactions12,14 can increase the apparent affinity by a factor of 103 to 104 while higher valency interactions can be potentiated by factors of 106. Therefore, the potential stability of the multiple interactions proposed in the following model can be significant even though any single Fbg/conjugated serotonin contact is of modest strength. A proposed model of COAT-platelets is shown in Figure
5. In this model,
serotonin-derivatized proteins bind to both their respective
receptors and to the serotonin binding sites on either Fbg or Tsp
(Figure 5A). The result is a stabilization of each procoagulant protein
on the cell surface due to increased avidity provided by multiple
binding interactions. In fact, extensive cross-linking of surface
proteins as shown in Figure 5B would result in a 2-dimensional
meshwork reminiscent of an immune complex.
It is not yet known whether Fbg and Tsp bind first to their respective receptors and then to serotonin-conjugated proteins or whether the binding order is reversed. Also, it is not clear why only a fraction of platelets become COAT-platelets upon stimulation with 2 agonists6,7; further elucidation of the mechanism involved with COAT-platelet production will be required to answer these questions. These observations, however, do provide evidence of an unexpected role for Tsp in platelet function. While Tsp has been documented to bind many adhesive proteins and several platelet receptors,15,16 this role in COAT-platelets was not anticipated. Knock-out mice deficient in Tsp-1 do exhibit a diffuse alveolar hemorrhage,17 though limited analysis of platelet function has not demonstrated any obvious abnormalities. Our report would suggest that a further evaluation of these mice is warranted. In addition, COAT-platelets offer a new role for 5-HT in hemostasis, and the possible involvement of COAT-platelets in physiological and pathologic processes must be considered. For example, recent observations concerning the protective effect of antidepressants (selective serotonin reuptake inhibitors [SSRIs]) against myocardial infarction remain unexplained.18,19 Because platelet 5-HT levels are lowered by SSRI drugs,20 involvement of COAT-platelets in these clinical observations deserves investigation.
Submitted February 2, 2002; accepted June 4, 2002.
Prepublished online as Blood First Edition Paper, June 14, 2002; DOI 10.1182/blood-2002-02-0354.
Supported by the National Institutes of Health (HL53585 and HL68129) and the Warren Medical Research Institute.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: George L. Dale, Department of Medicine, BSEB-330, OU Health Sciences Center, 941 Stanton Young Blvd, Oklahoma City, OK 73104; e-mail: george-dale{at}ouhsc.edu.
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© 2002 by The American Society of Hematology.
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