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Previous Article | Table of Contents | Next Article 
Blood, 1 January 2002, Vol. 99, No. 1, pp. 151-158
HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
Essential role for phosphoinositide 3-kinase in
shear-dependent signaling between platelet glycoprotein Ib/V/IX and
integrin IIb 3
Cindy L. Yap,
Karen E. Anderson,
Sascha C. Hughan,
Sacha M. Dopheide,
Hatem H. Salem, and
Shaun P. Jackson
From the Australian Centre for Blood Diseases,
Department of Medicine, Monash Medical School, Box Hill Hospital,
Victoria, Australia.
 |
Abstract |
Platelet adhesion and aggregation at sites of vascular injury are
critically dependent on the interaction between von Willebrand factor
(VWF) and 2 major platelet adhesion receptors, glycoprotein (GP)
Ib/V/IX and integrin IIb 3. GP Ib/V/IX
binding to VWF mediates platelet tethering and translocation, whereas
activation of integrin IIb 3 promotes
cell arrest. To date, the signaling pathways used by the VWF-GP Ib/V/IX
interaction to promote activation of integrin IIb 3, particularly under shear, have
remained poorly defined. In this study, the potential involvement of
type 1 phosphoinositide (PI) 3-kinases in this process was
investigated. Results show that platelet adhesion and spreading on
immobilized VWF results in a specific increase in the PI 3-kinase
lipid product, PtdIns(3,4)P2. Under static conditions,
inhibiting PI 3-kinase with LY294002 or wortmannin did not prevent
platelet adhesion, integrin IIb 3 activation, or platelet spreading although it significantly delayed the
onset of these events. In contrast, PI 3-kinase inhibition under shear
dramatically reduced both platelet adhesion and spreading. Real-time
analysis of intracellular calcium demonstrated that under static
conditions inhibiting PI 3-kinase delayed the onset of intracellular
fluxes in adherent platelets, but did not affect the final magnitude of
the calcium response. However, under shear, inhibiting PI 3-kinase
dramatically reduced intracellular calcium mobilization and integrin
IIb 3 activation, resulting in
impaired thrombus growth. The studies demonstrate a shear-dependent
role for PI 3-kinase in promoting platelet adhesion on immobilized VWF. Under static conditions, platelets appear to mobilize
intracellular calcium through both PI 3-kinase-dependent and
-independent mechanisms, whereas under shear PI 3-kinase is
indispensable for VWF-induced calcium release.
(Blood. 2002;99:151-158)
© 2002 by The American Society of Hematology.
 |
Introduction |
Platelet adhesion and aggregation at sites of blood
vessel injury are essential for the arrest of bleeding and for the
maintenance of vascular integrity. Under conditions of rapid blood
flow, the formation of the primary hemostatic plug requires the
synergistic contribution of multiple platelet receptor-ligand
interactions,1,2 foremost of which involves the sequential
binding of von Willebrand factor (VWF) to platelet adhesion receptors,
glycoprotein (GP) Ib/V/IX and integrin
IIb 3. The VWF-GP Ib/V/IX interaction is the first step in the hemostatic process that tethers platelets to the
site of vascular injury. A characteristic feature of this adhesive
interaction is its rapid reversibility such that platelets translocate
(roll) on immobilized VWF. During surface translocation, GP Ib/V/IX
transduces signals (outside-in signaling) to induce platelet
activation, converting integrin IIb 3 from
a low- to a high-affinity state (inside-out signaling) capable of
engaging the C1 domain of VWF.3-5 Recent in vivo studies
in mice lacking VWF or fibrinogen or both have demonstrated the central
role for VWF in promoting platelet-vessel wall and platelet-platelet
adhesive interactions during thrombus growth.6 However,
despite its fundamental importance, the mechanisms linking the VWF-GP
Ib/V/IX interaction to activation of integrin
IIb 3, particularly under shear
conditions, remain poorly defined.
An important signaling pathway operating in all mammalian cells
involves the activation of one or more members of the phosphoinositide (PI) 3-kinase family. These enzymes phosphorylate membrane inositol phospholipids at the 3-OH position and have been classified into 3 distinct classes based on their primary structure and in vitro lipid
substrate specificity.7,8 It is likely that all mammalian cells express representatives of each of the 3 types of PI 3-kinases; however, only the type 1 PI 3-kinases are capable of phosphorylating all 3 conventional lipids PtdIns, PtdIns(4)P,
PtdIns(4,5)P2 in vitro, generating PtdIns(3)P,
PtdIns(3,4)P2 and PtdIns(3,4,5)P3, respectively. PtdIns(3,4)P2 and PtdIns(3,4,5)P3
are considered the primary output signals of type 1 PI 3-kinases in
vivo, and have been implicated in regulating a diverse range of
cellular processes, including cell growth, prevention of apoptosis,
glucose transport, and cytoskeletal reorganization.
A great deal of information on the function of type 1 PI 3-kinases in
cells has been based on the use of the structurally distinct
pharmacologic inhibitors, LY294002 and wortmannin. These inhibitors
have been used to study the role of type 1 PI 3-kinases in platelets
and have demonstrated a potentially important role for these enzymes in
regulating the adhesive and signaling function of integrin
IIb 3.9 For example, evidence
from the study of Glanzmann thrombasthenic platelets (congenitally
deficient in integrin IIb 3) indicates
that the generation of the PI 3-kinase lipid product,
PtdIns(3,4)P2, is primarily dependent on signaling downstream of integrin
IIb 3.10 Furthermore, several
integrin IIb 3-dependent functional
responses, including platelet spreading11 and irreversible
platelet aggregation,12 are dependent on PI 3-kinases.
Although these studies have defined an important role for type 1 PI
3-kinases in integrin IIb 3 signaling
(inside-out signaling) there is less convincing evidence for an
absolute requirement for PI 3-kinases in inducing activation of
integrin IIb 3 activation (outside-in
signaling) by the majority of physiologic platelet stimuli studied to
date.13
A potential role for type 1 PI 3-kinases in GP Ib/V/IX signaling has
been suggested by the observation that VWF binding to GP Ib/V/IX can
induce the cytoskeletal association and activation of p85/p110 form of
type 1 PI 3-kinase.14 More recently, VWF stimulation of
platelets was shown to initiate complex formation between the p85
subunit of PI 3-kinase and GP Ib/V/IX.15 In this report
we have investigated the potential involvement of type 1 PI 3-kinases
in shear-dependent signaling between GP Ib/V/IX and integrin
IIb 3.
 |
Materials and methods |
Materials
LY294002, EGTA-AM, and adenosine
5'-O-(1-Thio-triphosphate) (ATP S) were from Calbiochem (La Jolla,
CA). Adenosine 3'-phosphate 5'-phosphosulfate (A3P5PS) was purchased
from Sigma (St Louis, MO). Wortmannin was purchased from Sapphire
Bioscience (Crow's Nest, New South Wales, Australia). Oregon
Green 488 BAPTA-1, AM and Fura Red, AM were
from Molecular Probes (Eugene, OR). DiOC6 was obtained from
Sigma. Apyrase was purified from potatoes according to the method of
Molnar and Lorand.16 Human VWF was purified to homogeneity
from plasma cryoprecipitate according to the method of Montgomery and
Zimmerman.17 AR-C69931MX was generously supplied by
Astrazeneca R & D Charnwood (Leicestershire, England). All other
reagents were obtained from sources described
previously.14,18,19
Antibodies
PAC-1 monoclonal antibody was from Becton Dickinson (Victoria,
Australia) and fluorescein isothiocyanate (FITC)-conjugated antimouse
IgM ( -IgM) antibody was from Southern Biotechnology Associates
(Birmingham, AL).
In vitro static and flow studies
For washed platelet and platelet reconstitution studies, blood
was collected from healthy volunteers who had not received any
antiplatelet medication in the preceding 2 weeks. Platelets were
isolated and washed as described previously18 and
resuspended in modified Tyrode buffer (10 mM Hepes, 12 mM
NaHCO3, pH 7.4, 137 mM NaCl, 2.7 mM KCl, 5 mM glucose),
containing 1 mM CaCl2 or 1 mM MgCl2 or both
where indicated. Autologous red blood cells were obtained by an initial
centrifugation of anticoagulated whole blood at 200g for 30 minutes. The platelet-rich plasma was removed and red blood cells were
washed 3 times with washing buffer (10 mM Hepes, pH 7.4, 140 mM NaCl, 5 mM glucose). Plasma was obtained from centrifugation of anticoagulated
blood (15 mM trisodium citrate, pH 7.4) at 2000g for 10 minutes. Washed platelets were pretreated with vehicle alone (dimethyl
sulfoxide [DMSO]), LY294002 (0-25 µM), or wortmannin (0-100 nM) for
15 minutes, or alternatively pretreated with apyrase (up to 16.5 U/mL)
or the adenosine diphosphate (ADP) receptor antagonists, AR-C69931MX
(100 nM) and A3P5PS (200 µM), and ATP S (50-100 µM) for 30 minutes before static and flow-based assays were performed (150 s-1 or 1800 s-1) according to a modified method
of Yuan et al20 and Cooke et al,21
respectively. In control studies, we demonstrated that the
concentrations of apyrase, ATP S, AR-C69931MX, and A3P5PS used in our
experimental assays abolished platelet aggregation or platelet shape
change in washed platelets induced by 10 µM exogenous ADP. In some
studies, washed platelets were reconstituted with either red blood
cells alone (50% [vol/vol] autologous packed red blood cells), in
the presence of 0.4 U/mL apyrase (ADPase activity), or red blood cells
and plasma prior to perfusion through VWF-coated microcapillary tubes.
Analysis of platelet adhesion and surface area was performed as
described by Yap et al22 and expressed as a percent of
control. For whole blood studies, anticoagulated blood (15 mM trisodium
citrate, pH 7.4) was pretreated with vehicle alone (DMSO), LY294002
(0-200 µM), apyrase (8.25 U/mL), ATP S (100 µM), or AR-C69931MX
(100 nM) and A3P5PS (200 µM) for 10 minutes before perfusion through
VWF-coated microcapillary tubes at 1800 s-1. In control
studies, we confirmed that the concentrations of apyrase, ATP S,
AR-C69931MX, and A3P5PS used in our experimental assays prevented
platelet aggregation in whole blood induced by 10 µM exogenous ADP
using a sensitive single-platelet detection assay.
Platelet imaging studies
In static adhesion assays, washed platelets were allowed to
adhere to VWF-coated coverslips in the presence of PAC-1 antibody (1 µg/mL). In flow adhesion assays, washed platelets reconstituted with
red blood cells were perfused through microcapillary tubes for 5 minutes prior to the perfusion of PAC-1 (1 µg/mL) over adherent platelets for 15 minutes. Adherent platelets were fixed, incubated with
a FITC-conjugated anti-IgM antibody, and visualized using confocal
microscopy (× 63W; Leica TCS SP; Leica, Heidelberg, Germany). For the
imaging of platelet thrombi, adherent platelets were fixed and stained
with DiOC6 (1 µM). Thrombi were imaged using fluorescent confocal microscopy and reconstructed in Voxblast (Vaytek,
Fairfield, IA).
Quantitation of platelet thrombi
Following formation of thrombi, red cells were lysed by
perfusing 1% ammonium oxalate through the microcapillary tubes.
Adherent platelets were then lysed with 0.1% Triton lysis buffer and
lactate dehydrogenase (LDH) levels determined using the COBAS MIRA S
Chemistry System (Roche, Somerville, NJ). This quantitative method was
validated independently by examining thrombus dimensions by confocal
imaging, according to the method of Kulkarni et al.23
Analysis of 32P-labeled phospholipids
Platelets were labeled with inorganic 32P (11.1 MBq
[0.3 mCi/mL]) for 2 hours at 37°C and the level of
phospholipids determined as described by Carter et al.24
Platelets in suspension (resting) or adherent to VWF were lysed with
radioimmunoprecipitation assay (RIPA) buffer (10 mM Tris HCl, pH 7.2, 1% Triton X-100, 1% sodium deoxycholate, 0.1% sodium dodecyl sulfate
[SDS], 158 mM NaCl), and phospholipids extracted with a
chloroform/methanol-based mixture (100 µL chloroform/methanol, 1:2,
75 µL 3.1 M HCl, 100 µL chloroform). Following deacylation with
methylamine/butanol/methanol (42:9:47) phospholipids were identified by
SAX high-performance liquid chromatography (HPLC) analysis using
3H-labeled commercial standards.
Preparation of scanning electron microscopy samples
Adherent platelets were fixed with 2% glutaraldehyde in 100 mM
Na2HPO4/NaH2PO4, pH
7.4, for 60 minutes then incubated with 1% OsO4 in 100 mM
Na2HPO4/NaH2PO4, pH
7.4, for 30 minutes. The fixed platelets were dehydrated by successive
immersions in increasing concentrations of ethanol followed by critical
point drying. The coverslips or microcapillary tubes, which had been
dissected laterally, were mounted on scanning electron microscopy stubs
and coated with gold prior to imaging using an Hitachi S570 scanning
electron microscope.
Ratiometric calcium measurements
Analysis of intracellular calcium fluxes was performed according
to the method of Yap et al.22 Briefly, platelets were
loaded with calcium indicator dyes, Oregon Green 488 BAPTA-1,
AM (1 µM), and Fura Red, AM (1.25 µM) for
30 minutes at 37°C, then washed and resuspended in Tyrode buffer
containing either extracellular calcium (1 mM) or EGTA/Mg++
(1 mM each), prior to incubation with PI 3-kinase inhibitors. Changes
in the concentration of cytosolic calcium were derived from the ratio
of signal intensity in the Oregon Green and Fura Red channels using
confocal microscopy. The calcium dynamics in individual platelets were
monitored every 0.586 seconds over a 73.25-second or 37.5-second time
interval for static or flow experiments, respectively, and recorded for
off-line single cell analysis as described previously.22
The number of platelets demonstrating oscillatory calcium transients
over the time period examined was determined. Platelet translocation
was determined based on the displacement of a tethered platelet from
its original point over a 37.5-second period.
Statistical analysis
Significant differences were detected using Student t
test and one-way ANOVA, using the Prism software package (Graphpad
Software for Science, San Diego, CA).
 |
Results |
To investigate the potential involvement of type 1 PI
3-kinases in regulating platelet adhesion, integrin
IIb 3 activation and spreading on
immobilized VWF, washed platelets were pretreated with the
well-characterized pharmacologic PI 3-kinase inhibitors, LY294002 or
wortmannin. As demonstrated in Figure 1A,
wortmannin or LY294002 exhibited a modest dose-dependent inhibitory
effect on platelet adhesion under static conditions, with a maximal
inhibition of 22% ± 3.45% (P < .01) using LY294002
(25 µM) and 30% ± 4.81% (P < .01) with wortmannin
(100 nM). These inhibitors did not, however, inhibit integrin
IIb 3 activation, as assessed by binding of the activation-specific monoclonal antibody, PAC-1 (Figure 1B). In
control studies, we demonstrated that integrin
IIb 3 activation under these experimental
conditions was not dependent on released ADP, because pretreating
platelets with apyrase (16.5 U/mL; Figure 1B) or with the ADP receptor
antagonists, AR-C69931MX ( -P2Y12) and A3P5PS
( -P2Y1) or ATP S ( -P2Y12 and
-P2Y1) (data not shown) did not prevent PAC-1 binding.
Examination of platelet morphology demonstrated that pretreatment of
platelets with wortmannin (0-100 nM) or LY294002 (0-25 µM) resulted
in a minor, yet significant (P < .05), effect on the
ability of cells to spread (~11% reduction in platelet surface area
in LY294002- and wortmannin-treated platelets [Figure
2A]). High-resolution imaging of spread
platelets demonstrated that a significant proportion (> 50%) of
LY294002- and wortmannin-treated cells exhibited irregular cell margins
and had not fully spread (Figure 2B). Real-time analysis of platelet
spreading demonstrated an important role for PI 3-kinase in regulating
the rate of platelet spreading. For example, control platelets adhering
to VWF extended dynamic filopodial projections that extended and
retracted from the cell surface. The formation of these projections was
closely followed by the extension of lamellipodial sheets, resulting in full platelet spreading over 10 to 15 minutes (Figure 2C). Pretreating platelets with LY294002 (25 µM) or wortmannin (100 nM) slightly delayed the onset of filopodial formation (typically by < 3 minutes; Figure 2C). In contrast to cells pretreated with vehicle, there was a
consistent delay in the subsequent formation of lamellipodial sheets
(10-15 minutes), such that platelet spreading typically occurred over
20 to 30 minutes.

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| Figure 1.
The role of PI 3-kinase in regulating platelet adhesion
and integrin IIb 3 activation under static
conditions and the effect of apyrase on VWF-induced integrin
IIb 3 activation.
Washed platelets (1.5 × 108/mL) were incubated with
vehicle alone (control) or the indicated concentrations of LY294002
(0-25 µM) or wortmannin (0-100 nM) for 15 minutes or with apyrase (16 U/mL) for 30 minutes. Platelets were allowed to adhere and spread on
immobilized human VWF (10 µg/mL) for 60 minutes under static
conditions. In panel B, pretreated platelets were incubated with PAC-1
antibody, prior to adhesion and spreading. These results demonstrate
(A) the effect of LY294002 or wortmannin on the level of platelet
adhesion, and (B) the effect of LY294002, wortmannin, or apyrase on
PAC-1 binding as visualized by confocal microscopy (× 63 W objective;
bar = 10 µm). Statistical analysis of the results was performed
using a t test and the P values are indicated
where appropriate (P < .01**). Results are the mean ± SEM of 3 experiments, and images are from a single experiment
representative of 3.
|
|

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| Figure 2.
The role of PI 3-kinase in regulating platelet
spreading under static conditions.
Washed platelets (1.5 × 108/mL for panels A and B or
1.5 × 107/mL for panel C) were incubated with vehicle
alone (control) or the indicated concentrations of LY294002 (0-25 µM)
or wortmannin (0-100 nM) for 15 minutes. These results demonstrate (A)
the mean surface area of adherent platelets, and (B) the morphology of
spread platelets as determined by scanning electron microscopy
(bar = 2 µm). Statistical analysis of the results was performed
using a t test and the P values are indicated
where appropriate (P < .05*). Results are the mean ± SEM of 3 experiments, and images are from a single experiment
representative of 3. In panel C, platelet spreading was visualized in
real time by differential interference contrast microscopy and recorded
on video for off-line analysis (× 100 oil objective; bar = 5 µm).
The images presented are typical of cells from a single experiment and
are representative of 3 independent experiments.
|
|
To investigate whether the inability of PI 3-kinase inhibitors
to prevent integrin IIb 3 activation and
platelet spreading was due to incomplete inhibition of PI 3-kinase, we
examined the effects of these inhibitors on the generation of PI
3-kinase lipid products. As demonstrated in Figure
3A, PtdIns(3,4)P2 was
undetectable in resting platelets. However, this lipid increased to at
least 0.15% of total PI levels following platelet spreading on
immobilized VWF (Figure 3A). This increase in PtdIns(3,4)P2
is similar to that previously reported for thrombin-stimulated
platelets and platelets spread on fibrinogen.11,25 In
contrast, the level of PtdIns(3)P was unaltered in these cells and
PtdIns(3,4,5)P3 was not detected (data not shown).
Pretreatment of platelets with either LY294002 or wortmannin led to a
dose-dependent inhibition of PtdIns(3,4)P2 production in
spreading platelets, with a maximal inhibition of about 95% and 100%
using LY294002 (25 µM) and wortmannin (100 nM), respectively (Figure
3A,B). The effects of these inhibitors were specific in that they did
not inhibit the levels of PtdIns, PtdIns(4)P, and
PtdIns(4,5)P2 (Figure 3C). Further evidence that LY294002
(25 µM) and wortmannin (100 nM) effectively inhibited PI 3-kinase
was obtained from studies demonstrating that both inhibitors prevented
integrin IIb 3 activation and spreading of
platelets on a fibrinogen matrix (Figure 3D). In addition, both
inhibitors completely eliminated other PI 3-kinase-dependent events
such as phosphorylation of the downstream PI 3-kinase target, PKB/Akt,
and platelet aggregation induced by heat-aggregated IgG and CD-9 (data
not shown).

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| Figure 3.
The effect of LY294002 and wortmannin on VWF-induced
generation of PtdIns(3,4)P2 and on integrin
IIb 3 activation and spreading on
immobilized fibrinogen.
Washed platelets (1.5 × 108/mL) were incubated
with vehicle alone (control) or the indicated concentrations of
LY294002 (0-25 µM) or wortmannin (0-100 nM) for 15 minutes. (A-C)
Platelets were suspended in Tyrode buffer (A, resting) and allowed to
spread on immobilized VWF (10 µg/mL) for 60 minutes under static
conditions (A, spreading: control and LY294002). Platelets in
suspension or adherent on the matrix were subsequently lysed with RIPA
buffer, lipids extracted and analyzed by SAX HPLC. These results
demonstrate: (A) the generation of the PI 3-kinase lipid product,
PtdIns(3,4)P2 (PI[3,4]P2), in resting
platelets and in spread platelets pretreated with vehicle (control) or
LY294002 (25 µM); (B) the level of inhibition of
PtdIns(3,4)P2 production in spreading platelets pretreated
with LY294002 (0-25 µM; solid line) or wortmannin (0-100 nM; dotted
line); and (C) the effect of LY294002 and wortmannin on the levels of
PtdInsP (PI), PtdIns(4)P (PI[4]P), and PtdIns(4,5)P2
(PI[4,5]P2) in spreading platelets. (D) Pretreated
platelets were incubated with PAC-1 antibody prior to adhesion and
spreading on immobilized fibrinogen (100 µg/mL) for 60 minutes.
Adherent platelets were fixed and stained with a FITC-conjugated
secondary antibody prior to visualization by confocal microscopy
(× 63W objective). (A-D) Images and graphs are from a single
experiment representative of 3.
|
|
Our recent studies have demonstrated that VWF-induced integrin
IIb 3 activation is critically dependent
on intracellular calcium mobilization.22 To examine the
relationship between inhibition of PI 3-kinase and calcium release,
cytosolic calcium levels were monitored during platelet spreading on
VWF. As demonstrated in Figure 4, panels
A and B, resting platelets exhibited a cytosolic calcium level below 50 nM, which did not undergo oscillations. Platelets firmly adherent to
VWF underwent dynamic calcium oscillations in about 60% of cells
(Figure 4A). The range of calcium concentrations varied widely between
individual cells, with calcium oscillations typically fluctuating
between 150 and 800 nM.22 Pretreatment of platelets with
wortmannin (100 nM) delayed the onset of the oscillatory calcium
transients by 5 to 10 minutes (Figure 4A); however, they did not affect
the final magnitude of the response (Figure 4B). Similar results were
obtained with LY294002 (25 µM; Figure 4A). The inhibitory effect of
LY294002 and wortmannin on the initiation of the oscillatory calcium
transients was consistent with the delayed spreading response in these
cells. Because PI 3-kinase has been implicated in regulating calcium
influx as well as the release of intracellular stores, we investigated
the effect of LY294002 and wortmannin on intracellular calcium
mobilization. Consistent with our recent findings,22
chelating extracellular calcium with the calcium chelator, EGTA, did
not prevent oscillatory calcium transients, but had a major inhibitory
effect (~75%) on the magnitude of the calcium response. Pretreatment
of EGTA-treated platelets with LY294002 or wortmannin delayed the onset
of oscillatory calcium transients by 5 to 10 minutes; however, the
final magnitude of these oscillatory calcium responses was unaffected
by these inhibitors (data not shown), suggesting that the primary
function of PI 3-kinase is to regulate intracellular calcium
mobilization.

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| Figure 4.
The role of PI 3-kinase in regulating platelet calcium
responses under static conditions.
Calcium indicator dye-loaded platelets were incubated with vehicle
alone (control), LY294002 (25 µM), or wortmannin (100 nM) for 15 minutes prior to adhesion on immobilized VWF (10 µg/mL). Adherent
platelets were allowed to spread in the presence of extracellular
Ca++ (1 mM) for up to 60 minutes under static conditions.
Changes in the cytosolic calcium concentration of adherent cells were
monitored at the indicated time points by confocal microscopy (× 63W
objective) and fluorescence ratios quantified. The results presented in
panel A demonstrate the percentage of platelets undergoing oscillatory
calcium transients at the indicated time points. Results represent
mean ± SEM from 3 to 5 independent experiments. The results
presented in panel B show a representative calcium oscillation profile
of individual vehicle-treated (control) and wortmannin-treated
platelets at 0 minute (thin line) and after 15 minutes of spreading
(bold line). Statistical analysis was performed using a t
test comparing control versus LY294002- or wortmannin-treated platelets
(P < .05*; P < .01**).
|
|
To investigate the functional importance of PI 3-kinase under
shear conditions, we examined the effect of LY294002 and wortmannin on
platelet adhesion and spreading on immobilized VWF using an in vitro
flow-based adhesion assay. In contrast to adhesion assays performed
under static conditions, inhibition of PI 3-kinase with either
wortmannin or LY294002 profoundly affected the ability of platelets to
adhere to a VWF matrix under flow. As demonstrated in Figure
5A, under low shear conditions (150 s-1) pretreating platelets with LY294002 or wortmannin
inhibited platelet adhesion in a dose-dependent manner, with maximal
inhibition of about 70% (P < .05). Under high shear
conditions (1800 s-1), inhibiting PI 3-kinase reduced
platelet adhesion by up to 90% (P < .001). Real-time
analysis of platelet adhesion under flow revealed that LY294002 or
wortmannin did not affect the ability of cells to tether or translocate
on the VWF matrix but dramatically reduced the ability of these cells
to form stationary adhesion contacts (data not shown). This reduction
in stationary adhesion correlated with more than 95% reduction in
PAC-1 binding (Figure 5D). Continuous observation of translocating
platelets for prolonged periods (20 minutes) demonstrated that these
cells were unable to form stable adhesion contacts at all times points
examined (data not shown). Inhibition of PI 3-kinase had no effect on
the ability of platelets to change shape and extend filopodia on
immobilized VWF; however, lamellipodial formation was completely
inhibited (Figure 5B,C). In further control studies, we confirmed that
ADP was not essential for stationary platelet adhesion under high shear
conditions, because platelets pretreated with the ADP receptor antagonists, ATP S (100 µM) or AR-C69931MX/A3P5PS (100 nM and 200 µM, respectively), or with apyrase (8.25 U/mL) adhered normally to
the VWF matrix (data not shown).

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| Figure 5.
The role of PI 3-kinase in regulating platelet
adhesion, spreading, and integrin IIb 3
activation under flow conditions.
Washed platelets (1.5 × 108/mL) were incubated with
vehicle alone (control) or the indicated concentrations of LY294002
(0-25 µM) or wortmannin (0-100 nM) for 15 minutes. Pretreated
platelets were either perfused immediately over immobilized VWF (100 µg/mL) at 150 s-1 or reconstituted with red blood cells
prior to perfusion at 1800 s-1. In some experiments,
tethered platelets were incubated with PAC-1 antibody prior to fixation
and staining with a FITC-conjugated secondary antibody. These results
demonstrate the effect of the PI 3-kinase inhibitors on (A) the level
of stationary platelet adhesion and (B) the mean surface area of
adherent platelets following perfusion at 150 s-1 or 1800 s-1; (C) the morphology of adherent platelets as visualized
by scanning electron microscopy (bar = 2 µm); and (D) platelet
spreading and PAC-1 binding (bar = 10 µm). (A,B) Results represent
mean ± SEM from 4 independent experiments. Statistical analysis
was performed using a t test comparing control versus
LY294002- or wortmannin-treated platelets (P < .05*;
P < .01**; P < .001***). (C,D) Images are
from a single experiment representative of 3.
|
|
Analysis of cytosolic calcium during shear-dependent platelet
adhesion demonstrated a critical role for PI 3-kinase in this process.
As demonstrated in Figure 6A,
pretreatment of platelets with wortmannin (100 nM) in the
presence of EGTA abolished sustained calcium oscillations in more than
90% of platelets relative to control platelets. Whereas control
platelets underwent strong oscillatory calcium transients and formed
stationary adhesion contacts, wortmannin-treated platelets (100 nM)
translocated continuously and exhibited minor calcium oscillations
(Figure 6B,C). Similar results were obtained with LY294002 (data not
shown). These studies demonstrate an important requirement for PI
3-kinase in promoting calcium mobilization under flow.

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| Figure 6.
The role of PI 3-kinase in regulating calcium
mobilization under flow conditions.
Calcium indicator dye-loaded platelets were incubated with vehicle
alone (control) or wortmannin (100 nM) for 15 minutes prior to
reconstitution with red blood cells and perfusion over immobilized VWF
(100 µg/mL) at 1800 s-1. Changes in the cytosolic calcium
concentration of adherent cells were monitored by confocal microscopy
(× 63W objective) and fluorescence ratios quantified. The results
presented in panel A demonstrate the effect of wortmannin on the
percentage of cells undergoing oscillatory calcium transients relative
to untreated (control) platelets. The images and results presented in
panels B and C show a representative calcium oscillation response
(solid line) and the displacement (dotted line) of individual vehicle-
(control) and wortmannin-treated platelets under shear
conditions. Results and images are from a single experiment
representative of 3. Bar = 10 µm.
|
|
To investigate the potential importance of PI 3-kinase in
regulating thrombus formation under experimental conditions more closely simulating those experienced by platelets in vivo, flow studies
were performed on anticoagulated whole blood. As demonstrated in Figure
7A, perfusing anticoagulated whole blood
through VWF-coated microcapillary tubes (1800 s-1) for 5 minutes resulted in the formation of platelet-rich thrombi. Analysis of
these thrombi by confocal imaging demonstrated that they covered
approximately 30% to 40% of the VWF-coated surface and had a height
of 7 to 10 µm (Figure 7A). In contrast, pretreating whole blood with
increasing concentrations of LY294002 resulted in a dose-dependent
inhibition of thrombus growth (Figure 7A,B). Real-time analysis of
LY294002-treated platelets (50-200 µM) revealed that the majority of
tethered cells rolled along the VWF matrix and did not form stationary
adhesion contacts, similar to that observed with washed platelets (data
not shown). It should be noted that the requirement for higher LY294002
concentrations to inhibit platelet adhesion in whole blood is
presumably due to plasma protein binding to LY294002, because a 5- to
10-fold increase in concentration of this reagent was required to
inhibit CD-9-induced platelet aggregation in platelet-rich plasma
relative to washed platelets (data not shown). Further evidence that PI 3-kinase was essential for platelet thrombus formation on VWF was
derived from studies using wortmannin. In these studies, washed platelets were initially pretreated with wortmannin (100 nM) to irreversibly inhibit PI 3-kinase. The cells were subsequently reconstituted with red blood cells and plasma and examined for their
ability to form stationary adhesion contacts on immobilized VWF.
Similar to that observed with LY294002, wortmannin completely inhibited
the ability of platelets to form stationary adhesion contacts and
thrombi on VWF (data not shown).

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| Figure 7.
The role of PI 3-kinase in regulating platelet thrombus
formation under flow conditions.
Anticoagulated whole blood was incubated with vehicle alone (control)
or the indicated concentrations of LY294002 (0-200 µM) for 15 minutes
prior to perfusion over immobilized VWF (100 µg/mL) at 1800 s-1. In panel A, thrombi were fixed and incubated with
DiOC6. Platelet thrombi were reconstructed using a
computer-assisted image analysis program. The upper panels represent an
oblique view to demonstrate surface coverage; the lower panels
represent a side-on view to demonstrate differences in thrombus height.
The results in panel B demonstrate the effect of PI 3-kinase
inhibition on thrombus formation.
|
|
 |
Discussion |
The results presented here demonstrate for the first time a
key signaling role for type 1 PI 3-kinases in linking the VWF-GP Ib/V/IX interaction to integrin IIb 3
activation under physiologic flow conditions. This conclusion is
primarily based on studies using the pharmacologic inhibitors, LY294002
and wortmannin. Wortmannin, a fungal metabolite that irreversibly
inhibits the catalytic function of PI 3-kinase, has been well
characterized to specifically inhibit PI 3-kinase at concentrations up
to 100 nM.26 At higher concentrations, wortmannin also
inhibits PI 4-kinase, myosin light-chain kinase, and phospholipase
A2. LY294002, a quercetin analogue that reversibly inhibits
PI 3-kinase, has no inhibitory effects on these enzymes and has
generally been regarded as a selective PI 3-kinase inhibitor at
concentrations up to 25 µM.27 However, a recent study
has demonstrated that casein kinase 2 (CK2), a serine-threonine kinase involved in promoting cell growth, is also inhibited by LY294002 at low
micromolar concentrations.28 CK2 is not, however,
inhibited by wortmannin at concentrations as high as 1 µM, suggesting
that the inhibitory effects of LY294002 in our studies are unlikely to
be primarily due to effects on CK2. To further strengthen our hypothesis that PI 3-kinase is the responsible enzyme for
shear-dependent platelet adhesion, we have performed dose-response
studies correlating the inhibitory effects on platelet adhesion with
the cellular levels of PtdIns(3,4)P2. In all studies we
observed an excellent correlation between these events, thereby
providing strong evidence for a key role for type 1 PI 3-kinases in
this process.
Our observations that PI 3-kinase inhibitors did not block
platelet spreading on VWF under static conditions was somewhat surprising given previous reports demonstrating an absolute requirement for this enzyme in promoting platelet spreading on a fibrinogen matrix.11 Several lines of evidence suggest that this
difference was not due to incomplete inhibition of PI 3-kinase, but,
in fact, reflects a specific difference between platelet spreading on
fibrinogen versus VWF. First, we have demonstrated that both LY294002
and wortmannin effectively inhibited generation of the PI 3-kinase lipid product, PtdIns(3,4)P2. Furthermore, inhibition of PI
3-kinase activity with both inhibitors completely blocked PKB/Akt
phosphorylation (unpublished observations, February 2001).
Second, we demonstrated that both LY294002 and wortmannin completely
inhibited platelet spreading on immobilized fibrinogen under identical
conditions to those used in our spreading studies on VWF. Finally, both
inhibitors abolished other PI 3-kinase-dependent processes, including
platelet aggregation induced by heat-aggregated IgG or anti-CD9 antibodies.
Our findings demonstrating an important role for PI 3-kinase in
regulating calcium mobilization in adherent platelets supports a
growing body of evidence for an important link between PI 3-kinase signaling and calcium fluxes. PI 3-kinase has been demonstrated to
regulate both calcium influx and mobilization, although the extent of
its involvement in these processes appears to be specific for both cell
type and stimulus. A role for PI 3-kinase, in particular its
PtdIns(3,4,5)P3 lipid product, in calcium influx has been demonstrated through studies in platelets and T cells. For example, platelets deficient in src homology 2 (SH2)-containing inositol 5'
phosphatase (SHIP) exhibited a specific increase in the levels of
PtdIns(3,4,5)P3, resulting in enhanced transmembrane
calcium flux.29 Similarly, addition of exogenous
PtdIns(3,4,5)P3 to T cells promotes calcium influx, without
affecting intracellular calcium mobilization.30 In other
cell types, including platelet-derived growth factor (PDGF)-stimulated
NIH 3T3 cells31 and COS-1 cells,32 and
antigen-stimulated B cells,33 inhibiting PI 3-kinase
primarily leads to a decrease in IP3 generation and calcium
release from intracellular stores. PtdIns(3,4,5)P3 has been
implicated in this process because microinjection of pleckstrin
homology (PH) domains that specifically bind this lipid decrease
IP3 formation and calcium mobilization in COS-1
cells32 and megakaryocytes,34 respectively. Although we were unable to detect a rise in PtdIns(3,4,5)P3
levels following platelet spreading on VWF, the level of increase in PtdIns(3,4)P2 reported here is in agreement with that
demonstrated for platelets adherent and spread on immobilized
fibrinogen.11 The most likely explanation for only
observing a rise in PtdIns(3,4)P2 in our studies is that in
vitro generation of PtdIns(3,4,5)P3 occurs more rapidly and
precedes the appearance of PtdIns(3,4)P2,35 suggesting that PtdIns(3,4,5)P3 is likely to be detected at
an earlier time point.
In all studies to date, PI 3-kinase has been demonstrated to
primarily serve as a modulator of phospholipase C (PLC )
activation and IP3 formation and was not found to be
essential for calcium release. In contrast, in our studies PI 3-kinase
appears to have an essential role for sustained calcium oscillations
under shear conditions. Moreover, the effects of PI 3-kinase
inhibitors on the time course and magnitude of the calcium responses in
our static assays appears distinct from that previously described. For
example, we have demonstrated that inhibiting PI 3-kinase prolongs the
onset of calcium mobilization, but does not have any effect on the
final magnitude of the calcium response. Thus, PI 3-kinase appears to
be essential for inducing the "early" release of calcium from
internal stores and does not appear to be required for subsequent
calcium influx. These observations raise the possibility that PI
3-kinase inhibitors prevent the formation of irreversible platelet
adhesion under shear conditions, because this "early" calcium
response may be essential for activation of integrin
IIb 3. In this context, it is of interest
that prolonged interaction of translocating platelets with the VWF
matrix (~20 minutes) did not result in stationary platelet adhesion.
It is therefore possible that PI 3-kinase participates in a
shear-specific signaling pathway. This latter possibility would be in
keeping with previous studies in endothelial cells in which
shear-induced nitric oxide production was dependent on the activation
of PI 3-kinase.36,37
A key outstanding issue is the mechanism by which the VWF-GP Ib
interaction induces PI 3-kinase activation. Previous studies examining
shear-induced platelet activation have suggested that platelet
activation induced by the VWF-GP Ib interaction occurs indirectly
through the release of ADP.38-40 Dense granule ADP has a
well-defined role in promoting platelet activation by a number of
platelet agonists and has been demonstrated to induce PI 3-kinase activation.41 However, we do not believe that this is the
major mechanism for PI 3-kinase activation during platelet adhesion to
VWF, because ADP receptor antagonists do not prevent activation of
integrin IIb 3 under these experimental
conditions. A recent study by Canobbio et al42 has
suggested that VWF-induced platelet activation is critically dependent
on Fc RIIA and thromboxane2 (TXA2)
generation. Fc RIIA has previously been postulated to be physically
and functionally linked to GP Ib/V/IX and activates platelets through a
PI 3-kinase-dependent mechanism.43-45 However, this
signaling pathway appears distinct from those operating during platelet
adhesion to VWF under flow22 and during shear-induced platelet aggregation,39 because VWF-dependent platelet
activation under these conditions is insensitive to the inhibitory
effects of aspirin.
A number of recent studies from several independent laboratories have
suggested that GP Ib/V/IX can signal directly to regulate the affinity
status of integrin IIb 3 independent of
ADP, TXA2, and Fc receptors.22,46,47 The
precise mechanism by which GP Ib signals has not been elucidated,
although one potential mechanism for PI 3-kinase activation involves
direct binding to the 14.3.3 adapter protein. The 14.3.3 protein
is physically linked to the cytoplasmic tail of GP Ib and has
recently been suggested to be important for GP Ib/V/IX-induced integrin
IIb 3 activation, based on studies of
Chinese hamster ovary (CHO) cell lines expressing GP Ib/IX and integrin
IIb 3.47 Although there is
evidence for complex formation between 14.3.3 and the p85/p110 form
of PI 3-kinase in T cells,48 there is as yet no evidence
that this association promotes kinase activation. A recent study by
Munday et al15 has suggested a direct association between
GP Ib/V/IX and PI 3-kinase; however, the significance of this
association, given its low stoichiometry, remains unclear. It is
possible that PI 3-kinase activation in VWF-stimulated platelets is in
part regulated through integrin IIb 3
outside-in signaling. Previous studies have highlighted the synergistic
contribution of GP Ib/V/IX and integrin
IIb 3 to cytoskeletal signaling complex
formation18,49 and have also demonstrated that direct
ligand binding to integrin IIb 3 is
sufficient to induce PI 3-kinase activation and a selective increase
in the cellular levels of PtdIns(3,4)P2.12
These observations, combined with the demonstration that ligand
binding to integrin IIb 3 induces
intracellular calcium mobilization, raises the interesting possibility
that integrin IIb 3-dependent PI
3-kinase activation may play an important role in promoting calcium
flux in VWF-stimulated platelets. Future studies are currently under way to examine the relative contribution of GP Ib/V/IX and integrin IIb 3 to PI 3-kinase activation and
calcium mobilization in VWF-stimulated platelets.
In conclusion, our studies demonstrate for the first time an essential
role for type 1 PI 3-kinases in regulating the earliest steps of the
hemostatic process, namely, the shear-induced activation of integrin
IIb 3 following platelet adhesion to VWF.
In this context, it is of interest that wortmannin was originally
described as a hemorrhagic factor,50,51 a finding that has
not been easily reconciled with in vitro studies demonstrating a modest
effect of wortmannin on platelet activation induced by the majority of physiologic agonists studied to date.9 Although it remains to be established whether the bleeding diathesis induced by wortmannin is primarily due to effects on platelets, and in particular GP Ib/V/IX
signaling, our findings nonetheless provide important new insight into
the functional role of PI 3-kinase in regulating the hemostatic
function of platelets.
 |
Acknowledgments |
We would like to thank Suhasini Kulkarni for technical assistance.
 |
Footnotes |
Submitted May 29, 2001; accepted August 21, 2001.
Supported by grants from the National Health and Medical Research
Council of Australia, the National Heart Foundation of Australia, and
the Welcome Trust. C.Y. is a recipient of the Australian Post-Graduate Research Award. K.A. is a National Health and Medical Research Council
C. J. Martin/R.G. Menzies Fellow.
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: Shaun P. Jackson, Australian Centre for Blood
Diseases, Dept of Medicine, Monash Medical School, Box Hill Hospital,
Arnold St, Box Hill, Victoria 3128, Australia; e-mail:
shaun.jackson{at}med.monash.edu.au.
 |
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