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Blood, 15 March 2006, Vol. 107, No. 6, pp. 2218.
Could shear stress be the answer?BAYLOR COLLEGE OF MEDICINE
This study demonstrates that mutations within the A2 domain that impair the secretion of VWF also influence the proteolysis of VWF by ADAMTS13 because this effect is a general property of VWD type 2A.
In this issue of Blood, Hassenpflug and colleagues demonstrate that type 2A mutations of both groups 1 and 2 enhance the susceptibility to proteolysis by ADAMTS13. To evaluate the effect of the mutations, the authors examined the ability of recombinant ADAMTS13 to cleave recombinant full-length VWF variants containing type 2A mutations of both groups. This approach precluded the use of plasma as a source of ADAMTS13, and the results were influenced only by the enzyme and its substrate. Eleven of the 13 VWF mutants tested displayed enhanced susceptibility to proteolysis, and the authors demonstrate for the first time that 3 mutations known to impair secretion of VWF (group 1) also increased its susceptibility to proteolysis by ADAMTS13. Thus, the authors suggest that any mutation within the A2 domain of VWF that increases the susceptibility to proteolysis by ADAMTS13 is a general property of VWD type 2A.
It is thus possible that mutations within the A2 domain may act not only by destabilizing the overall structure of the domain, but could weaken its interaction with either or both of the other A domains, A1 or A3. In both cases the effect seems to be independent of perturbing the tri-domain conformation under stasis, because the authors observed that the chaotropic agent urea was not sufficient to increase proteolysis in some mutants. As acknowledged by the authors, shear forces play an important role on the activity of ADAMTS13 in vivo,1 and thus, it is most likely that the type 2A mutants make the A domain(s) more susceptible to shear-induced conformational change. This could explain why in this study, which was carried out under static conditions, 2 mutants (G1505E and I1628T) failed to enhance susceptibility to proteolysis. The notion that shear stress is required for efficient VWF cleavage is supported by the observations that a recombinant A2 domain protein is rapidly cleaved in the absence of both denaturant agents and divalent cations2 and that recombinant A2 variants containing type 2A mutations of group 2 had little or no effect on proteolysis by ADAMTS13.3 As suggested by the authors, high-resolution structures of VWF or of the A1A2A3 region will help us to understand the molecular mechanism by which the A2 domain in VWF is altered to expose the cleavage site for ADAMTS13 in flowing blood. References
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