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Blood, 1 May 2004, Vol. 103, No. 9, pp. 3374-3380.
Prepublished online as a Blood First Edition Paper on January 22, 2004; DOI 10.1182/blood-2003-07-2234.

Submitted July 7, 2003
Accepted December 4, 2003
Identification and characterization of a very low density lipoprotein receptor binding peptide from tissue factor pathway inhibitor that has antitumor and antiangiogenic activity
Todd A Hembrough*, Jose F Ruiz, Bonnie M Swerdlow, Glenn M Swartz, Hans J Hammers, Li Zhang, Stacy M Plum, Mark S Williams, Dudley K Strickland, and Victor S Pribluda
Discovery Research, EntreMed Inc., Rockville, MD, USA
Holland Laboratory, American Red Cross, Rockville, MD, USA
* Corresponding author; email: toddh{at}entremed.com.
Tissue factor pathway inhibitor (TFPI) is the major physiological inhibitor of the extrinsic coagulation pathway. We have previously shown that TFPI is also a potent inhibitor of endothelial proliferation in vitro, and of primary and metastatic tumor growth in vivo. Surprisingly, TFPIs antitumor activity was demonstrated to be independent of its anticoagulant activity, suggesting a possible non-hemostatic mechanism of action for TFPI in these models. This antitumor mechanism may involve the very low-density lipoprotein (VLDL) receptor, because TFPIs in vitro antiproliferative activity is mediated through interaction with the VLDL receptor. In the current study, we identify a 23 amino acid fragment of TFPI (TFPIc23) localized to the C-terminus, which mediates binding to the VLDL receptor. The TFPIc23 peptide inhibits endothelial cell proliferation through an apoptotic mechanism and blocks vessel outgrowth in in vitro assays, and this activity is mediated through interactions with the VLDL receptor. In vivo, this peptide potently inhibits angiogenesis in Matrigel and chick CAM models, and also inhibits metastatic tumor growth. Our data demonstrate that this VLDL receptor binding fragment of the TFPI molecule has apoptotic, antiangiogenic and antitumor activity and suggests a possible mechanism whereby TFPI can regulate angiogenesis and tumor growth independently of its anticoagulant activity.

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