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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3766-3772.
Prepublished online as a Blood First Edition Paper on January 15, 2004; DOI 10.1182/blood-2003-08-2712.

Submitted August 7, 2003
Accepted January 5, 2004
Nicked beta2-glycoprotein I: A marker of cerebral infarct and a novel role in the negative feedback pathway of extrinsic fibrinolysis
Shinsuke Yasuda, Tatsuya Atsumi*, Masahiro Ieko, Eiji Matsuura, Kazuko Kobayashi, Junko Inagaki, Hisao Kato, Hideyuki Tanaka, Minoru Yamakado, Minoru Akino, Hisatoshi Saitou, Yoshiharu Amasaki, Satoshi Jodo, Olga Amengual, and Takao Koike
Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
Department of Cell Chemistry, Institute of Molecular and Cellular Biology, Okayama University Medical School, Okayama, Japan
National Cardiovascular Center Research Institute, Osaka, Japan
Narita R&D Center, Iatron laboratories Inc., Mito, Chiba, Japan
Department of Medicine, Mitsui Memorial Hospital, Tokyo, Japan
Azabu Neurosurgical Hospital, Department of Neurosurgery, Sapporo, Japan
* Corresponding author; email: at3tat{at}med.hokudai.ac.jp.
2-glycoprotein I ( 2GPI) is proteolytically cleaved by plasmin in domain V (nicked 2GPI), being unable to bind to phospholipids. This cleavage may occur in vivo and elevated plasma levels of nicked 2GPI were detected in patients with massive plasmin generation and fibrinolysis turnover. In this study, we reported higher prevalence of elevated ratio of nicked 2GPI against total 2GPI in patients with ischemic stroke (63%) and healthy subjects with lacunar infarct (27%) when compared to healthy subjects with normal MRI findings (8%), suggesting that nicked 2GPI might have a physiological role beyond that of its parent molecule in patients with thrombosis. Several inhibitors of extrinsic fibrinolysis are known, but a negative feedback regulator has not been yet documented. We demonstrated that nicked 2GPI binds to Glu-plasminogen with KD of 0.37 x 10-6 M, presumably mediated by the interaction between the fifth domain of nicked 2GPI and the fifth kringle domain of Glu-plasminogen. Nicked 2GPI also suppressed plasmin generation up to 70% in the presence of tissue plasminogen activator, plasminogen, and fibrin. Intact 2GPI lacks these properties. These data suggest that 2GPI/plasmin-nicked 2GPI control extrinsic fibrinolysis via a negative feedback pathway loop.

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