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Blood, 15 May 2004, Vol. 103, No. 10, pp. 3783-3788.
Prepublished online as a Blood First Edition Paper on January 29, 2004; DOI 10.1182/blood-2003-12-4240.

Submitted December 11, 2003
Accepted January 12, 2004
A Novel Plasma Proteinase Potentiates 2-Antiplasmin Inhibition of Fibrin Digestion
Kyung N Lee*, Kenneth W Jackson, Victoria J Christiansen, Keun H Chung, and Patrick A McKee
William K. Warren Medical Research Center and Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
* Corresponding author; email: kyung-lee{at}ouhsc.edu.
Human 2-antiplasmin ( 2AP), also known as 2-plasmin inhibitor, is the major inhibitor of the proteolytic enzyme plasmin that digests fibrin. Two N-terminal forms of 2AP circulate in human plasma: a 464-residue protein with Met as the N-terminus, Met- 2AP, and a 452-residue version with Asn as the N-terminus, Asn- 2AP. We have discovered and purified a proteinase from human plasma that cleaves the Pro12-Asn13 bond of Met- 2AP to yield Asn- 2AP and have named it antiplasmin-cleaving enzyme (APCE). APCE is similar in primary structure and catalytic properties to membrane-bound fibroblast activation protein/seprase for which a physiologic substrate has not been clearly defined. We found that Asn- 2AP becomes crosslinked to fibrin by activated factor XIII ~13X faster than native Met- 2AP during clot formation and that clot lysis rates are slowed in direct proportion to the ratio of Asn- 2AP/Met- 2AP in human plasma. We conclude that APCE cleaves Met- 2AP to the derivative Asn- 2AP, which is more efficiently incorporated into fibrin and consequently makes it strikingly resistant to plasmin digestion. APCE may represent a new target for pharmacologic inhibition, since less generation and incorporation of Asn- 2AP could result in a more rapid removal of fibrin by plasmin during atherogenesis, thrombosis, and inflammatory states.

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