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Blood, 15 October 2008, Vol. 112, No. 8, pp. 3227-3233.
Prepublished online as a Blood First Edition Paper on July 8, 2008; DOI 10.1182/blood-2008-02-139113.
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Submitted February 14, 2008
Accepted July 1, 2008
The glycoprotein Ib-IX-V complex contributes to tissue factor-independent thrombin generation by recombinant factor VIIa on the activated platelet surface
Cees Weeterings, Philip G de Groot, Jelle Adelmeijer, and Ton Lisman*
Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, Netherlands
Institute of Biomembranes, Utrecht University, Utrecht, Netherlands
Surgical Research Laboratory, Department of Surgery, University Medical Center Groningen, Groningen, Netherlands
* Corresponding author; email: j.a.lisman{at}chir.umcg.nl.
Several lines of evidence suggest that recombinant factor VIIa (rFVIIa) is able to activate factor X on an activated platelet, in a tissue factor (TF)-independent manner. We hypothesized that besides the anionic surface, a receptor on the activated platelet surface is involved in this process.
Here, we showed that, in an ELISA set-up, a purified extracellular fragment of GPIb bound to immobilized rFVIIa. Surface plasmon resonance established a Kd of about 20 nM for this interaction. In addition, CHO cells transfected with the GPIb-IX-V complex could adhere to immobilized rFVIIa, whereas wild-type CHO cells could not. Furthermore, platelets stimulated with a combination of collagen and thrombin adhered to immobilized rFVIIa under static conditions. Platelet adhesion was inhibited by treatment with O-sialoglycoprotein endopeptidase (OSE), which cleaves GPIb from the platelet surface. In addition, rFVIIa-mediated thrombin generation on the activated platelet surface was inhibited by cleaving GPIb from its surface.
In summary, three lines of evidence showed that rFVIIa interacts with the GPIb-IX-V complex, and this interaction enhanced TF-independent thrombin generation mediated by rFVIIa on the activated platelet surface. The rFVIIa-GPIb interaction could contribute to cessation of bleeding after administration of rFVIIa to patients with bleeding disorders.

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