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Tiêu đề Altered inactivation pathway of factor Va by activated protein C in the presence of heparin
Tác giả Gerry A. F. Nicolaes, Kristoffer W. Sørensen, Ute Friedrich, Guido Tans, Jan Rosing, Ludovic Autin, Björn Dahlbäck, Bruno O. Villoutreix
Trường học Maastricht University
Chuyên ngành Biochemistry
Thể loại Journal article
Năm xuất bản 2004
Định dạng
Số trang 13
Dung lượng 576,28 KB

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We have studied the influence of heparin on APC-catalyzed FVa inactivation by kinetic analysis of the time courses of inac-tivation.. We performed a detailed kinetic analysis of the influe

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Altered inactivation pathway of factor Va by activated protein C

in the presence of heparin

Gerry A F Nicolaes1, Kristoffer W Sørensen1,2, Ute Friedrich2,3, Guido Tans1, Jan Rosing1, Ludovic Autin4, Bjo¨rn Dahlba¨ck2and Bruno O Villoutreix4

1

Department of Biochemistry, Cardiovascular Research Institute Maastricht, the Netherlands;2Department of Clinical Chemistry, University Hospital, Malmo¨, Sweden;3Immunochemistry Department, Novo Nordisk A/S, Gentofte, Denmark;4INSERM U428, University of Paris V, France

Inactivation of factor Va (FVa) by activated protein C

(APC) is a predominant mechanism in the down-regulation

of thrombin generation In normal FVa, APC-mediated

inactivation occurs after cleavage at Arg306 (with

corres-pondingrate constant k¢306) or after cleavage at Arg506

(k506) and subsequent cleavage at Arg306 (k306) We have

studied the influence of heparin on APC-catalyzed FVa

inactivation by kinetic analysis of the time courses of

inac-tivation Peptide bond cleavage was identified by Western

blottingusingFV-specific antibodies In normal FVa,

un-fractionated heparin (UFH) was found to inhibit cleavage at

Arg506 in a dose-dependent manner Maximal inhibition of

k506by UFH was 12-fold, with the secondary cleavage at

Arg306 (k306) beingvirtually unaffected In contrast, UFH

stimulated the initial cleavage at Arg306 (k¢306) two- to

threefold Low molecular weight heparin (Fragmin) had

the same effects on the rate constants of FVa inactivation as UFH, but pentasaccharide did not inhibit FVa inactivation Analysis of these data in the context of the 3D structures of APC and FVa and of simulated APC–heparin and FVa– APC complexes suggests that the heparin-binding loops 37 and 70 in APC complement electronegative areas sur-roundingthe Arg506 site, with additional contributions from APC loop 148 Fewer contacts are observed between APC and the region around the Arg306 site in FVa The modeling and experimental data suggest that heparin, when bound to APC, prevents optimal dockingof APC at Arg506 and promotes association between FVa and APC at position Arg306

Keywords: coagulation; factor V; heparin; protein C; protein docking

Activated factor V (FVa) is an essential cofactor in the

prothrombin-activatingcomplex, stimulatingthe activity

of membrane-bound factor Xa (FXa) more than

100 000-fold [1,2] Hence, FVa is an ideal target for

the regulation of thrombin formation [3]

Downregula-tion of FVa activity is achieved through proteolysis

mainly mediated by the anticoagulant protein C pathway

(reviewed in [4,5]) Protein C is composed of a heavy and

a light chain held together by a single disulfide bond [6]

The light chain contains the c-carboxyglutamic acid

(Gla)-rich domain and two epidermal growth factor-like

domains [7] The heavy chain comprises a short

activa-tion peptide and a serine protease (SP) domain which contains the active site of the enzyme Activated protein

C (APC), the product of a thrombin–thrombomodulin-catalyzed activation of the zymogen protein C, proteo-lytically inactivates the coagulation cofactors, FVa and FVIIIa [8], in reactions stimulated by the APC cofactor protein S

FVa consists of a 105 kDa heavy (A1 and A2 domains) and a 71–74-kDa light (A3, C1, and C2 domains) chain which are noncovalently associated

DuringAPC-catalyzed inactivation of FVa, the heavy chain of FVa is cleaved at three sites: Arg306, Arg506 and Arg679 [9] The cleavages at Arg306 and Arg506 appear to

be crucial for inactivation, but the cleavage at Arg679 is probably less important [10] The cleavage at Arg506 is kinetically favored over that at Arg306 and results in the formation of an inactivation intermediate (FVaint), which retains partial FVa cofactor activity owingto its ability to bind FXa, albeit with lower affinity [10] The FVa activity is lost after cleavage at Arg306 In carriers of the common

FVLeidenmutation, in whom the Arg506 has been replaced

by a Gln, inactivation occurs via the slow Arg306 cleavage (reviewed in [11]) Cleavage at Arg306 results in a large reduction in FXa affinity and also the dissociation of the A2 domain, the two processes ultimately rendering FVa inactive as a cofactor of FXa [12,13] APC-catalyzed inactivation of FVa is modulated by other plasma components Thus, the nonenzymatic cofactor protein S

Correspondence to G A F Nicolaes, Department of Biochemistry,

Cardiovascular Research Institute Maastricht, Maastricht,

the Netherlands Fax: + 31 43 3884159, Tel.: + 31 43 3881539,

E-mail: G.Nicolaes@Bioch.Unimaas.nl

Abbreviations: APC, activated protein C; DEGR-FXa,

1,5-DNS-GGACK-factor Xa; DOPS, 1,2 dioleoyl-sn-glycero-3-phosphoserine;

DOPC, 1,2 dioleoyl-sn-glycero-3-phosphocholine; FV, coagulation

factor V; FVa, activated FV; FVa 2 , the FVa isoform

lackingglyco-sylation at Asn2181; FVIII, factor VIII; Gla, c-carboxyglutamic acid;

SP, serine protease; UFH, unfractionated heparin.

Note: Numberingof amino-acid positions in protein C corresponds to

the chymotrypsinogen nomenclature.

(Received 29 January 2004, revised 30 March 2004,

accepted 4 May 2004)

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promotes cleavage at Arg306, whereas FXa specifically

blocks the cleavage at Arg506 [14]

It has recently been shown that basic residues in two

surface loops (37 and 70) in the SP domain of APC

(chymotrypsinogen nomenclature) form an extended

bind-ingsite for FVa [15–17] In addition, APC loop 148 also

plays a role in FVa degradation [18,19] Loop 60 is probably

less important as mutagenesis of positive residues in this

loop did not affect inactivation of FVa by APC [15,16]

Heparin is an important regulator of APC activity,

promotingthe interaction between APC and one of its

inhibitors, the serpin protein C inhibitor (PCI) [17] This is

probably mediated via a template mechanism, for which

bindingof heparin to basic residues in three of the four

surface loops in APC (60, 37 and 70) is crucial [17,20,21]

Interestingly, heparin has also been reported to stimulate

APC-catalyzed inactivation of intact FV, but not FVa [22,23]

We performed a detailed kinetic analysis of the influence

of heparin on the inactivation of FVa by APC and found a

specific heparin-mediated inhibition of the cleavage at

Arg506, whereas cleavage at Arg306 was mildly stimulated

Structural analysis strongly suggested that the

heparin-bindingloops 37, 60 and 70 in APC could complement

electronegative areas surrounding the Arg506 site of FVa

indicatingthat electrostatic interactions between regions of

FVa and APC could be critical for the formation of the

APC–FVa complex which is involved in the cleavage at

position Arg506 These electrostatic interactions are

inhib-ited by heparin when heparin is bound to the electropositive

cluster on loops 37, 60 and 70 located at one edge of the SP

domain of APC Our data further suggest that heparin can

potentially bridge APC to exosites around Arg306, thereby

facilitating cleavage at position Arg306

Materials and Methods

Proteins and reagents

Human FV and FVLeiden were purified from the plasma

of a normal individual and an individual homozygous for

the FV Arg506Gln mutation, and FVa2 was prepared as

described [24] Throughout the work presented here FVa2

was used Factor Xa, a-thrombin, protein S, human

activated protein C and prothrombin were purchased

from Kordia Laboratory Supplies (Leiden, the

Nether-lands) All coagulation factors were of human origin

unless otherwise stated 1,5-DNS-GGACK-factor Xa

(DEGR-FXa) was prepared as described previously [14]

The monoclonal antibody AHV 5146 was purchased from

Haematologic Technologies (Essex Junction, VT, USA)

Unfractionated heparin (UFH) and low molecular weight

heparin (Fragmin) were obtained from Leo (Ballerup,

Denmark); 1 IUÆmL)1 UFH contains  5.7

lgUF-HÆmL)1[23] Pentasaccharide was from Sanofi-Re´cherche

(Montpellier, France) Phospholipid vesicles [10% 1,2

dioleoyl-sn-glycero-3-phosphoserine (DOPS), 90% 1,2

dioleoyl-sn-glycero-3-phosphocholine (DOPC), mol/mol]

were prepared as described [25] The chromogenic

sub-strates S-2366 and S-2238 were obtained from

Chromo-genix (Milano, Italy), and biotraceTM poly(vinylidene

difluoride) transfer membranes from Pall Gelman

Labor-atory (Ann Arbor, MI, USA)

Expression and purification of recombinant human protein C

Recombinant protein C variants K37S/K38Q/K39Q (37-loop mutant), K62N/K63D (60-loop mutant), K37S/K38Q/K39Q/K62N/K63D (37+60-loop mutant) were created by PCR-based site-directed mutagenesis of the eukaryotic expression vector pGT-hyg(Eli Lilly), expressed in 293 cells (CRL-1573; ATCC), purified, and characterized as described previously [21,26]

Assay of FVa FVa activity was determined by quantification of the rate of FXa-catalyzed prothrombin activation, as described previ-ously [10] Briefly, in a reaction mixture that contained 0.5 lM prothrombin, a limitingamount of FVa (83 pM FVa), 5 nM FXa, 40 lM phospholipids (10 : 90 DOPS/ DOPC, mol/mol), 0.5 mgÆmL)1 ovalbumin, and 2 mM CaCl2, prothrombin activation was allowed for 1 min at

37C The amount of prothrombin activated was then determined usingS-2238 [2]

APC-catalyzed inactivation of FVa Time courses of FVa inactivation by APC were determined

by followingthe loss of FXa cofactor activity of FVa in the prothrombinase complex as a function of time Routinely, 0.8 nMplasma-derived human FVa or FVaLeidenwas prein-cubated with 25 lMphospholipid vesicles (10 : 90 DOPS/ DOPC, mol/mol) in the absence or presence of protein S (200 nM) and/or heparin (0.01–25 IUÆmL)1) in 25 mM Hepes buffer (pH 7.5), containing150 mM NaCl, 3 mM CaCl2, and 5 mgÆmL)1BSA, for 5 min at 37C Inactivation was started by addingwild-type APC or APC variants, and the progressive loss of FVa was monitored for up to 20 min

by transfer of aliquots to the FVa assay described above Analysis of kinetic data

Rate constants for APC-catalyzed Arg506 and Arg306 cleavage were obtained as described previously by fitting the time courses of FVa inactivation to a random-order, two-cleavage model using nonlinear least-squares analysis [10] In this model, FVa can be randomly cleaved at either Arg306 or Arg506 Cleavage at Arg306, with an apparent second-order rate constant of k¢306, results in complete loss of FVa cofactor activity (FVai; pathway 1, Eqn 1) Alternatively, initial cleavage at Arg506, with a correspondingrate constant of k506, results in a reaction intermediate (FVaint) with 40% residual cofactor activ-ity, which must be further cleaved at Arg306 (k306) in order to completely abolish FVa cofactor activity (path-way 2, Eqn 2)

Factor Vak

0 306

Factor Vak! Factor Va506 int

k306

! Factor Vai ð2Þ

In wild-type FVa, in which cleavage at Arg506 is 20-fold faster than cleavage at Arg306, the major part ( 95%) of

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FVa is inactivated via pathway 2 To reliably determine

k¢306, single exponential inactivation time courses were

determined for FVaLeiden, representingcleavage at Arg306

only and the k¢306values obtained were used in the fits for

normal FVa We have verified our previous findings [10]

that the APC-catalysed FVa inactivation time courses were

second-order throughout, i.e were directly proportional to

FVa and APC concentrations between 0 and 1.5 nMFVa

and between 0.05 and 5 nMAPC Thus, the second-order

rate constants obtained by this method can be directly

compared within the given ranges of FVa and APC

Statistical analysis usingthe StatGraphics Plus for Windows

package was performed to determine kinetic parameter

significance

Western blot analysis of FVa inactivation by APC

Human FVa (10 nM), phospholipid vesicles (25 lM) and

wild-type APC were incubated at 37C in 25 mM Hepes

(pH 7.5), containing150 mM NaCl, 3 mM CaCl2, and

5 mgÆmL)1BSA in the absence and presence of 25 IUÆmL)1

UFH Aliquots of 20 lL were removed at various time

points, and subjected to SDS/PAGE (7.5% gel) under

reducingconditions After transfer to poly(vinylidene

diflu-oride) membranes, heavy chain fragments were visualized

usinga monoclonal antibody (AHV 5146) directed against

the FVa heavy chain

Electrostatic potentials for APC and FVa A domains

The 3D structure of Gla-domainless APC [27] and the

homology model for the three A domains of FVa [28]

(co-ordinate file at http://www.klkemi.mas.lu.se/dahlback) were

investigated using the programs INSIGHTII, BIOPOLYMER

AND DELPHI(Accelrys, San Diego, CA, USA) Electrostatic

potentials were computed with DelPhi (reviewed in [29])

usinga standard set of formal charges The standard

protocol was applied The volume inside the APC or FVa

molecular surface was assigned a dielectric constant of 4 and

the outside volume was given a value of 80

Docking heparin-like molecules on to APC

Three different methods were used to dock heparin and

APC The first method follows the script reported by

Fernandez-Recio and coworkers [30] as integrated in the

modelingpackage ICM (Molsoft LLC, San Diego, CA,

USA) This first protocol included a pseudo-Brownian

rigid-body docking, an extended force field, and a soft

interaction energy function precalculated on a grid To

validate the dockingprotocol, it was first applied to three

different experimental protein–heparin complexes deposited

at the Protein Data Bank (PDB) files [31], PDB code 1bfc,

1azx, 1e0o [32–34] These proteins were energy-minimized

to allow relaxation of side chains, and to simplify

calcula-tions, we used a negatively charged polypeptide to mimic

heparin Negatively charged groups were moved with the

simulation software Discover (Accelrys) in order to

repro-duce the overall positioningin space of charges and overall

shape, as observed on the NMR/modeled structure of

heparin (file 1hpn [35])

Amino acids known to be part of the heparin-bindingsite

in these three crystallized protein–heparin complexes were given as startingpoint for the dockingsearch [30] At least one conformation of the simulated protein–peptide com-plexes amongthe lowest five dockingenergy scores repro-duced accurately the X-ray crystal structures of the equivalent complexes Therefore, the above dockingproto-col combined with partial knowledge of the binding site for heparin at the surface of APC as defined by several mutagenesis studies [17,18,21] was deemed appropriate to reasonably predict the overall orientation of a peptide mimickingheparin at the surface of APC

The second approach involved flexible dockingof heparin, PDB files 1hpn [35] and 1e0o [34], onto a rigid APC structure usingthe ICM package

Finally, a structure-based virtual screeningapproach (reviewed in [36]) was used to dock short sugar molecules in the APC loop 37 area The heparin (PDB file 1hpn) was shortened, and 10 trisaccharides were generated These sugar molecules were considered rigid during the docking but in order to consider some conformational flexibility, 13 conformers for each molecule were generated and all structures stored in a single data file A shape-based Gaussian docking function as integrated in the program FREDwas used to position the short sugar molecules at the surface of APC [37]

Partial docking of APC on to FVa The X-ray crystal structure of APC (with modifications in loop 148, see below) and a model structure for the three A domains of FVa (with some modifications at the Arg506 and Arg306 sites, see below) were used in two different automated dockingprocedures Rigid-body-dockingcalcu-lations with soft potentials were performed with the ICM package, as described [30] Alternatively, we used the approach reported by Norel et al [38] In dockingwith ICM, FVa Arg506 or Arg306 was given as starting point for the search, whereas for the method of Norel et al the entire surfaces of both interactingmolecules were investigated and

as such the search was not restricted to known binding regions (i.e at the Arg306 or Arg506 site)

In all experimentally known complexes of serine prote-ases/macromolecular inhibitors/substrates, the peptide bond to be cleaved tends to be located on a loop structure that protrudes far outside the molecular surface, either because this loop is indeed ill-structured or because its conformation has to change during the interaction with proteases A loop structure in FVa includingArg506 was predicted from the X-ray crystal structure of ceruloplasmin and does not project significantly outside the surface of FVa Numerous initial conformations (2000–20 000) were generated for residues 500–510 using the loop prediction program of Xiang et al [39] Several runs were performed, and the 10 best-energy conformations were kept From these structures, two residues before and after Arg506 were template-forced to partially adopt the conformation of the serpin reactive loop as present in the PDB file 1l99 [40] Similarly, the FVa loop that contains Arg306 was built again (residues 302–320) and several conformations were generated Because it is known that APC loop 148 plays a

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role in FVa inactivation [19,26] and as this loop is not

well defined in the PDB file 1aut, the APC loop

includ-ingresidues 145–153 was rebuilt usingthe approach of

Xiang et al., and the 10 lowest-energy conformations were

selected

One structure of FVa with the Arg506 loop sufficiently

solvent-exposed to allow interactions with APC was selected

for the dockingprocedures Dockingsimulations were

performed with the two best ranked structures for the FVa

Arg306 loop and an APC model in which the loop 148 tends

to be coveringthe active site (one of the lowest-energy

conformations)

For final optimization of the dockingprocedure, it was

necessary to include experimentally obtained data

Inter-active dockingwas consequently performed startingfrom

the best theoretical complexes (i.e the complexes that have

orientation compatible with key experimental/structural/

theoretical data) usingas guidelines the relative orientation

of a protease associated with a substrate/inhibitor as seen in

the X-ray crystal structure of a Michaelis serpin–protease

complex (file 1l99 [40]) to optimize further the positioningof

the molecules

Results

APC-catalyzed inactivation of FVa in the presence

of heparin

Heparin strongly influenced the time course of FVa

inactivation by wild-type APC (Fig 1) In the absence of

heparin (Fig 1A, open circles) the typical biphasic

inacti-vation curve was obtained for normal FVa (see also [10])

This is indicative of rapid cleavage at Arg506, which yields a

partially active reaction intermediate that is subsequently

fully inactivated on cleavage at Arg306 In the presence of

25 IUÆmL)1 heparin, FVa inactivation was significantly

reduced (Fig 1A, closed circles) The shape of the curve

suggested strong impairment of the fast first phase (Arg506

cleavage) of the reaction without influence on the second

phase (Arg306 cleavage) A direct effect of heparin in the

FVa assay was excluded because preincubation of FVa with

25 IUÆmL)1UFH or direct addition of heparin (1 IUÆmL)1)

to the FVa assay mixture resulted in assay outcomes that

were identical with those obtained in the absence of heparin

(data not shown)

To gain insights into which rate constants (k506and k¢306

in intact FVa and k306in FVaint) were influenced by heparin,

two additional experiments were performed In the first,

shown in Fig 1B, FVa was incubated for 5 min with APC

to allow completion of the first phase of the reaction, i.e

cleavage at Arg506 with all FVa activity converted into

FVaint Thereafter, the reaction volume was divided into

two equal parts and transferred into new reaction tubes

containingeither heparin or buffer Monitoringof FVa

activity in these two tubes was continued for another

25 min, duringwhich time the loss of FVa activity in the

absence of heparin (open circles) did not differ from that

obtained in the presence of heparin (closed circles) This

indicates that the presence of heparin did not influence the

k306in the partially active FVa intermediate In a second

experiment, the effect of heparin on the direct cleavage at

Arg306 (k¢ ) in FVa was determined from a time course of

Fig 1 Effect of heparin on the APC-catalyzed inactivation of FVa Plasma purified human FVa was inactivated by recombinant wild-type APC in the absence and presence of UFH as described in Materials and Methods (A) Time courses of inactivation of 1.5 n M FVa by 0.32 n M APC in the absence (s) or presence (d) of 25 IUÆmL)1UFH (B) FVa (1.5 n M ) was inactivated with 0.32 n M wild-type APC After

5 min of incubation, indicated by the arrow, the reaction volume was split into two equal volumes and transferred to two new tubes con-tainingeither 25 IUÆmL)1UFH (final concentration, d) or an amount

of compensation buffer (s), and the monitoringof FVa activity in the two reaction mixtures was continued (C) Time courses of inactivation

of 0.70 n M FVa Leiden by 1.0 n M APC in the absence (s) or presence (d) of 25 IUÆmL)1UFH The mean of two experiments is given Inactivation time courses were very reproducible with variations per time point < 7% From time courses like these, apparent second-order rate constants k 506 , k¢ 306 and k 306 were calculated as described in Materials and methods.

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FVaLeiden inactivation in the absence and presence of

heparin From these data, an approximately 2–3-fold (2.48;

standard error: 0.47) stimulation of the rate of inactivation

(k¢306) by heparin was calculated (Fig 1C) by fitting to a

single exponential Table 1 summarizes all rate constants

obtained by fittingall time courses to the random-order

cleavage model as described in Materials and methods,

under the constraints that k306 is minimally influenced by

heparin and using k¢306 obtained from the FVaLeiden

inactivation

Concentration dependence of heparin effect onk506

To further characterize the influence of heparin on the

APC-catalyzed inactivation of FVa and to confirm the specificity

of the effects observed in Fig 1, time courses of FVa

inactivation by wild-type APC were determined in the

presence of various concentrations of UFH (0.1–

55 IUÆmL)1), and rate constants for the inactivation were

calculated The effect of heparin on k506was dose-dependent

and saturable, with 50% inhibition observed at

 2 IUÆmL)1UFH (Fig 2)

The inhibitory effect was not specifically mediated by

unfractionated heparin because we found that 25 IUÆmL)1

low molecular weight heparin (which is less than 18

saccharide residues in length) displayed similar inhibitory

activity to UFH In contrast, equimolar amounts of

pentasaccharide did not influence the inactivation of FVa

by APC

To relate the inactivation curves of FVa to specific

cleavages in FVa, Western blotting was performed (Fig 3)

A monoclonal antibody (AHV 5146) against the FVa heavy

chain was used to visualize the inactivation fragments In

the absence of heparin, the transient 75 kDa fragment

representingthe heavy chain fragment 1–506, typical for the

partially active reaction intermediate (FVaint), can be seen

(pathway 2) The 30-kDa band represents the 307–506

fragment formed on cleavage at Arg306 in FVaint In the

presence of UFH, the pattern of fragment generation was

considerably different from that obtained in its absence The

amount of 75-kDa fragment was greatly reduced, and

instead a 60/62-kDa fragment accumulated, representing

the 307–709 fragment, which is the result of cleavage at

Arg306 in FVa These data indicate that heparin strongly

influences cleavage at Arg506, and shifts the pathway towards initial cleavage at Arg306 (pathway 1), after which Arg506 can be cleaved, resulting in the formation of a

30 kDa fragment

Kinetic analysis of cleavage of FVa at Arg506 by APC

To further characterize the inhibitory effect of heparin on the Arg506 cleavage, we performed a kinetic analysis by usingnonlinear regression analysis of initial rates of FVa inactivation by APC (initial rates representingalmost exclusively cleavage at Arg506) at FVa concentrations of 0.2–30 nM, in both the absence and presence of 25 IUÆmL)1 heparin (Fig 4) In the FVa assay, a lower concentration of FXa (0.5 nM) was used than in the standard FVa assay, in order to minimize the FXa cofactor activity of the reaction intermediate, FVaint This facilitated the determination of loss of FVa cofactor activity duringthe initial stage of inactivation and minimized the influence of the k

Table 1 Apparent second-order rate constants for the APC-catalyzed inactivation of FVa and FVaLeiden in the presence and absence of heparin Rate constants ( M )1 Æs)1) for inactivation of normal FVa (0.50–1.5 n M ) and FVa Leiden (0.50–1.5 n M ) catalyzed by recombinant wild-type APC (0.037– 1.0 n M ) obtained by fittingtime courses of inactivation, such as presented in Fig 1, to an integral time course equation as described in Materials and Methods Reactions were performed in 25 mm Hepes (pH 7.5), containing150 m M NaCl, 3 m M CaCl 2 and 5 mgÆmL)1BSA in the presence of

25 l M phospholipid vesicles (10 : 90 DOPS/DOPC, mol/mol) at 37 C in the absence or presence of 25 IUÆmL)1UFH FVa activity was assayed as described in Materials and Methods Rate constants given are means from at least three experiments, with SEM being < 20% Values for k¢ 306 for inactivation of normal FVa by APC were obtained from time courses of inactivation for FVa Leiden as described in Materials and methods ND, Not determined; k 506 and k 306 could not be determined in FVa Leiden because of the absence of the Arg506 cleavage site.

Rate constant

2.17 · 10 6

6.83 · 10 5

2.17 · 10 6

Fig 2 Effect of varying heparin concentration on APC-mediated clea-vage at Arg506 in FVa Rate constants for cleaclea-vage at Arg506 in FVa

by wild-type APC were calculated for inactivations in the presence of various concentrations of UFH Inactivations were performed and analyzed as described in Materials and methods Data points represent means ± SEM from three independent time courses of inactivation.

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cleavage The kinetic parameters obtained were Km-app¼

2.13 ± 0.49 nM (mean ± SEM) and kcat-app¼

0.68 ± 0.048 s)1in the absence of UFH, and Km-app¼

11.4 ± 1.49 nM and kcat-app¼ 0.26 ± 0.016 s)1 in the

presence of UFH, which correspond to second-order rate

constants for cleavage at Arg506 (kcat/Km) of

3.2· 108M )1Æs)1and 2.3· 107M )1Æs)1, respectively These

values are in reasonable agreement with the rate constants

obtained from fittingthe time courses of FVa inactivation

(cf Figure 1, Table 1) These data suggest that, under the

conditions tested, heparin increases the Km of APC for

cleavage of FVa at Arg506 5.5-fold and at the same time

decreases the kcat 2.6-fold, thus actingas a mixed-type

inhibitor of APC As this analysis was performed using

initial rates for inactivation of FVa that are almost

completely due to cleavage at Arg506, no individual kinetic

parameters can be deduced for the second cleavage at

Arg306

Effects of heparin on FVa inactivation in the presence

of DEGR-FXa and protein S

To further verify that heparin inhibits cleavage at Arg506

and stimulates initial cleavage at Arg306, inactivation of

FVa by APC with and without heparin was performed

in the presence and absence of 20 nM DEGR-FXa, which is known to completely and specifically block APC cleavage at Arg506 [14] The presence of DEGR-FXa resulted in abrogation of the fast phase of the reaction,

as compared with inactivation in the absence of DEGR-FXa Addition of 25 IUÆmL)1 UFH in the presence of DEGR-FXa stimulated the APC-mediated inactivation approximately twofold (data not shown), indicatingthat the stimulatory effect of heparin on the cleavage at Arg306 is also observed in the presence of FXa Theoretically, the addition of heparin may induce the formation of a binary FXa–FXa complex, thus abolish-ingthe inhibitory effect of DEGR-FXa on the Arg506 cleavage This possibility was excluded, however, because time courses of FVa inactivation in the presence of DEGR-FXa could be fitted, both with and without heparin, to a mono-exponential equation, indicating single cleavage at Arg306 only The effect of UFH on FVa inactivation by APC was also investigated in the presence of 200 nM protein S The resultingtime course

of inactivation of FVa by APC became monophasic, an effect known to be due to stimulation of the cleavage at Arg306 [14] Addition of 10 IUÆmL)1heparin resulted in

a somewhat slower inactivation rate (data not shown), which presumably is due to the inhibitory effect of UFH

on the cleavage at Arg506

Fig 4 Kinetic analysis of the inactivation of FVa by APC in the pres-ence and abspres-ence of heparin Initial rates of FVa inactivation were determined at various concentrations of FVa in the presence (d) or absence (d) of 25 IUÆmL)1UFH, after incubation with 0.14 n M APC (d) or 0.04 n M APC (s) The incubation was performed in 25 m M Hepes (pH 7.5), containing150 m M NaCl, 3 m M CaCl 2 and

5 mgÆmL)1 BSA in the presence of 25 l M phospholipid vesicles (10 : 90 DOPS/DOPC, mol/mol) at 37 C After different time inter-vals the FVa activity was determined as described in Materials and methods Initial rates of FVa inactivation are expressed as n M FVa inactivatedÆmin)1Æ(n M APC))1 The solid lines represent a fit of the data accordingto the Michaelis–Menten equation with K m-app ¼ 11.4 n M and k cat-app ¼ 0.26 s)1in the presence of UFH (d) and K m-app ¼ 2.1 n M and k cat-app ¼ 0.68 s)1in the absence of UFH (s).

Fig 3 Western blotting of FVa degradation To identify fragment

generation during APC-catalyzed inactivation of FVa, plasma purified

human FVa (10 n M ) was incubated with 25 l M phospholipid vesicles

(10 : 90 DOPS/DOPC, mol/mol) at 37 C in 25 m M Hepes (pH 7.5),

containing150 m M NaCl, 3 m M CaCl 2 and 5 mgÆmL)1BSA In the

absence of heparin (lanes 1–5), inactivation was started by the addition

of 0.33 n M wild-type APC In the presence of 25 IUÆmL)1UFH (lanes

6–10), FVa inactivation was started by the addition of 3.9 n M

wild-type APC Samples were withdrawn from the inactivation mixture and

subjected to SDS/PAGE Subsequently, proteins were blotted on a

poly(vinylidene difluoride) membrane usinga semidry blotting

apparatus After transfer to poly(vinylidene difluoride) membranes,

heavy chain fragments were visualized using a monoclonal antibody

(AHV 5146) directed against the FVa heavy chain Lanes 1–5 and 6–10

describe reaction samples of similar FVa activity with the percentages

of residual FVa cofactor activity being(no heparin, lanes 1–5) 100, 37,

20, 10 and 2 and (25 IUÆmL)1UFH, lanes 6–10) 100, 36, 17, 9 and 2,

respectively.

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Lack of heparin effect on FVa inactivation by

APC mutants deficient in heparin binding

To verify that the inhibition of APC-mediated FVa

inactivation by heparin is related to the ability of heparin

to bind APC, we used recombinant mutants of APC

harboringmutations in the heparin-bindingsite The APC

variants chosen were: K37S/K38Q/K39Q with strongly

reduced affinity for heparin; K62N/K63D which has a

modest effect on the APC–heparin interaction; K37S/

K38Q/K39Q/K62N/K63D which shows no detectable

bindingto heparin [21] Table 2 shows the apparent

second-order rate constants obtained from time courses of

inactivation of FVa by the various APC variants Results

obtained in the absence of heparin were consistent with

those on record [15] APC variants carryingmutations in

the 37 loop had much lower rate constants for cleavage at

Arg506, whereas the rate constants for cleavage at Arg306

were similar to those obtained with wild-type APC The

mutations in loop 60 did not affect k506 and showed a

modestly increased k¢306 (Table 2) In the presence of

heparin, the abilities of wild-type APC and the 60-loop

variant to cleave the Arg506 site in FVa were strongly

inhibited, with reduction of k506of 11.7-fold and 8.4-fold,

respectively, whereas only minor effects were seen on the

cleavage at Arg306 The addition of heparin during

inactivation of normal FVa by the loop-37 mutant

resulted in a further decrease in k506 and a small

stimulation in the secondary cleavage at Arg306 (k306)

However, heparin did not influence Arg506 cleavage in

FVa by the APC variant that completely lacked the

heparin-bindingcapacity (37+60 loop), but a small

(inhibitory) effect on k¢306and k306was noted

These observations suggest that, for heparin to exert its

inhibitory effect on the cleavage at Arg506, a normal

interaction with APC is required It is likely that the

heparin-bindingloop 37 of APC interacts directly with FVa

in an area adjacent to the Arg506 cleavage site and that this

interaction is severely hampered by heparin in the ternary

heparin–APC–FVa complex

Electrostatic potentials of APC and the A domains of FVa

Loops 37, 60, 70 and 148 in APC form an electropositive

surface, while the catalytic triad is located in an

electronegative environment (Fig 5) In FVa, both Arg306 and Arg506 are in electropositive regions How-ever, movingtowards the C-terminus, the prime side of Arg306 is first positive then neutral and finally positive, while the prime side of Arg506 is electronegative (Fig 5)

At this site, two electronegative zones that possibly interact with APC involve residues Asp513, Asp578 and Asp577 (site 1) and Glu323, Glu374, Asp373, and Glu372 (site 2) A very negatively charged segment following Cys656, which is the last residue in the homology model based on ceruloplasmin, formed by Asp659-Asp660-Asp661-Glu662-Asp663 may also play a role duringthe dockingof APC on to the FVa Arg506 site In contrast, the segment containing Arg306 protrudes outside the surface of FVa, and, besides the residues directly fitting into the catalytic groove, there are no obvious interacting regions for APC

Docking heparin-like molecule onto APC

As numerous problems have been noticed when tryingto dock heparin at the surface of a protein [41], we used three different methods To facilitate calculations, a negatively charged peptide mimicking the overall charge distribution and shape (see Materials and Methods) of a heparin molecule was created and the validity of this approach was tested The validated protocol was next applied to dock the heparin-like peptide on to APC The lowest conformation energies positioned the long axis of the peptide along a small electropositive groove formed by loops 37 and 70 (Fig 6) These orientations are compatible with known experimental data suggesting that APC loops 37, 60 and 70 are directly or indirectly involved in heparin binding[21] In our structural model, loop 60 had no direct contact with the negatively charged peptide, but the distance between Lys62 and Lys63 and negative groups on the peptide (6–8 A˚) was compatible with electrostatic interactions and preorientation of heparin

on the APC surface duringformation of an encounter complex However, it is important to note that direct contact could occur between the heparin-like peptide and loop 60 if flexibility had been allowed

In the second dockingapproach, APC was maintained rigid during the simulation but a real heparin molecule (10 sugar units, length 40 A˚) was used and flexibility was tolerated (Fig 6, inset) The top ranking conformation

Table 2 Apparent second-order rate constants for the inactivation of FVa and FVa Leiden catalyzed by several recombinant variants of APC in the presence and absence heparin Rate constants ( M )1 Æs)1) for inactivation of normal FVa (0.80 n M ) and FVa Leiden (0.80 n M ) catalyzed by recombinant wild-type APC (0.090–0.60 n M ) obtained by fittingtime courses of inactivation, such as presented in Fig 1, to an integral time course equation as described in Materials and Methods Reactions were performed in 25 m M Hepes (pH 7.5), containing150 m M NaCl, 3 m M CaCl 2 and 5 mgÆmL)1 BSA in the presence of 25 l M phospholipid vesicles (10 : 90 DOPS/DOPC, mol/mol) at 37 C in the absence or presence of 25 IUÆmL)1UFH FVa activity was assayed as described in Materials and Methods Rate constants given are means from at least two experiments.

APC variant

1.65 · 10 8

3.86 · 10 6

3.38 · 10 6

1.97 · 10 7

2.48 · 10 6

a

The value for k¢ 306 in the presence of heparin in FVa Leiden , could not be reliably measured, implyingit is < 4 · 10 5

M )1 Æs)1.

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positioned heparin against loops 37, 60 and 70 In this case,

heparin also had direct contact with positively charged

residues located on loop 60 The last approach followed a

protocol used for virtual ligand screening, and also

positioned the short sugar molecules in between loop 37

and loop 70 of APC

Docking of APC on to FVa

To elucidate molecular interactions between APC and FVa

at cleavage sites Arg306 and Arg506, two theoretical dockingprotocols were used [30,38] Because the segment containingArg306 and Arg506 had to fit into the APC

Fig 5 Molecular models of FVa and APC demonstrating positions of potentially important residues for the APC–FVa interaction Top left: 3D structure of Gla-domainless APC [27] shown with a view down the active site The catalytic triad (from left to right), D102, H57 and S195, is colored red The light chain structure (in white) only includes epidermal growth factor (EGF)1 and EGF2 domains (residues 49–146) The SP domain (yellow) runs from residues 16–244 (chymotrypsinogen nomenclature) Positively charged residues in loops 60, 37 and 70 play a key role in heparin binding Only the loops 37, 70 and 148 have been shown to form a binding exosite for FVa important for cleavage at Arg506 but not Arg306 Other regions may be important for interactions with FVa but are not defined at present.Top right: molecular surface of APC color-coded according to its electrostatic potentials (red, regions of negative potentials; blue, regions of positive potentials; white, neutral potential; a linear interpolation was used to produce the color for surface potentials between )3 and +3 kTÆe )1 ) Bottom left: 3D model for the three A domains of FVa The A1 domain is colored yellow, the A2 white, and the A3 green The position of the C domains is not clearly defined at present, and a negatively charged segment at the end of the A2 domain is missing Two cleavage sites for APC (Arg306 and Arg506) are highlighted Bottom right: molecular surface

of FVa domains A1, A2, and A3 color-coded accordingto electrostatic potentials Preliminary dockingof FVa Arg506 into the catalytic cleft of APC suggests that the 37 loop may interact with the FVa D578 area (see text) Docking of FVa Arg306 into APC does not suggest significant contact between the 37 and 148 loop exosites, and the 37 loop may point towards relatively neutral regions (see text).

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active site, and because we used essentially rigid-body

docking, several conformations of the loops displaying

Arg306 and Arg506 of FVa as well as the APC loop 148

were generated before docking computations Test dockings

were performed, and a theoretical FVa model with

struc-tural changes at the level of loop 306 and 506 was selected

for further dockingsimulation (data not shown) Similarly,

a model of APC in which the loop 148 partially covers the

active site as compared with the structure present in the

PDB file 1aut was selected (Fig 6)

When usingthe dockingmethod of Norel et al [38], we

noticed that, in the best-ranked complex, APC was

positioned very close to the Arg506 site in a conformation

basically suitable for cleavage at this site Some interactive

reorientations of APC were needed in order to remove steric

clashes This was performed usingthe orientation of a serpin

reactive loop crystallized into a serine protease as guideline

[40] Interestingly, in none of the predicted complexes was

APC positioned next to the Arg306 site, suggesting that the

shape complementarity in this region is not optimal With

the ICM method, models of the complex with APC docked

at FVa position 506 or 306 could be generated that are in

agreement with published experimental data To develop

our two final models of the FVa–APC complex, we merged

the two sets of computations reported above and performed

limited interactive reorientations of the two proteins to remove minor steric clashes (Fig 7)

When APC is docked at position 506, the electropositive loops 37, 70 and 148 of APC seem to have contact with the electronegative area in FVa formed by residues Asp513, Asp578 and Asp577 APC could also interact with FVa residues Asp659-Asp660-Asp661-Glu662-Asp663, but these residues are not present in the model as it was only possible

to predict the structure of the FVa A2 domain up to residue

656 FVa residues Glu323, Glu374, Asp373 and Glu372 could facilitate the dockingprocess, but the role of these residues is unknown In the present model, APC loop 60 does not seem to have significant contact with FVa When superimposingthe APC–heparin complex on to the APC– FVa complex, we observed that heparin clashes against FVa and/or could be very close to negatively charged FVa residues Asp513, Asp578 and Asp577 and/or Asp659-Asp660-Asp661-Glu662-Asp663 (Fig 7A) Con-tact between FVa and APC loop 148 only occurs when the 148 loop is in a partially closed conformation In the PDB file 1aut, the 148 loop is open and with this conformation, very limited direct contacts with FVa were noted

When APC is docked at position Arg306, only the electropositive segment containing FVa Arg306 seems to

Fig 6 APC–heparin docking and loop 148 predictions APC is shown with an orientation similar to the one presented in Fig 5 A neg-atively charged peptide mimicking heparin was docked on to the APC X-ray crystal structure, and the lowest-energy conforma-tions positioned the negatively charged ribbon

in direct contact with loops 37 and 70 This positioningis compatible with known experi-mental data Loop 148 is not well defined in the X-ray crystal structure, and different con-formations were generated The loops that tend to be closed above the active site have lower energies The very open conformation present in the APC PDB file represents only one possible structure; the loop probably oscillates between open and closed confor-mations as observed for the equivalent loop of thrombin Inset: APC is presented with the peptide mimickingheparin (ribbon) docked

on to its surface and with one of the lowest conformation energy obtained from the dockingof a flexible heparin molecule.

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Fig 7 Proposed models of APC docked at

Arg506 and Arg306 The 3D structure of APC

was docked on to FVa at position Arg 506 (A)

or at position Arg306 (B) FVa is shown as a

solid surface with the different A domains

color coded as in Fig 6 (bottom left) APC is

presented as a ribbon Different loops are

colored and labeled for orientation Some

residues expected to play a role in the

inter-action are mentioned (see text) The peptide–

heparin-like 3D structure was extracted from

our dockingsimulations and positioned on

top of APC When APC is docked at Arg506,

heparin seems to disturb the interaction,

whereas when APC is at Arg306, heparin

has enough room and could bridge the two

molecules (see text).

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