Owen, Whyte G.

Self‐replicating, self‐calcifying nanosized particles (NPs) can be isolated from mammalian blood and calcified human tissue. Intravenous injection of these biologic NPs into rabbits accelerates occlusion of endothelium‐denuded carotid arteries. Since platelet activation is an initiating step in arterial repair, experiments were designed to determine if biologic NPs alter platelet functions. Platelet rich plasma was prepared from human citrate anti‐coagulated blood. Platelet aggregation (light transmission) and ATP secretion were monitored in response to sTRAP (10 μM) prior to and following incubation with either control solution, biologic NPs (50, 150, 500 NTUs) or hydroxyapatite (HA). NPs increased light transmission and ATP secretion when added immediately to the platelet solution. Both rate and maximal aggregation induced by sTRAP were reduced in the presence of NPs. NPs increased stimulated release of ATP at moderate doses but only after 15 minutes of incubation. HA crystals reduced rather than augmented ATP secretion. These results suggest that NPs cause a shape change in platelets and formation of microaggregates under basal conditions. NPs selectively augment agonist‐stimulated ATP secretion in a dose and time dependent fashion. Therefore, NP activation of platelets could contribute to the increased vascular response to injury in vivo.

Heterogeneous, phospholipid‐rich sub‐micron vesicles (“microvesicles”) shed by activated vascular and blood cells may reflect or influence the coagulant propensity of blood. To determine how the anticoagulant used to collect the blood affects microvesicle (Mv) recovery and characteristics, blood was collected from laboratory volunteers and participants of the Kronos Early Estrogen Prevention Study (KEEPS) into tubes containing either sodium citrate, EDTA or hirudin plus tick anticoagulant peptide (H&T). Microvesicles prepared by double centrifugation were analyzed by flow cytometry to define size and surface markers. There were 2–3 times the number of platelet‐derived (CD61 positive) Mv in preparations from citrate and H&T plasma, relative to numbers in EDTA plasmas. Procoagulant activity of Mv was determined by surface phosphatidylserine (PS) expression using annexin‐V‐fluorescein. Annexin‐V (PS) positive Mv did not differ, but total (PS positive and negative) Mv was 2 fold lower from EDTA plasma compared to citrate and H&T. These results suggest that anticoagulation of blood itself alters microvesicle characteristics. Therefore, standardization and specification of the anticoagulant is warranted to identify potential contribution of microvesicles to cardiovascular pathophysiology. Funded by, NIH HL78638, Kronos Research Institute and Mayo Foundation.

Estrogen receptor beta (βER) is present in platelets but little is known about how βER contributes to platelet physiology. Platelet mitochondrial function and circulating platelet‐derived microparticles were analyzed in aged (24 months old) female wild type (WT) and estrogen receptor beta knockout (βERKO) mice. In intact, unstimulated platelets, ERβ did not co‐localized with mitochondria. Platelet lactate production, mitochondrial membrane potential and superoxide generation were similar in both groups, but activities of cytochrome bc 1 and cytochrome c oxidase were significantly less (P<0.05) in platelets of βERKO mice. Total numbers of platelet‐derived microparticles and those positive for procoagulant phosphatidylserine (PS) were two to three times higher (P<0.05) in βERKO than WT mice. Greater than 40% of procoagulant microparticles were derived from cells other than platelets in both groups of mice. Thrombin generating capacity of microvesicles was also greater in βERKO mice. Thus, loss of βER leads to significant changes in activities of enzymes of the mitochondrial electron transport system, and to increases in circulating procoagulant microparticles which may contribute to an increased thrombotic risk with aging in persons with βER gene polymorphisms. This study is supported by HL78638, AHA30503Z and Mayo Foundation.

Infection increases the risk of thrombotic disease. Platelets contribute to defense against infection and to thrombosis. Gram negative bacteria produce lipopolysaccharides (LPS) that activate Toll‐like‐receptor‐4 (TLR4) in the host and initiate inflammatory responses to infection. Platelets express TLR4, but whether or how LPS affects platelet functions that contribute to thrombotic disease is not understood. To determine if TLR4 signaling influences platelet functions that contribute to thrombotic disease, we studied responses of platelets from normal mice (C57BL/10SnJ; n=10) and mice that do not express TLR4 (C57BL/10ScN; dTLR4, n=10). Prior to LPS exposure, the number of circulating platelets, platelet RNA content and expression of P‐selectin following stimulation with thrombin were diminished in mice that lack TLR4 compared to wild type mice, while platelet aggregation and secretion of ATP were unchanged. These results suggest that loss of TLR4 function affects platelet production and membrane binding characteristics of the circulating platelet pool. One week following a single intravenous injection of LPS (200μg/kg/iv), the time it takes for the circulating platelet pool to turnover, both wild‐type and dTLR4 mice had similar numbers of circulating platelets, and thrombin‐induced expression of P‐selectin and platelet aggregation to collagen increased comparably in both groups of mice. These results indicate that TLR4 function is required for normal platelet homeostasis. Exposure to LPS stimulates a TLR4‐independent shift of the platelet pool toward a reactive phenotype, which could contribute to increased thrombotic risk during or following infection.

Infection and oral estrogen treatments are risk factors for thrombosis. Experiments were designed to evaluate in vitro effects of priming doses of LPS and physiological doses of estrogen on platelets from healthy, newly menopausal women. Blood was collected from early postmenopausal women (42–56 years old) with a menopausal age between 6 months to 3 years into anticoagulants (citrate, hirudin and TAP). Platelet rich plasma was prepared and preincubated with LPS (ultrapure LPS from E. Coli: 10ng‐1000ng/mL) and/or 17β‐estradiol(10 −10 M/mL) Four groups were studied: control, LPS, 17β‐estradiol, 17β‐estradiol+LPS). Platelet aggregation was measured by lumiaggregometry. Thrombin receptor agonist peptide (TRAP 10μM) was used as an agonist. Platelet dense granules ATP secretion was measured by luciferin bioluminescence. Only the highest concentration of LPS (100ng/ml) decreased the maximum and rate of ATP secretion from dense granules and aggregation. At physiological concentrations, 17β‐estradiol did not affect platelet aggregation alone or in combination with LPS. These data suggest that LPS and estrogen may not increase thrombotic risk by direct activation of platelets; effects most likely require the interaction of the platelets with other cells in the circulation. (Supported by NIH HL78638, the Mayo Foundation, Kronos Longevity Institute and Japanese Menopause Society)

Risk of CAD increases at menopause and platelets contribute to the etiology of CAD. We hypothesized that individual variation in platelet procoagulant activity at menopause correlates with the extent of CAD as reflected by coronary artery calcification ( CAC ). We developed several novel and global assays of platelet procoagulant activity: dense (ATP release) and alpha (P‐selectin expression) granule secretion and GPα IIb β 3 fibrinogen‐binding (PAC1 binding) to ADP stimulation, and prostaglandin E 1 (PEG 1 ) sensitivity as a surrogate for prostacyclin sensitivity. Platelets were prepared from venous blood collected from women screened for the Kronos Early Estrogen Prevention Study (n=125; mean±SD age=52.5±2.4 years) within 19.4±9.2 months of last menses. Baseline CAC score was determined. Of conventional CAD risk factors, only systolic blood pressure correlated with positive CAC score (n=23). ATP secretion tended to be less in women with positive CAC scores and was negatively correlated with blood glucose (P<0.001). P‐selectin expression and PAC1 binding increased with total cholesterol (P<0.05). PEG 1 sensitivity increased with increasing age and waist circumference (P<0.05). These results indicate that platelet functions change with age and in association with conventional risk factors for the disease in women at menopause. Supported by the Kronos Longevity Research Institute and NIH HL90639.

Abstract Introduction: Assays of plasma von Willebrand factor (VWF) ristocetin cofactor activity (VWF:RCo) are essential for the laboratory diagnosis of von Willebrand disease (VWD). However, the current manual platelet aggregation/aggregometry method has relatively poor operating characteristics. Our goal was to develop a simple, accurate and sensitive platelet based assay. Methods: VWF protein from normal or patient plasma was first captured on the polyclonal anti-VWF antibody coated plastic plate surface. VWF:RCo activity was assayed by the binding of mitotracker (a red fluorochrome)-labeled, formalin-fixed normal platelets in the presence of ristocetin (1mg/ml) and under agitation (200 rpm by vortex). The fluorescence from the bound platelets, measured by a fluorescence microtiter plate reader (Fluor4000, BioRad), was related to the calibrator plasma signal (6∼150% or IU/dL), and reported as % or IU/dL. We tested plasma samples from normal donors (n=16) and known VWD patients (type 1, n=6; type 2, n=9) based on clinical history and levels of plasma VWF antigen (VWF:Ag), VWF:RCo activity (manual platelet aggregation/aggregometry method), factor VIII activity and VWF multimer analysis. Results: For both normal donors and VWD patients, VWF:RCo activities by the plate assay vs. manual platelet aggregation/aggregometry method correlated closely (R2=0.84), and VWF:RCo/VWF:Ag ratios did not differ significantly. Platelet binding to VWF-coated plastic wells is both VWF specific and ristocetin dependent. Conclusions: Although this new platelet based VWF:RCo plate assay is still being optimized and validated, the preliminary data suggest that it is simple, accurate and sensitive.

Abstract Studies of the Syk −/− mouse have implicated spleen tyrosine kinase (Syk), a signaling protein with both kinase and scaffolding activities, in platelet signaling following engagement of GPVI and αIIbβ3 by collagen and fibrinogen, respectively. The present study was designed to determine whether specific inhibition of the kinase activity of Syk, without targeting the Syk scaffolding function, affected in vivo arterial thrombosis. In preliminary experiments, blood from wild-type and Syk−/− mice was perfused through collagen-coated capillaries under arterial shear rates to study ex vivo thrombosis. While blood from wild-type mice formed robust thrombi (37±4.7 μm3/μm2), none was observed in Syk−/− mice. Thrombi intermediate in size (16±3.9 μm3/μm2) developed in Syk+/− mice. To achieve specific pharmacological targeting of the kinase activity of Syk, P142-76, a potent (IC50 = 4 nM) and selective Syk kinase inhibitor was utilized. P142-76 was screened against a broad panel of 139 purified kinases at 50 nM. While Syk kinase was inhibited by 92%, all other kinases retained more than 70% of their activity. In washed human platelets, P142-76 inhibited convulxin (CVX)-induced phosphorylation of LAT (linker for activation of T-cells; IC50 = 111 nM) and intracellular calcium increases (IC50 = 31 nM). The GPVI/Syk-specificity of P142-76 activity was confirmed by its inability to inhibit intracellular calcium increases induced by the PAR1 thrombin receptor agonist TRAP. P142-76 also inhibited CVX-induced aggregation of both human washed platelets (IC50 = 87 nM) and platelet-rich plasma (IC50 = 2.5 μM). Considering the controversial data in respect to the participation of GPVI in arterial thrombosis in murine models, the dependence of arterial thrombosis on Syk function was studied in vivo in pigs. Cross-species activity of P142-76 was confirmed in vitro (CVX-induced PRP aggregation IC50= 350 nM; 5 μM P142-76 completely inhibited thrombosis triggered by collagen in the perfusion chamber assay). At a plasma concentration which abolished ex vivo CVX-induced but not ADP-induced pig platelet aggregation, P142-76 significantly inhibited the deposition of [111In]-labeled platelets in a carotid artery crush swine thrombosis model, without compromising primary hemostasis. % aggregation Swine (n=3) Platelet Deposition % inhibition Plasma Conc (ng/ml) Bleed Time (min) Activated Clotting Time (sec) ADP (20 μM) CVX (250 ng/ml) Control Artery 0 0 3±0.9 133±22 100 100 Treated Artery 76±6.5 1343±304 3.5±0.3 130±13 100 0 To clarify further the contribution of the kinase activity of Syk to arterial thrombosis, effects of P142-76 on human blood were evaluated in real time in the collagen-coated perfusion chamber. Low concentrations of P142-76 (0.3 μM) affected thrombus stability, while increasing concentrations (1–5 μM) delayed and then completely inhibited thrombus formation. Furthermore, P142-76 destabilized pre-formed thrombi, indicating a critical role for Syk in conferring strength to platelet-platelet interactions, i.e. αIIbβ3-mediated cohesion. Our data indicate that the kinase activity of Syk acts in arterial thrombosis through at least two distinct mechanisms. First, Syk kinase confers stability to platelet-platelet interactions downstream of αIIbβ3. Second, it initiates thrombus formation on collagen surfaces. This dual activity of the kinase activity of Syk makes it a preferred target for inhibition of arterial thrombosis, as it does not compromise primary hemostasis.

Infection increases propensity for thrombotic events. Gram negative pathogens release lipopolysaccharides (LPS), which initiate intracellular signaling cascades through activation of toll‐like‐receptor 4 (TLR4). Platelets contribute to defense from infection and to thrombosis, but little is known about how LPS affects platelet production, life span and reactivity. Platelet life span was determined by in vivo biotinylation in wild type (C57BL/10SnJ; WT) and TLR4 deficient (C57BL/10ScN; dTLR4) mice before and after a single intravenous injection of LPS (1ng – 500ng/25g body weight). Prior to LPS injection, the number of platelets and percentage of reticulated platelets in dTLR4 mice was less than in WT mice but there were no differences in platelet life span, indicating that loss of TLR4 affects platelet production and not life span. A single injection of LPS dose dependently increased percentages of P‐selectin positive platelets and of reticulated platelets but decreased the number of biotin positive platelets within 24hrs in WT but not in dTLR4 mice. Results suggest that LPS–simulated infection reduces life span of circulating platelet and increases production of more reactive (reticulated) platelets from megakaryocytes through TLR4 mechanisms. Thus, a single exposure to LPS represents a “priming” mechanism which could increase risk for thrombosis with infection. (Funded by NIH‐HL78638 and Mayo Fnd.)

Thrombin Quick (TQ) may be isolated following treatment of Prothrombin Quick [Owen, et al, Mayo Clinic Proceedings, 53: 29-33, (1978)] with Taipan venom, phospholipid and ca2+. The clotting activity of TQ with fibrinogen is 1/200 that of nornar thrombin (T). The activation of Factors V and VIII, and the aggregation of platelets by TQ occurs with an effectiveness of about 1/50 that of thrombin. when incubated with antithrombin III, both T ad TQ fom inhibitor complexes as determined by dodecylsulfate gel electropheresis. Titration of T and TQ with the fluorescent inhibitor dansylarginine-4-ethylpiperidine amide indicates an equivalent number of active sites based on protein absorption at 280 nm. However, the two enzymes may be distinquished by the decreased fluorescence enhancement observed with TQ relative to T, indicating an increased polarity in the inhibitor binding site of TQ. With the substrate benzoylarginine ethylester, TQ has a Km = 4.5 × 10-5M and kcat= 6.93 compared to Km = 4.0 × 10-5M and kcat= 17.7 for T. This indicates that the defect in TQ esterase activity is in the catalytic mechanism itself and not in substrate binding. The rate of inhibition of TQ by diisopropylphosphofluoridate is decreased. Decreased acylation and deacylation rates for TQ relative to T are observed for hydrolysis of the active site titrant 4-methykl-umbelliferyl-p-guanidinobenzoate