Binding of Various Thrombin Fractions to Fibrin and the Influence of AT-III on Their Adsorption

Glycoprotein Ibα–Mediated Platelet Adhesion and Aggregation to Immobilized Thrombin Under Conditions of Flow

OBJECTIVE

Thrombin interacts with platelets via the protease-activated receptors (PARs) 1 and 4, and via glycoprotein Ibalpha (GPIbalpha). Recently, it was shown that platelets are able to adhere to immobilized thrombin under static conditions via GPIbalpha.

METHODS AND RESULTS

Here, we show that platelets are also able to adhere to and form stable aggregates on immobilized thrombin under conditions of flow. Adhesion and aggregation to thrombin was dependent on the interaction with GPIbalpha, as addition of glycocalicin or an antibody blocking the interaction between thrombin and GPIbalpha inhibited platelet adhesion. Additionally, platelet adhesion to recombinant thrombin mutants, which are unable to bind GPIbalpha, was severely suppressed. Furthermore, platelet adhesion to thrombin was dependent on activation of PARs, and partly on granule secretion and thromboxane-A2 synthesis. Immobilization of thrombin on a fibrin network resulted in substantially increased adhesion compared with fibrin alone. The adhesion to fibrin alone was completely abolished by addition of dRGDW, whereas fibrin-bound thrombin still showed substantial platelet adhesion in the presence of dRGDW, indicating that fibrin-bound thrombin is able to directly capture platelets under flow.

CONCLUSIONS

These results indicate that platelets are able to adhere to thrombin under flow conditions, which is dependent on the interaction with GPIbalpha.

Zinc modulates thrombin adsorption to fibrin

Human thrombin with high affinity to Sepharose insolubilized fibrin monomers (high-affinity thrombin) was used to investigate the effect of Zn(II) on the thrombin adsorption to fibrin. Results showed that at Zn(II) concentrations exceeding 100 mumols/l, thrombin binding to fibrin was decreased concomitant with the Zn(II) concentration and time; at lower Zn(II) concentrations, thrombin adsorption was enhanced. Experimental results were identical by using 125I-labelled high-affinity alpha-thrombin or by measuring the thrombin activity either by chromogenic substrate or by a clotting time method. In contrast, Ca(II) alone (final conc. 3 mmol/l) or in combination with Zn(II) was not effective. However, at higher Ca(II) concentrations (7.5-15 mmol/l), thrombin adsorption was apparently decreased. Control experiments revealed that Zn(II) had no impact on the clottability of fibrinogen, and that the results of the experiments with Ca(II) were not altered by possible cross-linking of fibrin. We conclude that unlike Ca(II), Zn(II) is highly effective in modulating thrombin adsorption to fibrin.

Antithrombin III activity (residual thrombin activity) in plasma from non-medicated or heparinized horses

Two synthetic substrate assays (fluorometric and chromogenic) were used to measure antithrombin-III (AT-III) activity (residual thrombin activity) in non-medicated and heparin (sodium) treated horses. In 18 non-medicated horses the fluorometric substrate assay (FSA) values were similar to previous reports but they reflected inconsistent trends and larger deviations in the heparin-treated groups (Group 2: 40 and 100 U/kg IV, n = 6; Group 3: 240 U/kg IV, n = 5; Group 4: 80 U/kg IV followed by 160 U/kg SC, n = 8) when compared to the chromogenic substrate assay (CSA) values. The CSA values for the 18 non-medicated horses indicated a higher AT-III activity (lower residual thrombin activity) than the FSA. AT-III activity was quantified in 18 non-medicated horses (29 mg/dl) and compared well with values for humans (30 mg/dl) and dogs (40 mg/dl). Plasma heparin concentrations, determined by the FSA, correlated well with the 'therapeutic range' (1.5 fold to 2.5 fold prolongation of the activated partial thromboplastin time (APTT) normal value) and values reported for humans. The effect of heparin therapy on AT-III activity in four treatment regimens was evaluated. AT-III activity was not significantly affected (with one exception) by a single dose of intravenous (IV) heparin (40 and 100 U/kg) nor by repeated subcutaneous (SC) injections of heparin (240 U/kg). A transient increase in residual thrombin activity was measured 12 h after an intravenous (80 U/kg) injection of heparin. Large doses of heparin (80 U/kg IV followed by 160 U/kg SC) given every 12 h produced a progressive prolongation of the APTT. In this group the APTT remained prolonged 48 h after the last treatment.