Conformational changes and loss of opsonic function in frozen or heat-treated plasma fibronectin

Differential properties of organ-specific serum opsonins for liver and spleen macrophages

Earlier we reported that serum contains organ-specific opsonins which selectively enhance recognition of liposomes by macrophages in the specific organs of the reticuloendothelial system (Moghimi, S.M. and Patel, H.M. (1988) FEBS Lett. 233, 143-147). The results presented here describe the properties of these organ-specific opsonins which differentiate between liver-specific and spleen-specific opsonins responsible for the enhancement of phagocytosis of liposomes by Kupffer cells and spleen macrophage, respectively. Liver-specific opsonin is a heat-stable macromolecule which on heating or on freezing and thawing exhibits enhanced opsonic activity. Serum also contains a dialysable factor which inhibits its opsonic activity. On the other hand, the spleen-specific opsonin is a heat-labile macromolecule which is sensitive to freezing and thawing and requires a dialysable serum co-factor for its optimum opsonic activity on spleen macrophages. Removal of this factor from serum brings about an irreversible conformational change in the opsonin. Evidence suggests that the spleen-specific opsonin may be composed of more than one different opsonin molecule. It is suggested that the serum factor(s) that inhibits liver-specific opsonic activity and enhances the spleen-specific activity may not be the same molecule, but in both the cases the factor(s) may mediate its function by modifying the process of the opsonisation of liposomes or by influencing the interaction of the opsonised liposomes with the respective cells. We propose that purification of the organ-specific opsonins may provide an opportunity to target drug carriers selectively to a specific organ of the reticuloendothelial system, and help us to evaluate their role in the altered opsonin states known to exist in certain diseases.

Progressive loss of fibronectin-mediated opsonic activity in plasma cryoprecipitate with storage. Role of fibronectin fragmentation

Septic injured patients often manifest a deficiency of plasma fibronectin. Several studies have shown improvements in organ function in such patients following infusion of fibronectin-rich plasma cryoprecipitate, while other studies found no improvement. One explanation for these differences may be the use of plasma cryoprecipitate which has been stored for various time intervals prior to its use as a source of fibronectin. This investigation tested the hypothesis that the opsonic activity of fibronectin in cryoprecipitate may decline with increased storage duration. Using a bioassay of opsonic activity, we evaluated human plasma cryoprecipitate that was stored at either -20 or -80 degrees C for various intervals (2 weeks to 12 months) after its preparation from fresh donor plasma. Our findings demonstrated that the opsonic activity of fibronectin in cryoprecipitate declined with increasing time of storage. Significant loss (p less than 0.05) of opsonic activity was first evident after 2 months of storage. Storage at -80 degrees C did not prevent this decline in opsonic activity as compared to storage at -20 degrees C. Immunoblot analysis revealed extensive fragmentation of the dimeric fibronectin (440 kdaltons) and the presence of lower molecular weight fragments in 4- to 12-month-old plasma cryoprecipitate. Therefore, plasma cryoprecipitate of varying ages (storage time) when used as a source of fibronectin for replacement therapy to support phagocytic function in septic injured patients may result in different fibronectin-mediated responses. The decline in activity may be due, in part, to fragmentation of the fibronectin molecule.

Fibronectin: applications to clinical medicine

In summary, the role of fibronectin in clinical medicine is not yet certain. Correlation of sepsis and organ failure with decreased fibronectin levels is still to some degree questionable; controlled clinical trials are urgently needed. The risk of hepatitis, AIDS, and other transfusion-transmitted diseases must be balanced by data substantiating the clinical efficacy of fibronectin therapy. To date, no results from controlled trials using purified fibronectin have been reported. Final judgement must be reserved pending results of appropriate human studies. It is likely, however, that even if fibronectin is proven to be clinically useful, the patient population which will achieve some benefit from its use will be restricted to septic and/or critically ill patients. As noted by Mosher and Grossman however, physicians treating such patients would likely welcome any new and effective therapeutic intervention.

Fibronectin assays and their clinical application: a review

Cold insoluble globulin (fibronectin) was discovered 30 years ago but recently there has been a remarkable growth of knowledge concerning its interaction with the cell cytoskeleton and its role in cell-cell and cell-matrix adhesion. The protein is also a major plasma opsonin with a role in regulating fixed macrophage activity and it is this area in which clinical applications are now beginning to develop. Methods are discussed for measuring the concentration of the protein and its opsonic function in vitro, and for the evaluation of fixed macrophage function in vivo. Also discussed are the metabolism of the protein, the implications of opsonin depletion in patients with serious injury or infection and the attempts to reverse this with plasma protein replacement therapy.