A mechanism for hereditary angioedema caused by a methionine-379-to-lysine substitution in kininogens

ABSTRACT

Hereditary angioedema (HAE) is associated with episodic kinin-induced swelling of the skin and mucosal membranes. Most patients with HAE have low plasma C1-inhibitor activity, leading to increased generation of the protease plasma kallikrein (PKa) and excessive release of the nanopeptide bradykinin from high-molecular-weight kininogen (HK). However, disease-causing mutations in at least 10% of patients with HAE appear to involve genes for proteins other than C1-inhibitor. A point mutation in the Kng1 gene encoding HK and low-molecular weight kininogen (LK) was identified recently in a family with HAE. The mutation changes a methionine (Met379) to lysine (Lys379) in both proteins. Met379 is adjacent to the Lys380-Arg381 cleavage site at the N-terminus of the bradykinin peptide. Recombinant wild-type (Met379) and variant (Lys379) versions of HK and LK were expressed in HEK293 cells. PKa-catalyzed kinin release from HK and LK was not affected by the Lys379 substitutions. However, kinin release from HK-Lys379 and LK-Lys379 catalyzed by the fibrinolytic protease plasmin was substantially greater than from wild-type HK-Met379 and LK-Met379. Increased kinin release was evident when fibrinolysis was induced in plasma containing HK-Lys379 or LK-Lys379 compared with plasma containing wild-type HK or LK. Mass spectrometry revealed that the kinin released from wild-type and variant kininogens by PKa is bradykinin. Plasmin also released bradykinin from wild-type kininogens but cleaved HK-Lys379 and LK-Lys379 after Lys379 rather than Lys380, releasing the decapeptide Lys-bradykinin (kallidin). The Met379Lys substitutions make HK and LK better plasmin substrates, reinforcing the relationship between fibrinolysis and kinin generation.

High molecular weight kininogen interactions with the homologs prekallikrein and factor XI: importance to surface-induced coagulation

BACKGROUND

In plasma, high molecular weight kininogen (HK) is either free or bound to prekallikrein (PK) or factor (F) XI (FXI). During contact activation, HK is thought to anchor PK and FXI to surfaces, facilitating their conversion to the proteases plasma kallikrein and FXIa. Mice lacking HK have normal hemostasis but are resistant to injury-induced arterial thrombosis.

OBJECTIVES

To identify amino acids on the HK-D6 domain involved in PK and FXI binding and study the importance of the HK-PK and HK-FXI interactions to coagulation.

METHODS

Twenty-four HK variants with alanine replacements spanning residues 542-613 were tested in PK/FXI binding and activated partial thromboplastin time clotting assays. Surface-induced FXI and PK activation in plasma were studied in the presence or absence of HK. Kng1-/- mice lacking HK were supplemented with human or murine HK and tested in an arterial thrombosis model.

RESULTS

Overlapping binding sites for PK and FXI were identified in the HK-D6 domain. HK variants with defects only in FXI binding corrected the activated partial thromboplastin time of HK-deficient plasma poorly compared to a variant defective only in PK-binding. In plasma, HK deficiency appeared to have a greater deleterious effect on FXI activation than PK activation. Human HK corrected the defect in arterial thrombus formation in HK-deficient mice poorly due to a specific defect in binding to mouse FXI.

CONCLUSION

Clinical observations indicate FXI is required for hemostasis, while HK is not. Yet, the HK-FXI interaction is required for contact activation-induced clotting in vitro and in vivo suggesting an important role in thrombosis and perhaps other FXI-related activities.

Observation of the radiation environment and solar energetic particle events in Mars orbit in May 2018- June 2022

The dosimeter Liulin-MO for measuring the radiation environment onboard the ExoMars Trace Gas Orbiter (TGO) is a module of the Fine Resolution Epithermal Neutron Detector (FREND). Here we present results from measurements of the charged particle fluxes, dose rates and estimation of dose equivalent rates at ExoMars TGO Mars science orbit, provided by Liulin-MO from May 2018 to June 2022. The period of measurements covers the declining and minimum phases of the solar activity in 24th solar cycle and the rising phase of the 25th cycle. Compared are the radiation values of the galactic cosmic rays (GCR) obtained during the different phases of the solar activity. The highest values of the dose rate and flux from GCR are registered from March to August 2020. At the minimum of 24th and transition to 25th solar cycle the dose rate from GCR is 15.9 ± 1.6 µGy h-1, particle flux is 3.3 ± 0.17 cm-2s-1, dose equivalent rate is 72.3 ± 14.4 µSv h-1. Since September 2020 the dose rate and flux of GCR decrease. Particular attention is drawn to the observation of the solar energetic particle (SEP) events in July, September and October 2021, February and March 2022 as well as their effects on the radiation environment on TGO during the corresponding periods. The SEP event during15-19 February 2022 is the most powerful event observed in our data. The SEP dose during this event is 13.8 ± 1.4 mGy (in Si), the SEP dose equivalent is 21.9 ± 4.4 mSv. SEP events recorded in Mars orbit are related to coronal mass ejections (CME) observed by SOHO and STEREO A coronagraphs. Compared are the time profiles of the count rates measured by Liulin-MO, the neutron detectors of FREND and neutron detectors of the High Energy Neutron Detector (HEND) aboard Mars Odyssey during 15-19 February 2022 event. The data obtained is important for the knowledge of the radiation environment around Mars, regarding future manned and robotic flights to the planet. The data for SEP events in Mars orbit during July 2021-March 2022 contribute to the details on the solar activity at a time when Mars is on the opposite side of the Sun from Earth.

Comparison of the particle flux measured by Liulin-MO dosimeter in ExoMars TGO science orbit with those calculated by models

The knowledge of the space radiation environment in spacecraft transition and in Mars vicinity is of importance for the preparation of the human exploration of Mars. ExoMars Trace Gas Orbiter (TGO) was launched on March 14, 2016 and was inserted into circular Mars science orbit (MSO) with a 400 km altitude in March 2018. The Liulin-MO dosimeter is a module of the Fine Resolution Epithermal Neutron Detector (FREND) aboard ExoMars TGO and has been measuring the radiation environment during the TGO interplanetary travel to Mars and continues to do so in the TGO MSO. One of the scientific objectives of the Liulin-MO investigations is to provide data for verification and benchmarking of the Mars radiation environment models. In this work we present results of comparisons of the flux measured by the Liulin-MO in TGO Mars orbit with calculated estimations. Described is the methodology for estimation the particle flux in Liulin-MO detectors in MSO, which includes modeling the albedo spectra and procedure for calculation the fluxes, recorded by Liulin-MO on the basis of the detectors shielding model. The galactic cosmic rays (GCR) and Mars albedo radiation contribution to the detectors count rate was taken into account. The GCR particle flux was calculated using the Badhwar O'Neil 2014 model for December 1, 2018. Detailed calculations of the albedo spectra of protons, helium ions, neutrons and gamma rays at 70 km height, performed with Atmospheric Radiation Interaction Simulator (AtRIS), were used for deriving the albedo radiation fluxes at the TGO altitude. In particular, the sensitivity of the Liulin-MO semiconductor detectors to neutron and gamma radiation has been considered in order to calculate the contribution of the neutral particles to the detected flux. The results from the calculations suggest that the contribution of albedo radiation can be about 5% of the measured total flux from GCR and albedo at the TGO altitude. The critical effect of TGO orientation, causing different shading of the GCR flux by Mars, is also analysed in detail. The comparison between the measurements and estimations shows that the measured fluxes exceed the calculated values by at least 20% and that the effect of TGO orientation change is approximately the same for the calculated and measured fluxes. Accounting for the ACR contribution, secondary radiation and the gradient of GCR spectrum from 1 AU to 1.5 AU, the calculated flux may increase to match the measurement results. The results can serve for the benchmarking of GCRs models at Martian orbit.

Impairment of serine transport across the blood-brain barrier by deletion of Slc38a5 causes developmental delay and motor dysfunction

Brain L-serine is critical for neurodevelopment and is thought to be synthesized solely from glucose. In contrast, we found that the influx of L-serine across the blood-brain barrier (BBB) is essential for brain development. We identified the endothelial Slc38a5, previously thought to be a glutamine transporter, as an L-serine transporter expressed at the BBB in early postnatal life. Young Slc38a5 knockout (KO) mice exhibit developmental alterations and a decrease in brain L-serine and D-serine, without changes in serum or liver amino acids. Slc38a5-KO brains exhibit accumulation of neurotoxic deoxysphingolipids, synaptic and mitochondrial abnormalities, and decreased neurogenesis at the dentate gyrus. Slc38a5-KO pups exhibit motor impairments that are affected by the administration of L-serine at concentrations that replenish the serine pool in the brain. Our results highlight a critical role of Slc38a5 in supplying L-serine via the BBB for proper brain development.

Factor XII Structure-Function Relationships

Factor XII (FXII), the zymogen of the protease FXIIa, contributes to pathologic processes such as bradykinin-dependent angioedema and thrombosis through its capacity to convert the homologs prekallikrein and factor XI to the proteases plasma kallikrein and factor XIa. FXII activation and FXIIa activity are enhanced when the protein binds to a surface. Here, we review recent work on the structure and enzymology of FXII with an emphasis on how they relate to pathology. FXII is a homolog of pro-hepatocyte growth factor activator (pro-HGFA). We prepared a panel of FXII molecules in which individual domains were replaced with corresponding pro-HGFA domains and tested them in FXII activation and activity assays. When in fluid phase (not surface bound), FXII and prekallikrein undergo reciprocal activation. The FXII heavy chain restricts reciprocal activation, setting limits on the rate of this process. Pro-HGFA replacements for the FXII fibronectin type 2 or kringle domains markedly accelerate reciprocal activation, indicating disruption of the normal regulatory function of the heavy chain. Surface binding also enhances FXII activation and activity. This effect is lost if the FXII first epidermal growth factor (EGF1) domain is replaced with pro-HGFA EGF1. These results suggest that FXII circulates in blood in a "closed" form that is resistant to activation. Intramolecular interactions involving the fibronectin type 2 and kringle domains maintain the closed form. FXII binding to a surface through the EGF1 domain disrupts these interactions, resulting in an open conformation that facilitates FXII activation. These observations have implications for understanding FXII contributions to diseases such as hereditary angioedema and surface-triggered thrombosis, and for developing treatments for thrombo-inflammatory disorders.

Mechanisms involved in hereditary angioedema with normal C1-inhibitor activity

Patients with the inherited disorder hereditary angioedema (HAE) suffer from episodes of soft tissue swelling due to excessive bradykinin production. In most cases, dysregulation of the plasma kallikrein-kinin system due to deficiency of plasma C1 inhibitor is the underlying cause. However, at least 10% of HAE patients have normal plasma C1 inhibitor activity levels, indicating their syndrome is the result of other causes. Two mutations in plasma protease zymogens that appear causative for HAE with normal C1 inhibitor activity have been identified in multiple families. Both appear to alter protease activity in a gain-of-function manner. Lysine or arginine substitutions for threonine 309 in factor XII introduces a new protease cleavage site that results in formation of a truncated factor XII protein (Δ-factor XII) that accelerates kallikrein-kinin system activity. A glutamic acid substitution for lysine 311 in the fibrinolytic protein plasminogen creates a consensus binding site for lysine/arginine side chains. The plasmin form of the variant plasminogen cleaves plasma kininogens to release bradykinin directly, bypassing the kallikrein-kinin system. Here we review work on the mechanisms of action of the FXII-Lys/Arg309 and Plasminogen-Glu311 variants, and discuss the clinical implications of these mechanisms.

Titanium is a potent inducer of contact activation: implications for intravascular devices

BACKGROUND

Titanium (Ti) and its alloys are widely used in manufacturing medical devices because of their strength and resistance to corrosion. Although Ti compounds are considered compatible with blood, they appear to support plasma contact activation and may be thrombogenic.

OBJECTIVES

The objective of this study was to compare Ti and titanium nitride (TiN) with known activators of contact activation (kaolin and silica) in plasma-clotting assays and to assess binding and activation of factor XII, (FXII), factor XI (FXI), prekallikrein, and high-molecular-weight kininogen (HK) with Ti/TiN.

METHODS

Ti-based nanospheres and foils were compared with kaolin, silica, and aluminum in plasma-clotting assays. Binding and activation of FXII, prekallikrein, HK, and FXI to surfaces was assessed with western blots and chromogenic assays.

RESULTS

Using equivalent surface amounts, Ti and TiN were comparable with kaolin and superior to silica, for inducing coagulation and FXII autoactivation. Similar to many inducers of contact activation, Ti and TiN are negatively charged; however, their effects on FXII are not neutralized by the polycation polybrene. Antibodies to FXII, prekallikrein, or FXI or coating Ti with poly-L-arginine blocked Ti-induced coagulation. An antibody to FXII reduced FXII and PK binding to Ti, kallikrein generation, and HK cleavage.

CONCLUSION

Titanium compounds induce contact activation with a potency comparable with that of kaolin. Binding of FXII with Ti shares some features with FXII binding to soluble polyanions but may have unique features. Inhibitors targeting FXII or FXI may be useful in mitigating Ti-induced contact activation in patients with titanium-based implants that are exposed to blood.

A site on factor XII required for productive interactions with polyphosphate

BACKGROUND

During plasma contact activation, factor XII (FXII) binds to surfaces through its heavy chain and undergoes conversion to the protease FXIIa. FXIIa activates prekallikrein and factor XI (FXI). Recently, we showed that the FXII first epidermal growth factor-1 (EGF1) domain is required for normal activity when polyphosphate is used as a surface.

OBJECTIVES

The aim of this study was to identify amino acids in the FXII EGF1 domain required for polyphosphate-dependent FXII functions.

METHODS

FXII with alanine substitutions for basic residues in the EGF1 domain were expressed in HEK293 fibroblasts. Wild-type FXII (FXII-WT) and FXII containing the EGF1 domain from the related protein Pro-HGFA (FXII-EGF1) were positive and negative controls. Proteins were tested for their capacity to be activated, and to activate prekallikrein and FXI, with or without polyphosphate, and to replace FXII-WT in plasma clotting assays and a mouse thrombosis model.

RESULTS

FXII and all FXII variants were activated similarly by kallikrein in the absence of polyphosphate. However, FXII with alanine replacing Lys⁷³, Lys⁷⁴, and Lys⁷⁶ (FXII-Ala^73,74,76) or Lys⁷⁶, His⁷⁸, and Lys⁸¹ (FXII-Ala^76,78,81) were activated poorly in the presence of polyphosphate. Both have <5% of normal FXII activity in silica-triggered plasma clotting assays and have reduced binding affinity for polyphosphate. Activated FXIIa-Ala^73,74,76 displayed profound defects in surface-dependent FXI activation in purified and plasma systems. FXIIa-Ala^73,74,76 reconstituted FXII-deficient mice poorly in an arterial thrombosis model.

CONCLUSION

FXII Lys⁷³, Lys⁷⁴, Lys⁷⁶, and Lys⁸¹ form a binding site for polyanionic substances such as polyphosphate that is required for surface-dependent FXII function.

Recent advances in factor XII structure and function

PURPOSE OF REVIEW

Factor XII (FXII), the precursor of the protease FXIIa, contributes to pathologic processes including angioedema and thrombosis. Here, we review recent work on structure-function relationships for FXII based on studies using recombinant FXII variants.

RECENT FINDINGS

FXII is a homolog of pro-hepatocyte growth factor activator (Pro-HGFA). We prepared FXII in which domains are replaced by corresponding parts of Pro-HGA, and tested them in FXII activation and activity assays. In solution, FXII and prekallikrein undergo reciprocal activation to FXIIa and kallikrein. The rate of this process is restricted by the FXII fibronectin type-2 and kringle domains. Pro-HGA replacements for these domains accelerate FXII and prekallikrein activation. When FXII and prekallikrein bind to negatively charged surfaces, reciprocal activation is enhanced. The FXII EGF1 domain is required for surface binding.

SUMMARY

We propose a model in which FXII is normally maintained in a closed conformation resistant to activation by intramolecular interactions involving the fibronectin type-2 and kringle domains. These interactions are disrupted when FXII binds to a surface through EGF1, enhancing FXII activation and prekallikrein activation by FXIIa. These observations have important implications for understanding the contributions of FXII to disease, and for developing therapies to treat thrombo-inflammatory disorders.

A comparative study of LaBr3(Ce(3+)) and CeBr3 based gamma-ray spectrometers for planetary remote sensing applications

The recent availability of large volume cerium bromide crystals raises the possibility of substantially improving gamma-ray spectrometer limiting flux sensitivities over current systems based on the lanthanum tri-halides, e.g., lanthanum bromide and lanthanum chloride, especially for remote sensing, low-level counting applications or any type of measurement characterized by poor signal to noise ratios. The Russian Space Research Institute has developed and manufactured a highly sensitive gamma-ray spectrometer for remote sensing observations of the planet Mercury from the Mercury Polar Orbiter (MPO), which forms part of ESA's BepiColombo mission. The Flight Model (FM) gamma-ray spectrometer is based on a 3-in. single crystal of LaBr3(Ce(3+)) produced in a separate crystal development programme specifically for this mission. During the spectrometers development, manufacturing, and qualification phases, large crystals of CeBr3 became available in a subsequent phase of the same crystal development programme. Consequently, the Flight Spare Model (FSM) gamma-ray spectrometer was retrofitted with a 3-in. CeBr3 crystal and qualified for space. Except for the crystals, the two systems are essentially identical. In this paper, we report on a comparative assessment of the two systems, in terms of their respective spectral properties, as well as their suitability for use in planetary mission with respect to radiation tolerance and their propensity for activation. We also contrast their performance with a Ge detector representative of that flown on MESSENGER and show that: (a) both LaBr3(Ce(3+)) and CeBr3 provide superior detection systems over HPGe in the context of minimally resourced spacecraft and (b) CeBr3 is a more attractive system than LaBr3(Ce(3+)) in terms of sensitivities at lower gamma fluxes. Based on the tests, the FM has now been replaced by the FSM on the BepiColombo spacecraft. Thus, CeBr3 now forms the central gamma-ray detection element on the MPO spacecraft.

Adaptation of continuous-flow cavity ring-down spectroscopy for batch analysis of δ13C of CO2 and comparison with isotope ratio mass spectrometry

Measurements of δ(13)C in CO(2) have traditionally relied on samples stored in sealed vessels and subsequently analyzed using magnetic sector isotope ratio mass spectrometry (IRMS), an accurate but expensive and high-maintenance analytical method. Recent developments in optical spectroscopy have yielded instruments that can measure δ(13)CO(2) in continuous streams of air with precision and accuracy approaching those of IRMS, but at a fraction of the cost. However, continuous sampling is unsuited for certain applications, creating a need for conversion of these instruments for batch operation. Here, we present a flask (syringe) adaptor that allows the collection and storage of small aliquots (20-30 mL air) for injection into the cavity ring-down spectroscopy (CRDS) instrument. We demonstrate that the adaptor's precision is similar to that of traditional IRMS (standard deviation of 0.3‰ for 385 ppm CO(2) standard gas). In addition, the concentration precision (±0.3% of sample concentration) was higher for CRDS than for IRMS (±7% of sample concentration). Using the adaptor in conjunction with CRDS, we sampled soil chambers and found that soil-respired δ(13)C varied between two different locations in a piñon-juniper woodland. In a second experiment, we found no significant discrimination between the respiration of a small beetle (~5 mm) and its diet. Our work shows that the CRDS system is flexible enough to be used for the analysis of batch samples as well as for continuous sampling. This flexibility broadens the range of applications for which CRDS has the potential to replace magnetic sector IRMS.

Maps of subsurface hydrogen from the high energy neutron detector, Mars Odyssey

After 55 days of mapping by the High Energy Neutron Detector onboard Mars Odyssey, we found deficits of high-energy neutrons in the southern highlands and northern lowlands of Mars. These deficits indicate that hydrogen is concentrated in the subsurface. Modeling suggests that water ice-rich layers that are tens of centimeters in thickness provide one possible fit to the data.

Affinity purification of a mannose-binding protein, a sensitive tool in the diagnostics of IgM, via site-directed phosphorylated mannan bound to alumina

Ca2+ -dependent mannose-binding proteins (MBPs) belong to the family of animal lectins. They perform in vivo as defence molecules that act as opsonins by enhancing the clearance of mannose rich pathogens and have been used in vitro for the purification of IgM. MBPs have been previously isolated by methods based on binding the protein moiety of various mannan species to different matrices. However, the mannan-protein complexes did not have a constant protein content and the yield of the isolated MBPs was variable. In the present study we describe a new approach for the affinity purification of MBPs based on the main polysaccharide moiety of the complex. After removal of residual phosphate groups naturally occurring at the C-3 position of the sugar, which interfere with MBP recognition, the mannan was phosphorylated enzymatically at C-6, at which position the OH group is not required for lectin binding. The enzymatically phosphorylated mannan bound to an alumina column was used successfully for MBP separation from rabbit serum. The mannose-binding protein obtained was used in our study for diagnostic purposes in the identification and determination of very low concentrations of IgM.

Calcium-modulated conformational affinity chromatography. Application to the purification of calmodulin and S100 proteins

The purification of proteins by affinity chromatography is based on their highly specific interaction with an immobilized ligand followed by elution under conditions where their affinity towards the ligand is markedly reduced. Thus, a high-degree purification by a single chromatographic step is achieved. However, when several proteins in the crude mixture share affinity to a common immobilized ligand, they may not be resolved by affinity chromatography and subsequent "real" chromatographic purification steps may be required. It is shown that by using properly selected gradient elution conditions, the affinities of the various proteins towards the immobilized ligand may be gradually modulated and their separation may be achieved. This is exemplified by the isolation and separation of a group of Ca(2+)-activated proteins, Calmodulin, S100a and S100b, from bovine brain extract, using a melittin-Eupergit C affinity column which is developed with Ca(2+)-chelator gradients. As expected, separation of the three proteins into individual peaks, eluted in order of increasing affinity to the matrix, was obtained. Sigmoid selectivity curves calculated from the elution volumes under different elution conditions for each of the proteins were obtained, illustrating the chromatographic behaviour of the gradient affinity separation system.