Session: 330. Vascular Biology, Thrombosis, and Thrombotic Microangiopathies: Basic and Translational: Poster III
Hematology Disease Topics & Pathways:
Research, Fundamental Science
Aim: This study aims to investigate the effects of citrullination of TFPI on the inhibition of FXa, FVIIa/TF, and the cofactor activity of protein S.
Methods: The effect of TFPI citrullination on inhibition of FXa and FVIIa/TF was measured by chromogenic assays using purified components and by calibrated automated thrombography (CAT). The interaction with protein S was assessed by surface plasmon resonance (SPR) and solid-phase binding assays using immobilized protein S, recombinant TFPI, and synthetic TFPI domains. Thrombin generation was monitored using normal pooled plasma initiated with FXa, FXIa, and TF.
Results: Citrullination of TFPI abolished its ability to inhibit FXa- and FXIa-triggered thrombin generation. However, its impaired inhibition of TF-triggered thrombin generation could be partially rescued by protein S. Chromogenic assays revealed that citrullinated TFPI was essentially inactive as an inhibitor of the FVIIa-TF complex in the absence of protein S, but partially restored by protein S. Interaction studies revealed that binding of citrullinated TFPI to protein S was reduced approximately fourfold. Additionally, thrombin generation assays in protein S- and TFPI-depleted plasma showed that protein S could partially restore the anticoagulant activity of citrullinated TFPI in TF-triggered thrombin generation.
Conclusion: Citrullinated TFPI exhibits impaired natural anticoagulant activity, significantly losing its anti-FXa function while retaining some capacity to inhibit TF-triggered thrombin generation, which can be partially rescued by protein S. Despite the partial rescue, the interaction between citrullinated TFPI and protein S is notably weakened. This study underscores the importance of the interaction between TFPI and protein S in maintaining hemostasis and reveals the potential impact of PAD4-mediated citrullination on coagulation regulation during inflammation. The findings suggest that therapies targeting citrullination or enhancing TFPI-protein S interaction could be beneficial in inflammatory conditions associated with increased thrombotic risk.
Disclosures: Hackeng: Coagulation Profile B.V: Current holder of stock options in a privately-held company, Other: Founder; Cerus Corporation: Research Funding.