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1.
Virus Res ; 233: 51-59, 2017 04 02.
Article in English | MEDLINE | ID: mdl-28279802

ABSTRACT

Viral infections may predispose the airways to secondary bacterial infections that can lead to unfavorable progression of principally self-limiting illnesses. Such complicated respiratory infections include pneumonia, bronchitis, sinusitis, acute otitis media, and sepsis, which cause high morbidity and lethality. Some of the pathogenic consequences of viral infections, like the expression of bacterial adhesion receptors and the disturbance of physical barrier integrity due to inflammation, may create permissive conditions for co-infections. Influenza virus A (H3N2) is a major pathogen that causes secondary bacterial infections and inflammation that lead to pneumonia. The herbal medicine Echinacea purpurea, on the other hand, has been widely used to prevent and treat viral respiratory infections, and recent clinical data suggest that it may prevent secondary infection complications as well. We investigated the role of standardized E. purpurea (Echinaforce® extract or EF) on H3N2-induced adhesion of live nontypeable Haemophilus influenzae (NTHi) and Staphylococcus aureus, along with the expression of bacterial receptors, intracellular adhesion molecule-1 (ICAM-1), fibronectin, and platelet activating factor receptor (PAFr), by BEAS-2B cells. Inflammatory processes were investigated by determining the cellular expression of IL-6 and IL-8 and the involvement of Toll-like receptor (TLR-4) and NFκB p65. We found that influenza virus A infection increased the adhesion of H. influenzae and S. aureus to bronchial epithelial cells via upregulated expression of the ICAM-1 receptor and, to some extent, of fibronectin and PAFr. Echinaforce (EF) significantly reduced the expression of ICAM-1, fibronectin, and PAFr and consequently the adhesion of both bacterial strains. EF also effectively prevented the super-expression of inflammatory cytokines by suppressing the expression of NFκB and possibly TLR-4. These results indicate that E. purpurea has the potential to reduce the risk of respiratory complications by preventing virus-induced bacterial adhesion and through the inhibition of inflammation super-stimulation (cytokine storms).


Subject(s)
Anti-Infective Agents/pharmacology , Echinacea/chemistry , Epithelial Cells/drug effects , Superinfection/prevention & control , Toll-Like Receptor 4/antagonists & inhibitors , Transcription Factor RelA/antagonists & inhibitors , Cell Line , Coinfection , Epithelial Cells/cytology , Epithelial Cells/microbiology , Epithelial Cells/virology , Fibronectins/genetics , Fibronectins/immunology , Gene Expression Regulation , Haemophilus influenzae/drug effects , Haemophilus influenzae/growth & development , Haemophilus influenzae/pathogenicity , Host-Pathogen Interactions , Humans , Influenza A Virus, H3N2 Subtype/drug effects , Influenza A Virus, H3N2 Subtype/growth & development , Influenza A Virus, H3N2 Subtype/pathogenicity , Intercellular Adhesion Molecule-1/genetics , Intercellular Adhesion Molecule-1/immunology , Interleukin-6/genetics , Interleukin-6/immunology , Interleukin-8/genetics , Interleukin-8/immunology , Lung/cytology , Lung/drug effects , Lung/microbiology , Lung/virology , Plant Extracts/pharmacology , Platelet Membrane Glycoproteins/genetics , Platelet Membrane Glycoproteins/immunology , Receptors, G-Protein-Coupled/genetics , Receptors, G-Protein-Coupled/immunology , Signal Transduction , Staphylococcus aureus/drug effects , Staphylococcus aureus/growth & development , Staphylococcus aureus/pathogenicity , Superinfection/microbiology , Superinfection/virology , Toll-Like Receptor 4/genetics , Toll-Like Receptor 4/immunology , Transcription Factor RelA/genetics , Transcription Factor RelA/immunology
2.
Chin J Integr Med ; 23(12): 893-900, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28197937

ABSTRACT

OBJECTIVE: To explore the association of the platelet-activating factor receptor (PAFR) gene rs5938, rs313152 and rs76744145 polymorphisms with coronary heart disease (CHD) and blood stasis syndrome (BSS) of CHD in Chinese Han population. METHODS: A total of 570 CHD patients (299 with BSS and 271 with non-BSS) and 317 controls were enrolled. The PAFR gene rs5938, rs313152 and rs76744145 polymorphisms were genotyped using the multiplex SNaPshot technology. The statistical analysis was conducted using a multiple variable logistic regression model. RESULTS: Significant differences were detected in the genotypes frequency distributions of the rs5938 (P<0.01), but not the rs313152 (P>0.05), between the controls and CHD patients. Individuals with an rs5938 or rs313152 mutated allele had a low risk for CHD [adjusted odds ratio (aOR)=0.35, 95% confidence interval (CI): 0.23 to 0.56, P<0.01; aOR=0.65, 95% CI: 0.46 to 0.91, P<0.05, respectively]. After the CHD patients were stratified as BSS or non-BSS according to their Chinese medicine patterns, the rs5938 polymorphism mutated alleles had a significant association with a low risk for BSS of CHD (aOR=0.32, 95% CI: 0.18 to 0.57, P<0.01) and non-BSS of CHD (aOR=0.31, 95% CI: 0.17 to 0.55, P<0.01). The rs313152 polymorphism was associated with a low risk for BSS (aOR=0.51, 95% CI: 0.33 to 0.79, P<0.01), but not for non-BSS (aOR=1.22, 95% CI: 0.81 to 1.85, P<0.05). Furthermore, the interaction effect of the rs5938 and rs313152 polymorphisms for BSS of CHD was significantly based on an aOR value associated with the combination of the rs5938 GT genotype with the rs313152 TC genotype of 0.27 (95% CI: 0.1 to 0.7, P<0.01). CONCLUSION: The PAFR gene rs5938 or rs313152 polymorphisms might be a potential biomarker for susceptibility to CHD, especially to BSS of CHD in Chinese Han population.


Subject(s)
Asian People/genetics , Coronary Disease/genetics , Ethnicity/genetics , Genetic Association Studies , Genetic Predisposition to Disease , Platelet Membrane Glycoproteins/genetics , Polymorphism, Single Nucleotide/genetics , Receptors, G-Protein-Coupled/genetics , Demography , Epistasis, Genetic , Female , Humans , Male , Middle Aged , Odds Ratio , Syndrome
3.
Platelets ; 27(4): 322-32, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26559117

ABSTRACT

Anti-platelet agents play a central part in the treatment and prevention of acute thrombotic events. Discriminating animal models are needed for the development of novel agents. The chacma baboon has been extensively used as a model to evaluate anti-platelet agents. However, limited data exist to prove the translatability of this species to humans. We aimed to determine the suitability of the chacma baboon in preclinical human targeted GPIIb/IIIa, GPIbα and P2Y12 studies. Light-transmission platelet aggregometry (LTA), whole blood impedance aggregometry, receptor number quantification and genomic DNA sequencing were performed. Baboon ADP and arachidonic acid-induced LTA aggregation results differed significantly from human values, even at increased concentrations. LTA ristocetin-induced agglutination was comparable between species, but baboon platelets needed twice the concentration of ristocetin to elicit a similar response. Citrated baboon blood had significantly less aggregation than humans when evaluated with impedance aggregometry. However, hirudinised baboon whole blood gave similar aggregation as humans at the same agonist concentrations. GPIIb, GPIIIa and GPIbα numbers were significantly more on the baboon platelets. None of the amino acids deemed vital for receptor function, ligand binding or receptor inhibition, were radically different between the species. However, a conservative change in a calcium-binding region of GPIIb may render the baboon platelets more sensitive to calcium-binding agents. The chacma baboon may be used for the evaluation of human-targeted GPIIb/IIIa-, GPIbα- and P2Y12-inhibiting agents. However, the best anticoagulant, optimal agonist concentrations, increase in receptor number and sequence differences must be considered for any future studies.


Subject(s)
Blood Platelets/drug effects , Blood Platelets/metabolism , Platelet Aggregation Inhibitors/pharmacology , Platelet Membrane Glycoproteins/metabolism , Receptors, Cell Surface/metabolism , Adenosine Diphosphate/pharmacology , Amino Acid Sequence , Amino Acid Substitution , Animals , Arachidonic Acid/pharmacology , Drug Evaluation, Preclinical , Flow Cytometry , Humans , Male , Papio ursinus , Platelet Aggregation/drug effects , Platelet Membrane Glycoproteins/chemistry , Platelet Membrane Glycoproteins/genetics , Receptors, Cell Surface/chemistry , Receptors, Cell Surface/genetics , Receptors, Purinergic P2/chemistry , Receptors, Purinergic P2/genetics , Receptors, Purinergic P2/metabolism , Ristocetin/pharmacology
4.
Platelets ; 26(6): 552-7, 2015.
Article in English | MEDLINE | ID: mdl-25165849

ABSTRACT

An effective and safe anti-platelet drug is central to the management of patients with acute coronary syndrome (ACS). Glycoprotein VI (GPVI) is currently regarded as a potential target for novel anti-platelet agents due to its collagen-binding potential. Development of anti-thrombotics is associated with testing in animals. We have previously successfully evaluated anti-platelet drugs in the Cape Chacma baboon (Papio ursinus). However, various anti-GPVI agents did not have an effect on baboons when evaluated in our arterial thrombosis model. To evaluate the suitability of baboons for GPVI studies, we performed collagen-induced platelet aggregation, GPVI quantification and DNA sequencing. Baboon platelets needed double the amount of collagen compared to human platelets to illicit proper aggregation. GPVI quantification was unsuccessful due to non-binding of monoclonal antibodies. Sequencing of the GPVI gene revealed 36 SNPs leading to 14 amino acid changes, as well as a 9 bp deletion causing a 3 amino acid deletion. Several of the amino acid changes were within the ligand binding region of GPVI, causing limited binding of humanized anti-GPVI antibodies to the baboon platelets. Therefore, the baboon was deemed not suitable to evaluate human targeted anti-GPVI agents.


Subject(s)
Antibodies, Monoclonal/pharmacology , Platelet Aggregation Inhibitors/pharmacology , Platelet Membrane Glycoproteins/antagonists & inhibitors , Amino Acid Substitution , Animals , Antibodies, Monoclonal/therapeutic use , Base Sequence , Collagen/metabolism , Collagen/pharmacology , Drug Evaluation, Preclinical , Humans , Models, Animal , Molecular Sequence Data , Papio ursinus , Platelet Aggregation/drug effects , Platelet Aggregation/physiology , Platelet Aggregation Inhibitors/therapeutic use , Platelet Membrane Glycoproteins/chemistry , Platelet Membrane Glycoproteins/genetics , Platelet Membrane Glycoproteins/metabolism , Polymorphism, Single Nucleotide , Sequence Alignment
5.
Zhongguo Zhong Yao Za Zhi ; 36(14): 1860-4, 2011 Jul.
Article in Chinese | MEDLINE | ID: mdl-22016948

ABSTRACT

OBJECTIVE: To establish a new, real time, dynamic and direct optical detection method for mast cell degranulation caused by anaphylactoid reaction. METHOD: A CD63-GFP plasmid was constructed and introduced steadily into rat basophilic leukemia (RBL-2H3) cells. The movements of CD63-GFP, which was located on both the granule membranes and the plasma membranes of RBL cells stimulated by Compound 48/80, were studied by confocal laser scanning microscope (CLSM) and total internal reflection fluorescence microscope (TIRFM) both inside and on the surface of living RBL-2H3 cells. RESULT: Before antigen stimulation, most granules with CD63-GFP hardly moved in RBL cells. However, after antigen stimulation, the granules moved dramatically. They reached the plasma membranes in a few minutes and fused with them instantaneously. The velocity of the granule movement toward the plasma membranes on antigen stimulation was calculated to be 0.05 micron x s(-1). CONCLUSION: Analysis of the movement of each granule provided a new insight into the elementary process of degranulation. The method is rapid, sensitive and reliable, which could be used as a new detection method for anaphylactoid reaction in vitro.


Subject(s)
Anaphylaxis/immunology , Cell Degranulation , Mast Cells/cytology , Mast Cells/immunology , Anaphylaxis/diagnosis , Anaphylaxis/metabolism , Animals , Antigens, CD/genetics , Cell Line, Tumor , Cell Movement , Microscopy, Confocal , Microscopy, Fluorescence , Platelet Membrane Glycoproteins/genetics , Rats , Tetraspanin 30 , Time Factors
6.
J Investig Allergol Clin Immunol ; 19(6): 465-73, 2009.
Article in English | MEDLINE | ID: mdl-20128421

ABSTRACT

OBJECTIVE: The aim of our study was to determine the diagnostic usefulness of a newly developed basophil activation test (BAT) in patients allergic to Dermatophagoides pteronyssinus and pollens. We also analyzed the influence of cetirizine on CD63 upregulation. This popular antihistamine strongly inhibits skin tests, but its impact on BAT sensitivity remains unknown and deserves at least preliminary determination. METHODS: The study sample comprised 22 patients allergic to house dust mite and pollens and 19 healthy controls. All participants underwent skin prick testing and the newly developed flow-cytometric basophil activation test. The protocol for allergen-induced basophil CD63 upregulation consisted of whole blood samples that were processed and stained with anti-CCR3/CD63 antibodies added to the buffer at the beginning of stimulation. Skin prick tests and BAT were performed twice--before and 2 hours after ingestion of 10 mg of cetirizine. RESULTS: The new BAT is characterized by its short processing time, easy basophil gating, and strong CD63 upregulation with very high sensitivity and excellent specificity. Our results suggest that allergen-induced CD63 upregulation by higher doses of allergens is not inhibited 2 hours after administration of cetirizine (unlike skin prick tests). CONCLUSION: The BAT is a very useful and precise method for the diagnosis of allergy to aeroallergens. It is not influenced by cetirizine.


Subject(s)
Antigens, CD/metabolism , Basophil Degranulation Test/methods , Basophils/metabolism , Hypersensitivity/diagnosis , Platelet Membrane Glycoproteins/metabolism , Adult , Animals , Antigens, CD/genetics , Antigens, CD/immunology , Antigens, Dermatophagoides/immunology , Antigens, Plant/adverse effects , Antigens, Plant/immunology , Basophils/drug effects , Basophils/immunology , Basophils/pathology , Cell Degranulation/drug effects , Cell Degranulation/immunology , Cell Separation , Cells, Cultured , Cetirizine/administration & dosage , Cetirizine/pharmacology , Dermatophagoides pteronyssinus/immunology , Feasibility Studies , Female , Flow Cytometry , Gene Expression Regulation/drug effects , Gene Expression Regulation/immunology , Histamine H1 Antagonists, Non-Sedating/administration & dosage , Histamine H1 Antagonists, Non-Sedating/pharmacology , Humans , Hypersensitivity/drug therapy , Hypersensitivity/immunology , Hypersensitivity/pathology , Male , Platelet Membrane Glycoproteins/genetics , Platelet Membrane Glycoproteins/immunology , Pollen/adverse effects , Pollen/immunology , Sensitivity and Specificity , Tetraspanin 30
7.
Int J Immunopathol Pharmacol ; 20(2): 267-78, 2007.
Article in English | MEDLINE | ID: mdl-17624239

ABSTRACT

We recently identified the ectoenzyme CD203c as a novel basophil activation antigen that is upregulated in response to FcepsilonRI cross-linkage. We investigated the effects of various interleukins (ILs) on expression of CD203c on blood basophils using an antibody against CD203c and flow cytometry. Of all cytokines tested, only IL-3 was found to upregulate expression of CD203c on basophils above baseline levels. The effects of IL-3 were dose- and time-dependent (EC(50): 0.1-1 ng/ml) without differences observed between healthy and allergic donors. Whereas anti-IgE induced maximum upregulation of CD203c within 15 minutes, the IL-3-induced upregulation showed a maximum after 180 minutes. IgE-receptor cross-linking resulted in enhanced expression of both CD63 and CD203c, whereas IL-3 enhanced the levels of CD203c without promoting expression of CD63. The IL-3-induced upregulation of CD203c was also observed in highly enriched basophils and was counteracted by a blocking antibody against the alpha chain of the IL-3 receptor (CD123). The IL-3-induced upregulation of CD203c was also found to depend on the presence of calcium. To analyze signaling pathways involved in IL-3-induced upregulation of CD203c, pharmacologic inhibitors were applied. The PI3-kinase inhibitors, wortmannin and LY294002 counteracted the IL-3-induced expression of CD203c, whereas MEK- and PKC inhibitors showed no effects. In conclusion, IL-3 upregulates expression of CD203c on basophils through a specific receptor and via a PI3-kinase-dependent signaling-pathway. Compared to FcepsilonRI-mediated cell activation, IL-3-induced upregulation of CD203c is a late(r) event and is not accompanied by upregulation of CD63.


Subject(s)
Basophils/immunology , Basophils/metabolism , Betula/immunology , Interleukin-3/physiology , Phosphoric Diester Hydrolases/genetics , Pollen/immunology , Pyrophosphatases/genetics , Rhinitis, Allergic, Seasonal/immunology , Antigens, CD/biosynthesis , Antigens, CD/genetics , Cells, Cultured , Gene Expression Regulation/physiology , Humans , Phosphoric Diester Hydrolases/biosynthesis , Platelet Membrane Glycoproteins/biosynthesis , Platelet Membrane Glycoproteins/genetics , Pyrophosphatases/biosynthesis , Tetraspanin 30
8.
Am J Physiol Gastrointest Liver Physiol ; 291(5): G928-37, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17030900

ABSTRACT

Platelet-activating factor (PAF) is a proinflammatory mediator that may influence neuronal activity in the enteric nervous system (ENS). Electrophysiology, immunofluorescence, Western blot analysis, and RT-PCR were used to study the action of PAF and the expression of PAF receptor (PAFR) in the ENS. PAFR immunoreactivity (IR) was expressed by 6.9% of the neurons in the myenteric plexus and 14.5% of the neurons in the submucosal plexus in all segments of the guinea pig intestinal tract as determined by double staining with anti-human neuronal protein antibody. PAFR IR was found in 6.1% of the neurons with IR for calbindin, 35.8% of the neurons with IR for neuropeptide Y (NPY), 30.6% of the neurons with IR for choline acetyltransferase (ChAT), and 1.96% of the neurons with IR for vasoactive intestinal peptide (VIP) in the submucosal plexus. PAFR IR was also found in 1.5% of the neurons with IR for calbindin, 51.1% of the neurons with IR for NPY, and 32.9% of the neurons with IR for ChAT in the myenteric plexus. In the submucosal plexus, exposure to PAF (200-600 nM) evoked depolarizing responses (8.2 +/- 3.8 mV) in 12.4% of the neurons with S-type electrophysiological behavior and uniaxonal morphology and in 12.5% of the neurons with AH-type electrophysiological behavior and Dogiel II morphology, whereas in the myenteric preparations, depolarizing responses were elicited by a similar concentration of PAF in 9.5% of the neurons with S-type electrophysiological behavior and uniaxonal morphology and in 12.0% of the neurons with AH-type electrophysiological behavior and Dogiel II morphology. The results suggest that subgroups of secreto- and musculomotor neurons in the submucosal and myenteric plexuses express PAFR. Coexpression of PAFR IR with ChAT IR in the myenteric plexus and ChAT IR and VIP IR in the submucosal plexus suggests that PAF, after release in the inflamed bowel, might act to elevate the excitability of submucosal secretomotor and myenteric musculomotor neurons. Enhanced excitability of motor neurons might lead to a state of neurogenic secretory diarrhea.


Subject(s)
Enteric Nervous System/physiology , Intestine, Small/innervation , Intestine, Small/physiology , Platelet Activating Factor/physiology , Animals , Blotting, Western , Calbindins , DNA, Complementary/biosynthesis , DNA, Complementary/genetics , Electrophysiology , Enteric Nervous System/metabolism , Excitatory Postsynaptic Potentials/physiology , Female , Gastrointestinal Motility/physiology , Guinea Pigs , Immunohistochemistry , Intestine, Small/metabolism , Male , Membrane Potentials/physiology , Microelectrodes , Platelet Activating Factor/metabolism , Platelet Membrane Glycoproteins/biosynthesis , Platelet Membrane Glycoproteins/genetics , Receptors, G-Protein-Coupled/biosynthesis , Receptors, G-Protein-Coupled/genetics , Reverse Transcriptase Polymerase Chain Reaction , S100 Calcium Binding Protein G/biosynthesis , S100 Calcium Binding Protein G/genetics , Sympathetic Nervous System/physiology , Synapses/physiology , Synaptic Transmission/physiology
9.
Thromb Res ; 118(3): 371-80, 2006.
Article in English | MEDLINE | ID: mdl-16139873

ABSTRACT

Platelet glycoprotein VI (GPVI) is now considered to be a major player in platelet-collagen adhesive interactions leading to thrombus formation. GPVI blockade, or its depletion, has been shown in mice to result in complete protection against arterial thrombosis, without significant prolongation of bleeding time. GPVI may therefore represent a useful antithrombotic target. In order to reaffirm the role of GPVI in platelet-collagen interactions, we developed GPVI(null) mice by targeted disruption methodology. GPVI(null) mice platelets failed to respond to a high dose of fibrillar collagen, or convulxin, a GPVI agonist, but showed a normal response to other agonists such as ADP, PMA and arachidonic acid. We report, for the first time, that a proportion of GPVI(null) mice is protected against lethal thromboembolism, induced by the infusion of a mixture of collagen and epinephrine. Greater than 55% of GPVI(null) mice survived the challenge, whereas the maximal survival from the other genotypes was 17% (n=18 per genotype). Washed platelets obtained from GPVI(null) mice showed >90% reduction in adhesion to fibrillar collagen under static conditions. Platelet adhesion to collagen under dynamic conditions using a high shear rate (2600 s(-1)) was dramatically reduced using blood from GPVI(null) mice, while platelets from wild-type and heterozygous animals showed a similar amount of adhesion. Animals from each genotype had essentially similar tail bleeding time, suggesting that a complete deficiency of GPVI, at least in mice, does not result in an enhanced bleeding tendency. These observations clearly establish that blockade of GPVI may attenuate platelet-collagen interactions without adversely affecting the bleeding time.


Subject(s)
Bleeding Time , Blood Coagulation/drug effects , Fibrillar Collagens , Platelet Membrane Glycoproteins/metabolism , Pulmonary Embolism/chemically induced , Pulmonary Embolism/metabolism , Animals , Mice , Mice, Knockout , Platelet Membrane Glycoproteins/genetics , Pulmonary Embolism/prevention & control
10.
Blood ; 103(3): 903-11, 2004 Feb 01.
Article in English | MEDLINE | ID: mdl-14504096

ABSTRACT

Glycoprotein (GP) VI is the major receptor responsible for platelet activation by collagen, but the collagen-binding surface of GPVI is unknown. To address this issue we expressed, from insect cells, the immunoglobulin (Ig)-like ectodomains (residues 1-185) of human and murine GPVI, called hD1D2 and mD1D2, respectively. Both proteins bound specifically to collagen-related peptide (CRP), a GPVI-specific ligand, but hD1D2 bound CRP more strongly than did mD1D2. Molecular modeling and sequence comparison identified key differences between hD1D2 and mD1D2. Ten mutant hD1D2s were expressed, of which 4 had human residues replaced by their murine counterpart, and 6 had replacements by alanine. CRP binding studies with these mutants demonstrated that the exchange of lysine at position 59 for the corresponding murine glutamate substantially reduced binding to CRP. The position of lysine59 on the apical surface of GPVI suggests a mode of CRP binding analogous to that used by the related killer cell Ig-like receptors to bind HLA. This surface was confirmed as critical for collagen binding by epitope mapping of an inhibitory phage antibody against GPVI. This anti-GPVI, clone 10B12, gave dose-dependent inhibition of the hD1D2-collagen interaction. Clone 10B12 inhibited activation of platelets by CRP and collagen in aggregometry and thrombus formation by the latter in whole blood perfusion. Antibody 10B12 showed significantly reduced binding to the hD1D2-E59, and, on that basis, the GPVI:10B12 interface was modeled.


Subject(s)
Carrier Proteins/metabolism , Peptides , Platelet Membrane Glycoproteins/chemistry , Platelet Membrane Glycoproteins/genetics , Amino Acid Sequence , Animals , Antibodies, Blocking , Base Sequence , Binding Sites/genetics , Collagen/metabolism , DNA, Complementary/genetics , HLA Antigens/metabolism , Humans , In Vitro Techniques , Ligands , Lysine/chemistry , Mice , Models, Molecular , Molecular Sequence Data , Mutagenesis, Site-Directed , Platelet Membrane Glycoproteins/immunology , Platelet Membrane Glycoproteins/metabolism , Protein Structure, Tertiary , Receptors, Immunologic/metabolism , Recombinant Proteins/chemistry , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Sequence Homology, Amino Acid , Species Specificity
11.
FASEB J ; 17(6): 685-7, 2003 Apr.
Article in English | MEDLINE | ID: mdl-12586747

ABSTRACT

Platelets interact vigorously with subendothelial collagens that are exposed by injury or pathological damage of a vessel wall. The collagen-bound platelets trap other platelets to form aggregates, and they expose phosphatidylserine (PS) required for coagulation. Both processes are implicated in the formation of vaso-occlusive thrombi. We previously demonstrated that the immunoglobulin receptor glycoprotein VI (GPVI), but not integrin alpha2beta1, is essential in priming platelet-collagen interaction and subsequent aggregation. Here, we report that these receptors have yet a complementary function in ex vivo thrombus formation during perfusion of whole blood over collagen. With mice deficient in GPVI or blocking antibodies, we found that GPVI was indispensable for collagen-dependent Ca2+ mobilization, exposure of PS, and aggregation of platelets. Deficiency of integrin beta1 reduces the GPVI-evoked responses but still allows the formation of loose platelet aggregates. By using mice deficient in G(alpha)q or specific thromboxane A2 and ADP antagonists, we show that these autocrine agents mediated aggregation but not collagen-induced Ca2+ mobilization or PS exposure. Collectively, these data indicate that integrin alpha2beta1 facilitates the central function of GPVI in the platelet activation processes that lead to thrombus formation, whereas the autocrine thromboxane A2 and ADP serve mainly to trigger aggregate formation.


Subject(s)
Blood Platelets/metabolism , Integrin alpha2beta1/physiology , Platelet Membrane Glycoproteins/physiology , Thrombosis/metabolism , Adenosine Diphosphate/metabolism , Animals , Blood Platelets/drug effects , Calcium/metabolism , Collagen/administration & dosage , Collagen/metabolism , GTP-Binding Protein alpha Subunits, Gq-G11 , Heterotrimeric GTP-Binding Proteins/genetics , Heterotrimeric GTP-Binding Proteins/physiology , Integrin alpha2beta1/blood , Integrin alpha2beta1/genetics , Mice , Mice, Knockout , Platelet Adhesiveness/drug effects , Platelet Adhesiveness/physiology , Platelet Aggregation/drug effects , Platelet Membrane Glycoproteins/genetics , Receptors, IgG/genetics , Receptors, IgG/physiology , Thromboxane A2/metabolism
12.
Blood ; 99(4): 1205-14, 2002 Feb 15.
Article in English | MEDLINE | ID: mdl-11830467

ABSTRACT

This report describes a new low-frequency alloantigen, Oe(a), responsible for a case of neonatal alloimmune thrombocytopenia (NAIT). In a population study none of 600 unrelated blood donors was an Oe(a) carrier. By immunochemical studies the Oe(a) antigen could be assigned to platelet glycoprotein (GP) IIIa. Sequencing of GPIIIa complementary DNA from an Oe(a) (+) individual showed deletion of a lysine residue at position 611 (DeltaLys(611)). Analysis of 20 Oe(a) (-) and 3 Oe(a) (+) individuals showed that the DeltaLys(611) form of GPIIIa was related to the phenotype. Anti-Oe(a) reacted with the DeltaLys(611), but not with the wild-type isoforms on stable transfectants expressing GPIIIa, indicating that DeltaLys(611) directly induces the expression of Oe(a) epitopes. Under nonreducing conditions the Pro(33)DeltaLys(611) variant migrated with a slightly decreased molecular weight compared to the Pro(33)Lys(611) isoform suggesting that DeltaLys(611) has an influence on the disulfide bonds of GPIIIa. The Pro(33)DeltaLys(611) GPIIIa could undergo conformational changes and bind to fibrinogen in a similar manner as the Pro(33)Lys(611) isoform. No difference was found in the tyrosine phosphorylation of pp125(FAK), suggesting that DeltaLys(611) has no effect on integrin function. In contrast to all other low-frequency antigens, the DeltaLys(611) isoform was associated with the HPA-1b, but not with the high frequency HPA-1a allele. Comparison with GPIIIa DNA from nonhuman primates indicated that the HPA-1a allele represents the ancestral form of GPIIIa. It can be assumed that the Oe(a) form did arise as a result of a mutational event from an already mutated GPIIIa allele.


Subject(s)
Antigens, Human Platelet/genetics , Platelet Glycoprotein GPIIb-IIIa Complex/genetics , Platelet Glycoprotein GPIIb-IIIa Complex/immunology , Sequence Deletion , Thrombocytopenia/immunology , Adult , Antigens, CD/genetics , Antigens, CD/immunology , Antigens, CD/physiology , Antigens, Human Platelet/immunology , Antigens, Human Platelet/physiology , Cysteine , DNA Mutational Analysis , Female , Genetic Variation/genetics , Genetic Variation/immunology , Humans , Infant, Newborn , Integrin beta3 , Isoantibodies/adverse effects , Isoantibodies/immunology , Isoantigens/genetics , Isoantigens/immunology , Male , Maternal-Fetal Exchange/immunology , Pedigree , Platelet Glycoprotein GPIIb-IIIa Complex/physiology , Platelet Membrane Glycoproteins/genetics , Platelet Membrane Glycoproteins/immunology , Platelet Membrane Glycoproteins/physiology , Pregnancy , Pregnancy Complications, Hematologic/etiology , Pregnancy Complications, Hematologic/immunology , Repetitive Sequences, Amino Acid , Thrombocytopenia/etiology , Thrombocytopenia/genetics
13.
Arterioscler Thromb Vasc Biol ; 21(11): 1857-63, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11701478

ABSTRACT

- Glycoprotein VI (GPVI) is a platelet-specific receptor for collagen that figures prominently in signal transduction. An addition to binding to type I and III collagens, GPVI is also bound specifically by collagen-related peptide and convulxin (CVX), a snake venom protein. We developed a quantitative assay of platelet GPVI in which biotin-conjugated CVX binds selectively to GPVI in separated total platelet proteins by a ligand blot procedure. Using this approach, we have documented a 5-fold range in platelet GPVI content among 23 normal healthy subjects. In addition, we have determined that CVX-induced or collagen-related peptide-induced prothrombinase activity is directly proportional to the platelet content of GPVI. A statistically significant correlation was observed at 2 CVX concentrations: 14.7 ng/mL (R(2)=0.854 and P<0.001, n=11) and 22 ng/mL (R(2)=0.776 and P<0.001, n=12). In previous studies, we established a similar range of expression of the integrin collagen receptor alpha(2)beta(1) on platelets of normal subjects. Among 15 donors, there is a direct correlation between platelet alpha(2)beta(1) density and GPVI content (R(2)=0.475 and P=0.004). In view of the well-documented association of GPVI with platelet procoagulant activity, this study suggests that the variation in GPVI content is a potential risk factor that may predispose individuals to hemorrhagic or thromboembolic disorders.


Subject(s)
Blood Platelets/chemistry , Blood Platelets/enzymology , Lectins, C-Type , Platelet Membrane Glycoproteins/analysis , Platelet Membrane Glycoproteins/physiology , Thromboplastin/metabolism , Crotalid Venoms/metabolism , Crotalid Venoms/pharmacology , DNA, Complementary , Electrophoresis, Polyacrylamide Gel , Hemorrhage/etiology , Humans , Integrins/metabolism , Platelet Activation/drug effects , Platelet Membrane Glycoproteins/genetics , Receptors, Collagen , Thrombosis/etiology
14.
J Biol Chem ; 276(42): 38628-35, 2001 Oct 19.
Article in English | MEDLINE | ID: mdl-11507099

ABSTRACT

We have investigated receptor function and epitope expression of recombinant alpha(IIb)beta(3) mutated at Cys(177) or Cys(273) in the I-like domain as well as Cys(598), located in the fourth repeat of the membrane-proximal cysteine-rich region and mutated in a Glanzmann's thrombasthenia type II patient. The beta(3) mutants beta(3)C177A, beta(3)C273A, and beta(3)C598Y exhibited a decreased electrophoretic mobility in SDS-polyacrylamide gel electrophoresis under nonreducing conditions, confirming the disruption of the respective disulfide loops. Despite reduced surface expression, the alpha(IIb)beta(3)C177A, alpha(IIb)beta(3)C273A, and alpha(IIb)beta(3)C598Y receptors mediated cell adhesion to immobilized fibrinogen and translocated into focal adhesion plaques. The beta(3)C598Y mutation, but not the beta(3)C177A or beta(3)C273A mutations, induced spontaneous binding of the ligand mimetic monoclonal antibody PAC-1, while the beta(3)C177A and beta(3)C273A mutants exhibited reduced complex stability in the absence of Ca(2+). Epitope mapping of function-blocking monoclonal antibodies (mAbs) allowed the identification of two distinct subgroups; mAbs A2A9, pl2-46, 10E5, and P256 did not interact with alpha(IIb)beta(3)C273A and bound only weakly to alpha(IIb)beta(3)C177A, while mAbs AP2, LM609 and 7E3 bound normally to mutant alpha(IIb)beta(3)C273A, but interacted only weakly with mutant alpha(IIb)beta(3)C177A. Furthermore, a cryptic epitope recognized by mAb 4D10G3 and not exposed on wild type alpha(IIb)beta(3) became accessible only on mutant alpha(IIb)beta(3)C177A and was mapped to the 60-kDa chymotrypsin fragment of beta(3). Finally, the ligand-induced binding site (LIBS) epitopes AP5, D3, LIBS1, and LIBS2 were spontaneously expressed on all three mutants independent of RGDS or dithiothreitol treatment. Our results provide evidence that disruption of a single cysteine disulfide bond in the cysteine-rich repeat domain, but not in the I-like domain, activates integrin alpha(IIb)beta(3). In contrast, disruption of each of the disulfide bonds in the two long insertions of the I-like domain predicted to be in close contact with the alpha subunit beta-propeller domain affect the stability of the alpha(IIb)beta(3) heterodimer and inhibit complex-specific mAb binding without affecting the RGD binding capacity of the metal ion-dependent adhesion site-like domain.


Subject(s)
Antigens, CD/chemistry , Antigens, CD/genetics , Cysteine/chemistry , Mutation , Platelet Glycoprotein GPIIb-IIIa Complex/metabolism , Platelet Membrane Glycoproteins/chemistry , Platelet Membrane Glycoproteins/genetics , Animals , Antibodies, Monoclonal/metabolism , Blotting, Western , CHO Cells , Cell Adhesion , Cell Line , Cricetinae , Cysteine/genetics , DNA, Complementary/metabolism , Dimerization , Disulfides , Enzyme Activation , Epitopes/chemistry , Fibrinogen/metabolism , Flow Cytometry , Humans , Integrin beta3 , Ligands , Microscopy, Fluorescence , Models, Molecular , Precipitin Tests , Protein Conformation , Protein Structure, Tertiary , Recombinant Proteins/metabolism , Transfection
15.
Am J Physiol Heart Circ Physiol ; 278(4): H1168-76, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10749711

ABSTRACT

Platelet-activating factor (PAF) is a phospholipid with diverse biological functions mediated by a G protein-coupled receptor. We determined PAF receptor binding in lung membranes of four groups of perinatal lambs. Membrane protein (100 microg/ml) was incubated for 60 min at 30 degrees C with 0.5-24 nM of acetyl-[(3)H]PAF in 30 mM Tris buffer, pH 7.2, containing 0.25% BSA, 10 mM MgCl(2), and 125 mM choline chloride. PAF bound to membrane was isolated and quantified by scintillation spectrometry, followed with Scatchard analysis for receptor density (B(max)). The B(max) (means +/- SE, fmol/mg protein) were 445.8 +/- 12.3, 244.2 +/- 3.3, 250.6 +/- 3.6, and 419. 9 +/- 8.6 for the fetal, 90-min-old, <1-day-old, and 6- to 12-day-old lambs, respectively. The B(max) for the 90-min-old and <1-day-old lambs were not different but were significantly lower than those of either the term fetal or 6- to 12-day-old lambs. These data show a significant decrease in PAF binding to its receptor and in PAF B(max) in lung membranes of immediate newborn lambs. The dissociation constants (K(D), nM) were 7.7 +/- 0.52, 11.5 +/- 0.34, 6.9 +/- 0.48, and 5.0 +/- 0.53 for fetal, 90-min-old, <1-day-old, and 6- to 12-day-old newborn lamb lungs, respectively. The K(D) of the 90-min-old lamb was the highest of all. PAF receptor gene measured by RT-PCR showed a significant downregulation of PAF receptor gene mRNA in lungs of lambs <1 day old, suggesting a transcriptional regulation of PAF receptor gene expression in the immediate newborn period. We speculate that decreased PAF receptor binding immediately after birth will facilitate the fall in pulmonary vascular resistance in the immediate newborn period.


Subject(s)
Animals, Newborn/metabolism , Gene Expression Regulation, Developmental , Lung/metabolism , Platelet Membrane Glycoproteins/genetics , Receptors, Cell Surface , Receptors, G-Protein-Coupled , Animals , Azepines/metabolism , Azepines/pharmacology , Binding, Competitive/physiology , Cell Membrane/chemistry , Cell Membrane/metabolism , DNA, Complementary , Female , Lung/chemistry , Lung/growth & development , Molecular Sequence Data , Platelet Activating Factor/metabolism , Platelet Activating Factor/pharmacology , Platelet Aggregation Inhibitors/metabolism , Platelet Aggregation Inhibitors/pharmacology , Platelet Membrane Glycoproteins/metabolism , Pregnancy , Pulmonary Circulation/physiology , Radioligand Assay , Reverse Transcriptase Polymerase Chain Reaction , Sequence Homology, Nucleic Acid , Sheep , Triazoles/metabolism , Triazoles/pharmacology , Tritium
16.
Blood ; 95(7): 2329-36, 2000 Apr 01.
Article in English | MEDLINE | ID: mdl-10733503

ABSTRACT

Perforin is known to display a membranolytic activity on tumor cells. Nevertheless, perforin release during natural killer (NK)-cell activation is not sufficient to induce membrane target-cell damage. On the basis of the ability of perforin to interact with phospholipids containing a choline phosphate headgroup, we identify the platelet-activating factor (PAF) and its membrane receptor as crucial components in tumor cell killing activity of human resting NK cells. We demonstrate for the first time that upon activation, naive NK cells release the choline phosphate-containing lysolipid PAF, which binds to perforin and acts as an agonist on perforin-induced membrane damage. PAF is known to incorporate cell membranes using a specific receptor. Here we show that interferon-gamma (IFN-gamma) secreted from activated NK cells ends in PAF-receptor expression on perforin-sensitive K562 cells but not on perforin-resistant Daudi cells. In order to prove the capacity of PAF to interact simultaneously with its membrane PAF receptor and with perforin, we successfully co-purified the 3 components in the presence of bridging PAF molecules. The functional activity of this complex was further examined. The aim was to determine whether membrane PAF-receptor expression on tumor cells, driven to express this receptor, could render them sensitive to the perforin lytic pathway. The results confirmed that transfection of the PAF-receptor complementary DNA into major histocompatibility complex class I and Fas-receptor negative tumor cells restored susceptibility to naive NK cells and perforin attack. Failure of IFN-gamma to induce membrane PAF receptor constitutes the first described mechanism for tumor cells to resist the perforin lytic pathway.


Subject(s)
Cell Membrane/metabolism , Interferon-gamma/pharmacology , Killer Cells, Natural/immunology , Membrane Glycoproteins/pharmacology , Neoplasms/immunology , Platelet Membrane Glycoproteins/metabolism , Receptors, Cell Surface , Receptors, G-Protein-Coupled , Adult , Azepines/pharmacology , Calcium/pharmacology , Cytotoxicity, Immunologic , Gene Expression , Humans , Membrane Glycoproteins/metabolism , Perforin , Platelet Activating Factor/metabolism , Platelet Activating Factor/pharmacology , Platelet Aggregation Inhibitors/pharmacology , Platelet Membrane Glycoproteins/antagonists & inhibitors , Platelet Membrane Glycoproteins/genetics , Pore Forming Cytotoxic Proteins , Thiazoles/pharmacology , Transfection , Triazoles/pharmacology , Tumor Cells, Cultured
17.
Chin Med J (Engl) ; 112(10): 883-6, 1999 Oct.
Article in English | MEDLINE | ID: mdl-11717969

ABSTRACT

PURPOSE: To highlight the development and achievements of hemostasis and thrombosis research in China over the past 50 years. DATA SOURCES: Both Chinese and English language literature search using MEDLINE (1990-1998), and original articles published in the main Chinese and international journals. STUDY SELECTION: After reviewing all the main articles on thrombosis and hemostasis, 20 of them were selected that specifically addressed the stated purpose. DATE EXTRATION: The content that could present the progress in hemostasis and thrombosis in China was selected. RESULTS: Monoclonal antibodies have widely been used in basic research and laboratory diagnosis. Several novel gene mutations of coagulation factors have been identified. Some drugs of traditional Chinese medicine have proved to be efficient in treatment of thrombotic diseases. CONCLUSIONS: Significant achievements in basic, clinical and pharmacological research in the field of hemostasis and thrombosis have been made in China in the past 50 years. Some new discoveries in platelet membrane glycoproteins and coagulation factors research are believed to be contributions to the international scientific community. However, a specific effort using advanced techniques should be made for future development, especially in molecular biology research.


Subject(s)
Factor VIII/genetics , Hemophilia A/diagnosis , Hemostasis , Intracranial Thrombosis/therapy , Blood Coagulation Factors/genetics , Drugs, Chinese Herbal/therapeutic use , Humans , Intracranial Thrombosis/diagnosis , Mutation , Platelet Membrane Glycoproteins/genetics
18.
Biol Reprod ; 57(3): 575-9, 1997 Sep.
Article in English | MEDLINE | ID: mdl-9282993

ABSTRACT

Platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine; PAF), a potent signaling phospholipid, has a significant role in preimplantation embryo development. CFW mouse embryos respond to PAF with improved development and implantation rates. PAF's signal transduction mechanism in other cell types is receptor mediated. However, embryonic mRNA for the PAF receptor has not been detected. The study objectives were to determine the presence of PAF receptor mRNA in CFW mouse two-cell embryos by reverse transcription (RT)-polymerase chain reaction and Northern blot analysis and to ascertain the effect of PAF on intracellular calcium levels (a receptor-mediated event). Total RNA was purified by acid-phenol extraction and ethanol precipitation. Complementary DNA was synthesized by RT. RNA was primed with oligo-dT plus PAF receptor-specific primer (3' to 5') at 42 degrees C for 60 min, 95 degrees C for 10 min, and 5 degrees C for 5 min. The RT product was amplified with Taq polymerase and PAF receptor-specific primer (5' to 3') at 94 degrees C for 5 min and 54 degrees C for 5 min for one cycle, and at 72 degrees C for 3 min, 93 degrees C for 90 sec, and 61 degrees C for 150 sec for 30 cycles followed by 72 degrees C for 10 min and then holding at 4 degrees C. The product was analyzed by agarose gel electrophoresis, producing a single band (610 base pairs [bp]), thus demonstrating the presence of PAF-receptor mRNA. Sequence analysis of the cloned 610-bp fragment confirmed that it is the PAF receptor. Northern blot analysis also confirmed the expression of the PAF receptor in the CFW mouse preimplantation two-cell-stage embryo. PAF treatment of the two-cell-stage CFW mouse embryo resulted in a fourfold increase in intracellular calcium over background levels.


Subject(s)
Cleavage Stage, Ovum/metabolism , Platelet Activating Factor/metabolism , Platelet Membrane Glycoproteins/metabolism , Receptors, Cell Surface , Receptors, G-Protein-Coupled , Animals , Calcium/metabolism , Cleavage Stage, Ovum/drug effects , Cloning, Molecular , Female , Gene Expression Regulation, Developmental , Intracellular Fluid/metabolism , Male , Mice , Platelet Activating Factor/pharmacology , Platelet Membrane Glycoproteins/genetics , Polymerase Chain Reaction , Pregnancy , RNA, Messenger/genetics , RNA, Messenger/metabolism , Signal Transduction
19.
Biochem J ; 305 ( Pt 3): 829-35, 1995 Feb 01.
Article in English | MEDLINE | ID: mdl-7848283

ABSTRACT

Platelet-activating factor (PAF) is a potent lipid mediator of allergic inflammation through its interaction with eosinophils. Expression of the PAF receptor is modulated by many agents, including those responsible for cell differentiation. We report here that differentiation of a human eosinophilic leukaemia cell line, EoL-1, by sodium n-butyrate is associated with induction of PAF receptor gene expression, as indicated by: PAF receptor mRNA accumulation; increases in the binding of [3H]WEB 2086, a PAF antagonist; analysis of cell-surface expression of PAF receptor protein using a monoclonal anti-(PAF receptor) antibody; and augmentation of PAF-induced increase in the intracellular concentration of calcium. Using cDNA cloning, the receptor expressed in EoL-1 cells was identified as 'Transcript 1', one of two transcripts which was previously reported from human genomic analysis (Mutoh, Bito, Minami, Nakamura, Honda, Izumi, Nakata, Kurachi, Terano and Shimizu (1993) FEBS Lett. 322, 129-134). The PAF-induced calcium response and phosphoinositide turnover were decreased by pertussis toxin (PTX) treatment, suggesting that these signals are coupled largely with PTX-sensitive G-protein(s) in EoL-1 cells. These systems may provide a useful experimental model with which to investigate the relationship between eosinophilic differentiation and PAF receptor induction, and the role of eosinophils in allergic responses.


Subject(s)
Butyrates/pharmacology , Cell Differentiation/drug effects , Gene Expression , Hypereosinophilic Syndrome/metabolism , Platelet Membrane Glycoproteins/genetics , Receptors, Cell Surface , Receptors, G-Protein-Coupled , Amino Acid Sequence , Animals , Azepines/metabolism , Base Sequence , Butyric Acid , CHO Cells , Cloning, Molecular , Cricetinae , DNA, Complementary/chemistry , DNA, Complementary/genetics , Guinea Pigs , Humans , Hypereosinophilic Syndrome/pathology , Inositol 1,4,5-Trisphosphate/biosynthesis , Molecular Sequence Data , Pertussis Toxin , Platelet Membrane Glycoproteins/chemistry , RNA, Messenger/biosynthesis , Sequence Analysis, DNA , Triazoles/metabolism , Tritium , Tumor Cells, Cultured , Virulence Factors, Bordetella/pharmacology
20.
Biochim Biophys Acta ; 1097(2): 133-9, 1991 Sep 23.
Article in English | MEDLINE | ID: mdl-1911886

ABSTRACT

Platelet-type von Willebrand disease (PT-vWD) is an autosomal dominant bleeding disorder in which patient platelets exhibit an abnormally increased binding of circulating von Willebrand factor (vWF). We have recently shown that this abnormality is associated with a point mutation resulting in substitution of Val for Gly 233 in platelet membrane glycoprotein Ib alpha (GPIb alpha), a major component of the platelet GPIb/IX receptor for vWF. To investigate the effect of this substitution on the three-dimensional structure of this region of the protein, we have generated the allowed (low energy) conformations of the region of the GPI alpha protein containing residues 228-238 (with 5 residues on either side of the critical residue 233) with Gly 233 (wild type) and Val 233 (PT-vWD) using the computer program ECEPP (Empirical Conformational Energies of Peptides Program). The wild-type sequence is Tyr-Val-Trp-Lys-Gln-Gly-Val-Asp-Val-Lys-Ala. We find that the Gly 233-containing peptide can exist in two low energy conformers. The lowest energy conformer is a structure containing a beta-turn at Gln 232-Gly 233 while the alternative conformation is an amphipathic helical structure. Only the amphipathic helical structure is allowed for the Val 233-containing peptide which contains a hydrophobic 'face' consisting of Val 229, Val 233 and Val 236 and another hydrophilic surface composed of such residues as Lys 231 and Asp 235. No such surfaces exist for the lowest energy bend conformer for the Gly 233-containing peptide, but do exist in the higher energy helical structure. The amphipathic surfaces in the 228-238 region of the Val 233-containing GPIb alpha protein may associate strongly with complementary surfaces during vWF binding to the GPIb/IX receptor complex and may help explain heightened association of vWF with this receptor in PT-vWD.


Subject(s)
Blood Platelets/chemistry , Platelet Membrane Glycoproteins/chemistry , von Willebrand Diseases/blood , Amino Acid Sequence , Computer Simulation , Glycine/chemistry , Humans , Macromolecular Substances , Models, Molecular , Molecular Sequence Data , Mutation/genetics , Peptide Fragments/chemistry , Platelet Aggregation/physiology , Platelet Membrane Glycoproteins/genetics , Protein Conformation , Valine/chemistry , von Willebrand Diseases/genetics
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