A factor VIIIa-mimetic bispecific antibody, Mim8, ameliorates bleeding upon severe vascular challenge in hemophilia A mice.

Hemophilia A is a bleeding disorder resulting from deficient factor VIII (FVIII), which normally functions as a cofactor to activated factor IX (FIXa) that facilitates activation of factor X (FX). To mimic this property in a bispecific antibody format, a screening was conducted to identify functional pairs of anti-FIXa and anti-FX antibodies, followed by optimization of functional and biophysical properties. The resulting bispecific antibody (Mim8) assembled efficiently with FIXa and FX on membranes, and supported activation with an apparent equilibrium dissociation constant of 16 nM. Binding affinity with FIXa and FX in solution was much lower, with equilibrium dissociation constant values for FIXa and FX of 2.3 and 1.5 µM, respectively. In addition, the activity of Mim8 was dependent on stimulatory activity contributed by the anti-FIXa arm, which enhanced the proteolytic activity of FIXa by 4 orders of magnitude. In hemophilia A plasma and whole blood, Mim8 normalized thrombin generation and clot formation, with potencies 13 and 18 times higher than a sequence-identical analogue of emicizumab. A similar potency difference was observed in a tail vein transection model in hemophilia A mice, whereas reduction of bleeding in a severe tail-clip model was observed only for Mim8. Furthermore, the pharmacokinetic parameters of Mim8 were investigated and a half-life of 14 days shown in cynomolgus monkeys. In conclusion, Mim8 is an activated FVIII mimetic with a potent and efficacious hemostatic effect based on preclinical data.

Intraoperative blood loss during orthognathic surgery is predicted by thromboelastography.

PURPOSE: The aim of this prospective study was to evaluate the predictive value of the viscoelastic properties of whole blood samples collected preoperatively in relation to intraoperative blood loss in patients subjected to orthognathic surgery. MATERIALS AND METHODS: Forty-one consecutive patients underwent simultaneous mandibular and maxillary osteotomy. Whole blood samples were collected preoperatively. The intraoperative blood loss volume was precisely estimated. The viscoelastic properties of whole blood samples were evaluated by thromboelastography (TEG), a global method that addresses the complex interplay among coagulation factors, blood platelets, and components of the fibrinolytic system. Blood platelet count, activated partial thromboplastin time, prothrombin time, plasma fibrinogen concentration, and D-dimer concentration were determined by routine methods. RESULTS: Patients were separated into 2 groups according to their intraoperative bleeding volume (≤ 400 mL and >400 mL). No significant associations were observed between routine coagulation tests and intraoperative bleeding volume. The TEG results for the groups were compared. Significant associations were observed between intraoperative blood loss and the clot formation time, maximum clot firmness, and α angle, whereas bleeding volume was not related to the fibrinolytic resistance of the blood clot. An α angle exceeding 67° predicted with 95% certainty a blood loss of 400 mL or less. CONCLUSIONS: We conclude that intraoperative bleeding volume in patients subjected to orthognathic surgery can be predicted by means of preoperative TEG analysis. TEG results provide optimization of patient safety and can be used for the evaluation of bleeding risk.

Indication of drier periods on Mars from the chemistry and mineralogy of atmospheric dust.

The ubiquitous atmospheric dust on Mars is well mixed by periodic global dust storms, and such dust carries information about the environment in which it once formed and hence about the history of water on Mars. The Mars Exploration Rovers have permanent magnets to collect atmospheric dust for investigation by instruments on the rovers. Here we report results from Mössbauer spectroscopy and X-ray fluorescence of dust particles captured from the martian atmosphere by the magnets. The dust on the magnets contains magnetite and olivine; this indicates a basaltic origin of the dust and shows that magnetite, not maghemite, is the mineral mainly responsible for the magnetic properties of the dust. Furthermore, the dust on the magnets contains some ferric oxides, probably including nanocrystalline phases, so some alteration or oxidation of the basaltic dust seems to have occurred. The presence of olivine indicates that liquid water did not play a dominant role in the processes that formed the atmospheric dust.

Evaluation of carbohydrate molecular mechanical force fields by quantum mechanical calculations.

A quantitative evaluation of 20 second-generation carbohydrate force fields was carried out using ab initio and density functional methods. Geometry-optimized structures (B3LYP/6-31G(d)) and relative energies using augmented correlation consistent basis sets were calculated in gas phase for monosaccharide carbohydrate benchmark systems. Selected results are: (i). The interaction energy of the alpha-d-glucopyranose.H(2)O heterodimer is estimated to be 4.9 kcal/mol, using a composite method including terms at highly correlated (CCSD(T)) level. Most molecular mechanics force fields are in error in this respect; (ii). The (3)E envelope (south) pseudorotational conformer of methyl 5-deoxy-beta-d-xylofuranoside is 0.66 kcal/mol more stable than the (3)E envelope (north) conformer and the alpha-anomer of methyl d-glucopyranoside is 0.82 kcal/mol more stable than the beta-anomer; (iii). The relative energies of the (gg, gt and tg) rotamers of methyl alpha-d-glucopyranoside and methyl alpha-d-galactopyranoside are (0.13, 0.00, 0.15) and (0.64, 0.00, 0.77) kcal/mol, respectively. The results of the quantum mechanical calculations are compared with the results of calculations using the 20 second-generation carbohydrate force fields. No single force field is consistently better than the others for all the test cases. A statistical assessment of the performance of the force fields indicates that CHEAT(95), CFF, certain versions of Amber and of MM3 have the best overall performance, for these gas phase monosaccharide systems.