thromboplastin and Bernard-Soulier-Syndrome

Activation of coagulation factor X by a complex of factors IXa-VIIIa and prothrombin by a complex of factor Xa.Va is markedly enhanced in the presence of a negatively-charged phospholipid surface. A suitable phospholipid surface is provided by a platelet lysate but not by a suspension of intact platelets, due to the internal localization of phosphatidylserine in the platelet membrane. Upon stimulation of platelets with a combination of collagen and thrombin, or calcium ionophore A23187 or treatment with diamide, alterations in the distribution of membrane phospholipids take place resulting in the exposure of significant amounts of phosphatidylserine at the platelet surface. As a consequence, an increased number of intrinsic factor X and prothrombinase complexes can be assembled at the platelet surface thus leading to an acceleration of factor Xa and thrombin formation. Studies with pathological platelets have shown that neither release nor aggregation are essential to provoke prothrombinase activity. The relatively high prothrombinase activity of non-stimulated Bernard-Soulier platelets is in agreement with the slightly altered phospholipid distribution in these platelets, in which more phosphatidylserine is exposed at the outer surface. Disturbances in the membrane bilayer structure as well as changes in the plasma membrane-cytoskeleton interaction are considered as possible explanations for the increased transbilayer movement of phosphatidylserine.

Topics: Bernard-Soulier Syndrome; Binding Sites; Blood Coagulation; Blood Platelets; Cell Membrane; Factor V; Factor X; Humans; Membrane Lipids; Phospholipases A; Phospholipids; Platelet Storage Pool Deficiency; Prothrombin; Thrombasthenia; Thrombin; Thromboplastin

Platelets activated by alpha-thrombin express surface procoagulant activity (PCA) that accelerates the conversion of prothrombin to alpha-thrombin. Following activation with 10 nM alpha-thrombin, the PCA of normal platelets was approximately five-fold higher than that of Bernard-Soulier platelets (lacking GPIb). Normal platelet PCA was inhibited approximately 50% by activation in the presence of the anti-GPIb MoAbs LJIb10 or TM60. Moreover, normal platelet PCA was completely abrogated in the presence of a combination of both LJIb10 and c7E3, a MoAb directed against alphaIIbbeta3 (GPIIb/IIIa). In contrast. PCA expressed by Bernard Soulier or Glanzmann platelets was not inhibited by either LJIb10 or c7E3 MoAb. The platelet activating peptide SFLLRN at 10 microM, a concentration which fully activates platelet aggregation and Ca2+ mobilization, generated PCA activity one fifth of that generated by alpha-thrombin at 10 nM but anti-PAR1 antibodies did not affect thrombin-induced PCA expression. These results demonstrate that GPIb mediates, at least in part, the thrombin-induced activation of platelets that leads to PCA, and that alphaIIbbeta3 is also involved in PCA generation, but these results do not support a major role for PAR1 in this activation.

Topics: Adult; Bernard-Soulier Syndrome; Blood Coagulation Factors; Blood Platelets; Calcium Signaling; Female; Gene Expression Regulation; Humans; Male; Peptide Fragments; Platelet Activation; Platelet Glycoprotein GPIb-IX Complex; Platelet Glycoprotein GPIIb-IIIa Complex; Receptor, PAR-1; Receptors, Thrombin; Thrombasthenia; Thrombin; Thromboplastin

Prothrombinase activities of platelets have been measured in diluted platelet-rich plasma using a chromogenic substrate assay and purified coagulation factors. No abnormalities in prothrombinase activities were found for platelets from patients with storage pool disease (dense-body deficiency), grey platelet syndrome, and Glanzmann's thrombasthenia. It is concluded that neither release of dense bodies and alpha-granules nor aggregation of platelets are essential prerequisites for exposure of a procoagulant surface. Platelets from patients with Bernard-Soulier syndrome, however, have approximately 10-fold higher prothrombinase activities in the non-stimulated form than normal non-stimulated platelets. The increased procoagulant activity cannot be completely ascribed to an increase in platelet size. It is suggested that the increased prothrombinase activity reflects an increased exposure of phosphatidylserine at the outer surface of non-stimulated Bernard-Soulier platelets, earlier described by Perret et al (1983).

Topics: Bernard-Soulier Syndrome; Blood Platelet Disorders; Blood Platelets; Humans; Platelet Storage Pool Deficiency; Thrombasthenia; Thromboplastin