一种针对 PAR4 的功能阻断抗体在面对高反应性 PAR4 变体时具有显著的抗血栓作用。

A function-blocking PAR4 antibody is markedly antithrombotic in the face of a hyperreactive PAR4 variant.

机构信息

Australian Centre for Blood Diseases.

Department of Physiology, and.

出版信息

Blood Adv. 2018 Jun 12;2(11):1283-1293. doi: 10.1182/bloodadvances.2017015552.

Abstract

Thrombin activates human platelets via 2 protease-activated receptors (PARs), PAR1 and PAR4, both of which are antithrombotic drug targets: a PAR1 inhibitor is approved for clinical use, and a PAR4 inhibitor is in trial. However, a common sequence variant in human PAR4 (rs773902, encoding Thr120 in place of Ala120) renders the receptor more sensitive to agonists and less sensitive to antagonists. Here, we develop the first human monoclonal function-blocking antibody to human PAR4 and show it provides equivalent efficacy against the Ala120 and Thr120 PAR4 variants. This candidate was generated from a panel of anti-PAR4 antibodies, was found to bind PAR4 with affinity (K ≈ 0.4 nM) and selectivity (no detectable binding to any of PAR1, PAR2, or PAR3), and is capable of near-complete inhibition of thrombin cleavage of either the Ala120 or Thr120 PAR4 variant. Platelets from individuals expressing the Thr120 PAR4 variant exhibit increased thrombin-induced aggregation and phosphatidylserine exposure vs those with the Ala120 PAR4 variant, yet the PAR4 antibody inhibited these responses equivalently (50% inhibitory concentration, 4.3 vs 3.2 µg/mL against Ala120 and Thr120, respectively). Further, the antibody significantly impairs platelet procoagulant activity in an ex vivo thrombosis assay, with equivalent inhibition of fibrin formation and overall thrombus size in blood from individuals expressing the Ala120 or Thr120 PAR4 variant. These findings reveal antibody-mediated inhibition of PAR4 cleavage and activation provides robust antithrombotic activity independent of the rs773902 PAR4 sequence variant and provides rationale for such an approach for antithrombotic therapy targeting this receptor.

摘要

凝血酶通过 2 种蛋白酶激活受体(PAR)激活人血小板,即 PAR1 和 PAR4,这两种受体都是抗血栓药物靶点:一种 PAR1 抑制剂已获准临床应用,一种 PAR4 抑制剂正在临床试验中。然而,人类 PAR4 的一个常见序列变异(rs773902,编码 Thr120 替代 Ala120)使受体对激动剂更敏感,对拮抗剂的敏感性降低。在这里,我们开发了首个针对人 PAR4 的人源单克隆功能阻断抗体,并证明它对 Ala120 和 Thr120 PAR4 变体具有同等疗效。该候选药物源自一组抗 PAR4 抗体,与 PAR4 的亲和力(K≈0.4 nM)和选择性(对 PAR1、PAR2 或 PAR3 均无检测到结合)相当,并且能够近乎完全抑制凝血酶对 Ala120 或 Thr120 PAR4 变体的切割。与表达 Ala120 PAR4 变体的血小板相比,表达 Thr120 PAR4 变体的血小板在凝血酶诱导的聚集和血小板磷脂酰丝氨酸暴露方面增加,但 PAR4 抗体对这些反应的抑制作用相当(对 Ala120 和 Thr120 的 50%抑制浓度分别为 4.3 和 3.2 µg/mL)。此外,该抗体在体外血栓形成试验中显著损害血小板促凝活性,在表达 Ala120 或 Thr120 PAR4 变体的个体血液中,对纤维蛋白形成和整体血栓大小的抑制作用相同。这些发现表明,PAR4 切割和激活的抗体介导抑制提供了强大的抗血栓活性,与 rs773902 PAR4 序列变体无关,并为针对该受体的抗血栓治疗提供了这种方法的依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ecb/5998926/c99fcc4d6937/advances015552absf1.jpg

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