An αβ- and phosphatidylserine (PS)-binding recombinant fusion protein promotes PS-dependent anticoagulation and integrin-dependent antithrombosis.

Blood platelets are required for normal wound healing, but they are also involved in thrombotic diseases, which are usually managed with anticoagulant drugs. Here, using genetic engineering, we coupled the disintegrin protein echistatin, which specifically binds to the platelet integrin αβ receptor, to annexin V, which binds platelet membrane-associated phosphatidylserine (PS), to create the bifunctional antithrombotic molecule recombinant echistatin-annexin V fusion protein (-EchAV). Lipid binding and plasma coagulation studies revealed that -EchAV dose-dependently binds PS and delays plasma clotting time. Moreover, -EchAV inhibited ADP-induced platelet aggregation in a dose-dependent manner and exhibited potent antiplatelet aggregation effects. -EchAV significantly prolonged activated partial thromboplastin time, suggesting that it primarily affects the coagulation pathway. Flow cytometry results indicated that -EchAV could effectively bind to the platelet αβ receptor, indicating that -EchAV retains echistatin's receptor-recognition region. experiments in mice disclosed that -EchAV significantly prolongs bleeding time, indicating a significant anticoagulant effect resulting from the joint binding of -EchAV to both PS and the αβ receptor. We also report optimization of the -EchAV production steps and its purification for high purity and yield. Our findings indicate that -EchAV retains the active structural regions of echistatin and annexin V and that the whole molecule exhibits multitarget-binding ability arising from the dual functions of echistatin and annexin V. Therefore, -EchAV represents a new class of anticoagulant that specifically targets the anionic membrane-associated coagulation enzyme complexes at thrombogenesis sites and may be a potentially useful antithrombotic agent.