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PubMed2005

Prolonged prothrombin time, Factor VII and activated FVII levels in chronic liver disease are partly dependent on Factor VII gene polymorphisms.

BACKGROUND: Prothrombin time is a benchmark for functional assessment in cirrhosis and Factor VII levels (FVII), crucial in determining the prothrombin time, are genetically determined. METHODS: We have evaluated the prothrombin time, a number of haemostatic variables synthesised by the liver (FII, FV, FVII and activated FVII, AT and fibrinogen) and two polymorphisms of the FVII gene (5'F7 and 353R/Q) in: (a) patients with liver cirrhosis (n=118), (b) patients with chronic hepatitis (n=102) and (c) controls (n=100). RESULTS: By one-way analyses of variance, the prothrombin time and the mean levels of the FII, FV, FVIIc, FVIIa, and AT were statistically different between cirrhotics, chronic hepatitis patients and controls. The allele frequency of the FVII polymorphisms did not differ between the three groups. Those rare patients (4.6%) who were homozygous for the type 2 alleles had markedly reduced FVIIc and FVIIa levels. The analysis carried out taking into account Child class versus FVII genotype showed that the mean FVIIc levels were comparable for different genotypes within each Child's class, with the exception of the patients homozygous for the type 1 allele. CONCLUSION: Our findings help to explain the not infrequent finding of a severely prolonged prothrombin time in patients who are otherwise in a good functional class.

Alleles↗
PubMed2005

Factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations are not associated with chronic limb ischemia: the Linz Peripheral Arterial Disease (LIPAD) study.

OBJECTIVE: Factor V G1691A (Leiden), prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T mutations are considered risk factors for venous thromboembolism. It remains to be characterized whether the presence of these relatively common mutations poses a risk for peripheral arterial disease (PAD). Therefore, we intended to test, by conducting a case-control study, the hypothesis that PAD was associated with an increased prevalence of factor V G1691A, prothrombin G20210A, and MTHFR C677T mutations. METHODS: The study comprised 433 patients admitted for inpatient diagnostics and treatment of PAD in patients with chronic limb ischemia. Patients with acute ischemia or malignancy were excluded. A total of 433 control subjects matched to the patients with PAD in a 1:1 design by sex, age (+/-2 years), and diabetes mellitus status were recruited. Factor V G1691A, prothrombin G20210A, and MTHFR C677T genotypes were assessed by polymerase chain reaction. RESULTS: For the factor V G1691A polymorphism, the genotype frequencies in PAD patients were 92.8% GG (normal homozygotes = wild type) and 7.2% GA (mutant heterozygotes), and in control subjects they were 94.0% GG and 6.0% GA (chi 2 test; P = .493). The distribution of the prothrombin G20210A genotypes was 96.3% GG (normal homozygotes = wild type) and 3.7% GA (mutant heterozygotes) in PAD patients and was 97.2% GG and 2.8% GA in control subjects (chi 2 test; P = .442). Genotype frequencies for the MTHFR C677T polymorphism were 47.8% CC (normal homozygotes = wild type), 43.4% CT (mutant heterozygotes), and 8.8% TT (mutant homozygotes) in PAD patients, compared with 47.1% CC, 44.1% CT, and 8.8% TT in control subjects (chi 2 test; P = .977). Accordingly, as determined by logistic regression analysis, no significant odds ratios for heterozygous or homozygous genotypes of the three polymorphisms could be observed. CONCLUSIONS: PAD was not associated with an increased prevalence of factor V G1691A, prothrombin G20210A, and MTHFR C677T mutations in the population studied. Thus, there is no indication that of one of these mutations may be a risk factor for chronic limb ischemia. However, the role of these mutations in acute limb ischemia remains to be clarified.

Aged↗
PubMed1983

Calcium effects on prothrombin and its reaction with bifunctional alkylating reagents.

Monodisperse bovine prothrombin was prepared and its molecular states under several conditions examined. The protein showed no tendency to self-associate in the absence of calcium. Calcium (4 mM) caused small increases in the apparent molecular weight of the protein which may or may not represent protein dimerization with very low affinity. The allowed conclusion was that calcium-induced prothrombin dimerization is minimal up to protein concentrations of many mg/ml. Calcium-induced protein shape changes did not measurably alter the protein diffusion constant. A bifunctional alkylating reagent did produce extensive calcium-dependent prothrombin crosslinking. Prothrombin dimers formed by the crosslinking agent were not a measure of the state of native prothrombin.

Animals↗
PubMed1999

Undercarboxylation of recombinant prothrombin revealed by analysis of gamma-carboxyglutamic acid using capillary electrophoresis and laser-induced fluorescence.

The gamma-carboxyglutamic acid (Gla) content of several variants of human prothrombin has been measured by using capillary electrophoresis and laser-induced fluorescence (CE-LIF). Both plasma-derived prothrombin and recombinant prothrombin contain ten residues of Gla per molecule of protein. In contrast, a variant of human prothrombin (containing the second kringle domain of bovine prothrombin) was separated into two populations that differed in their Gla content. Direct measurement of the Gla content showed an association with the presence or absence of the calcium-dependent conformational change that is required for prothombinase function. Thus, the CE-LIF assay is useful in determining the carboxylation status of recombinant proteins.

1-Carboxyglutamic Acid↗
PubMed1996

Antibodies to beta 2-glycoprotein I and prothrombin in habitual abortion.

OBJECTIVE: To determine the occurrence of antibodies to beta 2-glycoprotein I (beta 2-GP-I) and prothrombin in women with histories of habitual abortions when pregnant and nonpregnant. DESIGN: Antibodies to beta 2-GP-I and prothrombin were measured by ELISA using irradiated polystyrene plates in 43 women with habitual abortions and 22 healthy controls. SETTING: Departments I and II of Obstetrics and Gynecology, University Central Hospital of Helsinki. PATIENT(S): Twenty-two women of the habitual abortion patients had never delivered (primary aborters) and 21 had delivered at least one living child before miscarriage (secondary aborters). INTERVENTION(S): Venous blood samples were collected before and during pregnancy. MAIN OUTCOME MEASURE(S): Immunoglobulin G class antibodies to beta 2-GP-I and prothrombin. RESULT(S): The secondary aborters showed higher levels of antibodies to prothrombin than the primary aborters when both pregnant and nonpregnant and also showed higher levels of antiprothrombin antibodies than the controls when pregnant. No such differences were found in levels of antibodies to beta 2-GP-I. The habitual abortion patients showed a tendency toward higher levels of these autoantibodies when pregnant than when nonpregnant. Gestational diabetes was more common among the antibody-positive habitual abortion patients than among the antibody-negative patients. CONCLUSION(S): Increased levels of antiprothrombin antibodies were associated with secondary abortions. Elevated levels of antibodies to beta 2-GP-I and prothrombin often were found in habitual abortion patients with gestational diabetes.

Abortion, Habitual↗
PubMed1998

Effects of Pallas' viper (Agkistrodon halys pallas) venom on blood coagulation and characterization of a prothrombin activator.

The action of Pallas' viper (Agkistrodon halys pallas) venom on blood coagulation was examined in vitro and a strong anticoagulant effect was observed. This action was abolished after treatment with a specific inhibitor of phospholipase A2 activity (p-bromophenacyl bromide), revealing a procoagulant action in low concentrations of treated venom (around 1 microgram/ml). The effect of the venom on haemostasis was further characterized by measuring its ability to activate purified blood coagulation factors. It is concluded that A. halys pallas venom contains prothrombin activation activity. A prothrombin activator (aharin) was purified from the venom by Sephadex G-75 gel filtration and ion-exchange chromatography on a Mono-Q column. It consisted of a single polypeptide chain, with a mol. wt of 63,000. Purified aharin possessed no amidolytic activity on chromogenic substrates. It did not act on other blood coagulation factors, such as factor X and plasminogen, nor did it cleave or clot purified fibrinogen. The prothrombin activation activity of aharin was readily inhibited by ethylenediamine tetracetic acid (a metal chelator), but specific serine protease inhibitors such as diisopropyl fluorophosphate and phenylmethanesulfonyl fluoride had no effect on it. These observations suggest that, like those prothrombin activators from Echis carinatus and Bothrops atrox venoms, the prothrombin activator from A. halys pallas venom is a metalloproteinase.

Anticoagulants↗
PubMed2000

Secretion, gamma-carboxylation, and endoplasmic reticulum-associated degradation of chimeras with mutually exchanged Gla domain between human protein C and prothrombin.

Warfarin, an antagonist of vitamin K, causes diminution of vitamin K-dependent coagulation factors in the circulation. Although all vitamin K-dependent factors have Gla domains, the warfarin-induced decrease in their plasma concentration differs among factors. In warfarin-treated HepG2 cells, we found modest and severe intracellular degradation of prothrombin and protein C, respectively. To investigate the structural features of these proteins that contribute to their warfarin sensitivity, chimeric prothrombin containing the prepropeptide and Gla domain of protein C was expressed in baby hamster kidney (BHK) cells. This chimera showed similar secretion kinetics and warfarin sensitivity to those of wild-type prothrombin, demonstrating that the Gla domain cannot solely explain the warfarin sensitivity of protein C. In contrast, two chimeric protein Cs containing either the Gla domain alone or the prepropeptide and Gla domain of prothrombin showed impaired secretion. Even though gamma-carboxylation proceeded normally, both chimeras were degraded intracellularly by the proteasome. From these results, we conclude that not only the folding of the Gla domain, but the entire structure and conformation of protein C and prothrombin, contribute to their quality control and susceptibility to warfarin-induced ER (endoplasmic reticulum)-associated degradation.

Adenosine Triphosphatases↗
PubMed1997

Quantitative PCR analysis reveals novel expression of prothrombin mRNA and regulation of its levels in developing mouse muscle.

Precise determination of mRNA levels is an essential element in any investigation of complex regulatory systems. Classical methodologies such as Northern hybridization suffer from requirements for significant samples of material and also a degree of nonspecificity. Recently, quantitative techniques involving PCR amplification have been devised. We have developed and applied such procedures to the determination of prothrombin messages in skeletal muscle cells during development. In addition to its role in the blood coagulation cascade, the serine protease thrombin has been shown to participate in several signaling events in the neuromuscular system. The inactive precursor, prothrombin, primarily produced in the liver, has also been shown to be synthesized and developmentally-regulated in the brain. In skeletal muscle, thrombin is a mediator of activity-dependent polyneuronal synapse elimination (ADPSE) which occurs in early postnatal development. Recent experiments showing that thrombin is released from myotubes in culture under the influence of acetylcholine suggest that locally-synthesized prothrombin may be the source of this Hebbian synaptic interaction. We have determined that prothrombin is expressed in skeletal muscle, as the likely source of thrombin involved in ADPSE, and the current results show the quantitative expression of muscle prothrombin during this time of intense synapse remodeling.

Animals↗
PubMed1999

N-glycosylation contributes to the intracellular stability of prothrombin precursors in the endoplasmic reticulum.

Rat prothrombin (rFII) and human prothrombin (hFII) are processed differently during their biosynthesis in a manner dependent upon gamma-glutamyl carboxylation, a vitamin K-dependent posttranslational modification of prothrombin precursors. The role of N-glycosylation in the cellular processing of prothrombin was examined in hepatoma (H-35 and HepG2) and transformed kidney (HEK293) cell lines. Aglyco-rFII obtained by tunicamycin treatment was degraded in warfarin-treated H-35 cells, but not in vitamin K-treated cells. Fully glycosylated rFII is also selectively retained and degraded in warfarin-treated H-35 cells. When rFII and hFII were transiently expressed in tunicamycin-treated HEK293 cells, rFII but not hFII was degraded to generate a 48-KD species. This degradation was independent of gamma-carboxylation, indicating that the sensitivity of aglyco-rFII and aglyco-hFII toward this specific proteolysis differs in HEK293 cells. By expressing chimeric rFII/hFII constructs in tunicamycin-treated HEK293 cells, it was shown that the kringle 2 structure of prothrombin was responsible for this difference. The 48-KD species was not observed in tunicamycin-treated H-35 cells, suggesting that this specific proteolytic processing of aglyco-rFII is also cell-type specific. Expression of rFII in other tunicamycin-treated nonhepatic cells suggests that this cell-specific difference in processing might be determined by a difference between hepatic and nonhepatic cells. The site-directed mutagenesis utilized in these studies also establishes that the N-glycosylation sites of rFII are at residues Asn77, 101, 378, and 518.

Animals↗
PubMed2001

Saponin permeabilization of rough microsomes from rat liver reveals a novel prothrombin pool.

Saponin permeabilization of rough microsomes in the presence of high salt revealed a novel pool of prothrombin associated by ionic interactions to the microsomal membrane. The lumenal content was obtained by treating rough microsomes with 0.32% saponin in a low salt (0.05 M KCl) buffer. By a subsequent treatment with 0.32% saponin in a slightly alkaline high salt buffer a fraction of peripherally associated membrane prothrombin was released from rough microsomes. Finally, the membrane-bound fraction was solubilized with 2.5% Triton X-100. The lumenal content fraction, the peripherally membrane-associated and the membrane-bound fraction from normal rats contained 55%, 29% and 16% of the total rough microsomal prothrombin, respectively. The corresponding fractions from warfarin-treated rats contained 86%, 5% and 9% of the total prothrombin. Following (14)C-gamma-carboxylation of intact microsomes for 30 min, the novel membrane-associated and the membrane-bound pool contained 42% and 33%, respectively, of labeled prothrombin. A similar distribution was found with warfarin-treated rats.

Animals↗
PubMed2001

Factor V Leiden and prothrombin gene mutation in inflammatory bowel disease in a Mediterranean area.

BACKGROUND: Thromboembolism has been reported to be associated with inflammatory bowel disease. AIM: To evaluate the association of factor V Leiden and prothrombin gene mutation with inflammatory bowel disease in a population of patients with thromboembolic events and inflammatory bowel disease and in a control population of patients with inflammatory bowel disease without thromboembolic events. PATIENTS AND METHODS: A series of 18 patients with inflammatory bowel disease and a history of arterial or venous thrombosis and 45 patients with inflammatory bowel disease without thromboembolic events were evaluated for the presence of factor V Leiden and prothrombin gene mutation. Frequency of gene mutation was compared with its occurrence in 100 healthy controls. RESULTS: One patient with inflammatory bowel disease without thromboembolic events was heterozygous for factor V Leiden mutation. whereas no patient with a thromboembolic event had factor V Leiden mutation. No patients (either cases or controls) had prothrombin gene mutation. In the healthy population the frequency of factor V Leiden and prothrombin mutation was 5% and 2%, respectively. CONCLUSIONS: Data emerging from the present study do not support any role of factor V Leiden and prothrombin gene mutation as the cause of thromboembolism in inflammatory bowel disease.

Colitis, Ulcerative↗
PubMed1994

Phosphatidylserine-containing membranes alter the thermal stability of prothrombin's catalytic domain: a differential scanning calorimetric study.

Denaturation profiles of bovine prothrombin and its isolated fragments were examined in the presence of Na2EDTA, 5 mM CaCl2, and CaCl2 plus membranes containing 1-palmitoyl-2-oleoyl-3-sn-phosphatidylcholine (POPC) in combination with bovine brain phosphatidylserine (PS). We have shown previously [Lentz, B. R., Wu, J. R., Sorrentino, A. M., & Carleton, J. A. (1991) Biophys. J. 60, 70] that binding to PS/POPC (25/75) large unilamellar vesicles resulted in an enthalpy loss in the main endotherm of prothrombin denaturation (Tm approximately 57-58 degrees C) and a comparable enthalpy gain in a minor endotherm (Tm approximately 59 degrees C) accompanying an upward shift in peak temperature (Tm approximately 73 degrees C). This minor endotherm was also responsive to Ca2+ binding and, in the absence of PS/POPC membranes, corresponded to melting of the N-terminal, Ca2+ and membrane binding domain (fragment 1). Peak deconvolution analysis of the prothrombin denaturation profile and extensive studies of the denaturation of isolated prothrombin domains in the presence and absence of PS/POPC vesicles suggested that membrane binding induced changes in the C-terminal catalytic domain of prothrombin (prethrombin 2) and in a domain that links fragment 1 with the catalytic domain (fragment 2). Specifically, the results have confirmed that the fragment 2 domain interacts with the stabilizes the prethrombin 2 domain and also have shown that fragment 2 interacts directly with the membrane. In addition, the results have demonstrated a heretofore unrecognized interaction between the catalytic and membrane binding domains. This interaction can account for another portion of the denaturation enthalpy that appears at high temperatures in the presence of membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Prothrombin biosynthesis: characterization of processing events in rat liver microsomes.

Plasma and hepatic microsomal forms of rat prothrombin have been compared by sodium dodecyl sulfate-polyacrylamide electrophoresis and isoelectric focusing. The major prothrombin species that accumulated in the microsomes of rats treated with warfarin had a molecular weight of 78 500 and a pI in 8 M urea of 6.3-6.5. Plasma prothrombin had a molecular weight of 83 500 and a pI of 5.3-5.7. Microsomes from normal rat liver contain a second pool of precursor with a molecular weight of 83 500, and digestion with the glycosidase Endo H indicated that this form has been processed to contain complex carbohydrates, while the Mr 78 500 form is a high mannose form and is the substrate for the vitamin K dependent carboxylase. Treatment of rats with tunicamycin revealed that glycosylation was not essential for carboxylation or secretion from the liver. Comparison of the aglyco forms of prothrombin and its precursors suggests that the intracellular forms contain a basic, Mr approximately 1500 peptide that is missing from the plasma form of prothrombin.

Animals↗
PubMed1987

Prothrombin Tokushima, a replacement of arginine-418 by tryptophan that impairs the fibrinogen clotting activity of derived thrombin Tokushima.

Structural studies on a hereditarily abnormal prothrombin, prothrombin Tokushima, have been performed to identify the difference responsible for its reduced fibrinogen clotting activity upon conversion to thrombin. The prothrombin sample used was from a heterozygote but contained exclusively a defective prothrombin molecule, since the patient was heterozygous for both dysprothrombinemia and hypoprothrombinemia. Amino acid sequence analysis of a peptide isolated from a lysyl endopeptidase digest of the abnormal thrombin indicated that Arg-418 (equivalent to Asn-101 in the chymotrypsin numbering system) had been replaced by Trp. This amino acid substitution can result from a single nucleotide change in the codon for Arg-418 (CGG----TGG). The Arg----Trp replacement found in the thrombin portion of prothrombin Tokushima appears to reduce its interaction with various substrates including fibrinogen and platelet receptors and accounts for the recurrent bleeding episode observed in the propositus.

Amino Acid Sequence↗
PubMed1988

Location of gamma-carboxyglutamyl residues in partially carboxylated prothrombin preparations.

Prothrombin contains 10 gamma-carboxyglutamyl (Gla) residues in the N-terminal (fragment 1) domain of the protein. Following anticoagulant administration, a spectrum of undercarboxylated, physiologically less active forms of prothrombin is secreted into bovine or human plasma. The sites of undercarboxylation in these prothrombin species have now been investigated. Plasma containing a mixture of partially carboxylated forms of prothombin was obtained from a dicoumarol-treated bovine, and three pools of partially carboxylated (four, six, or eight Gla) species were purified by adsorption onto barium citrate and barium oxalate, ammonium sulfate fractionation, and chromatography. Fragment 1 obtained from these variants was equilibrated with 3H2O and heated in a dry state to decarboxylate Gla and incorporate 3H into the resulting Glu residues. This peptide was then sequenced by Edman degradation, and the specific radioactivity of PTH-Glu was determined for each potential Gla-containing site. Data obtained from normal prothrombin fragment 1 fit a linear model when the log of specific activity of PTH-Glu was plotted against the cycle number. Analysis of the 80% variant showed a decrease in carboxylation only in the last two Gla residues, while data obtained from the 60% variant indicated a general decrease in carboxylation from the most amino- to the more carboxyl-terminal Gla residues. In the 40% Gla variant, all but the most amino-terminal of the Gla residues appeared to be undercarboxylated. These data indicate that the gamma-carboxylation of glutamyl residues in prothrombin does not occur randomly but instead with preferential carboxylation of the most amino-terminal Gla residues. When carboxylation is limited, the impairment of carboxylation is more severe at the more carboxyl-terminal residues.

1-Carboxyglutamic Acid↗
PubMed1990

Evaluation of membrane phase behavior as a tool to detect extrinsic protein-induced domain formation: binding of prothrombin to phosphatidylserine/phosphatidylcholine vesicles.

The temperature-composition phase diagram of mixed dimyristoylphosphatidylserine (DMPS) and dimyristoylphosphatidylcholine (DMPC) small unilamellar vesicles was determined in the presence and absence of bound bovine prothrombin by monitoring the phospholipid order-disorder phase separation using diphenylhexatriene (DPH) fluorescence anisotropy. The shape of the membrane temperature-composition diagram was essentially unaltered by the binding of prothrombin in the presence of Ca2+ although the two-phase (gel/fluid) region was slightly narrowed and shifted by 1-10 degrees C to higher temperatures. This result does not support the popular idea that extensive domains rich in negatively charged phospholipid are induced in response to prothrombin binding. Instead of implying domain formation, our results demonstrate that the observed increase in melting temperature associated with binding of prothrombin to acidic phospholipid membranes can be accounted for by the observed altered membrane order both in the fluid and in the solid lamellar phases. The membrane order in the liquid-crystalline phase increased with increased acidic lipid content, and much more so for DMPS than for dipentadecanoylphosphatidylglycerol (DC15PG). These results demonstrate that simple shifts in membrane phase behavior cannot be properly interpreted to prove the existence of charged lipid domains. In addition, we report the unexpected observation that prothrombin increased the anisotropy of DPH in DMPS/DMPC vesicles in the liquid-crystalline phase in the absence of Ca2+ as well as in its presence. This effect was seen to a lesser extent and only at a much higher charged-lipid content for DC15PG/DMPC vesicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1980

Conformational change of human prothrombin induced by calcium ions: an X-ray scattering study.

The scattered X-ray intensities from dilute solutions of prothrombin and Ca2+-prothrombin at 21 degrees C in 0.1 M Tris-HCl buffer of pH 7.4 indicate that the prothrombin molecule attains a more extended conformation when Ca2+ ions are bound. This is indicated from the distance distribution function: the largest distance within the prothrombin molecule increases from 130 to 150 A when Ca2+ ions are bound; the radius of gyration increases from 35.5 to 39.5 A. A comparison of the experimental scattering curves with theoretical scattering curves calculated for various triaxial bodies shows that the shape of the prothrombin molecule can be represented by two ellipsoids and that the effect of Ca2+ binding can be represented by a change in the angle between their major axes.

Calcium↗
PubMed1977

Investigation of the aggregation and activation of prothrombin using quasi-elastic light scattering.

The technique of quasi-elastic light scattering was used to measure the translational diffusion coefficient, D, of purified human prothrombin in buffered aqueous solutions and to monitor for the first time the fragmentation of this protein as it is converted to thrombin. The values of D20,w, measured at two different concentrations, are 4.72 X 10(-7) CM2/S at 2MG/CM3 and 4.51 X 10(-7) CM2/S at 5MG/CM3; the corresponding molecular weights (Mw of 92 000 and 120 000), obtained by combining sedimentation velocity measurements with the diffusion data, confirm the presence of molecular aggregates of prothrombin in these solutions. These results, as well as analysis of the intensity-intensity autocorrelation functions from two-component systems with various dimer conformations, indicated the presence of end-to-end dimers in these prothrombin solutions. The values obtained for D indicate a dimer weight fraction of 0.4 to 0.5 in the 2 mg/cm3 solution and 0.6 or greater in the 5 mg/cm3 solution. The fragmentation of prothrombin was monitored in a nonphysiologic activation system, containing taipan snake venom, dihexanoylphosphatidylcholine, and CaCl2. At a temperature of 15 degrees C, conversion to thrombin proceeded very slowly and was still incomplete after 90 h. A method for determing the percentage of converted prothrombin is an activated system containing aggregates from the average value of D and light scattering data is discussed.

Chemical Phenomena↗