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PubMed1989

Dissociation and reconstitution of bovine seminal RNAase: construction of a hyperactive hybrid dimer.

The quaternary structure of bovine seminal ribonuclease, the only dimeric protein in the superfamily of ribonucleases, is maintained both by noncovalent forces and by two intersubunit disulfides. The available monomeric derivatives of the enzyme may not be reassembled into dimers. They are catalytically active, but do not retain certain properties of the dimeric enzyme, such as: (i) the ability to respond cooperatively to increasing substrate concentrations in the rate-limiting reaction step; and (ii) the antitumor and immunosuppressive actions. In this report we described the preparation of stable monomers of seminal ribonuclease which can be reassociated into covalent dimers indistinguishable from the native protein. With this procedure a hybrid dimer was constructed, made up of a native subunit associated to a subunit catalytically inactivated by selective alkylation of the active site His-119. This dimer was found to have enzymic properties typical of monomeric ribonucleases, such as a hyperbolic saturation curve in the hydrolytic rate-limiting step of the reaction. However, the hybrid dimer was one order-of-magnitude more active than the dimeric enzyme.

Amino Acids↗

PubMed1993

Structural characterization of the two refold dimers of recombinant bovine somatotropin (bST).

Two major dimers are generated during the folding/oxidation of inclusion bodies of recombinant bovine somatotropin (bST). These dimers represent the major part of the inactive high molecular weight species that are formed in this process. The structures of the two dimers are unambiguously determined by peptide mapping using trypsin, thrombin cleavage, and selective DTT reduction experiments. Results indicate that the formation of both dimers involves the large disulfide loop cysteines. The latter-eluting dimer from RP-HPLC, previously reported as a large loop concatenated dimer, was revised to be an antiparallel disulfide-linked dimer. On the other hand, the first eluting dimer is a concatenane in which two monomers are held together by the interlocking of the two large disulfide loops.

Amino Acid Sequence↗

PubMed1997

D-dimer plasma levels during normal pregnancy measured by specific ELISA.

A progressive increase in D-dimer plasma levels together with an increase in fibrinogen has been previously reported during normal pregnancy. However, significantly different D-dimer levels have been observed in different assays, due to different specificity of the antibodies employed. The aim of this study was to verify the increase in fibrin degradation product levels during normal pregnancy, using a recently introduced specific D-dimer ELISA. We determined D-dimer (ELISA) and fibrinogen (clotting method) plasma levels in 63 normal pregnant women, during three different periods of pregnancy (A, 7-20 weeks; B, 21-30 weeks; C, > 30 weeks). During period A, D-dimer plasma levels (range 2-103 ng/ml) showed an insignificant increase compared with a control group of non-pregnant women (range 2-73 ng/ml). During periods B and C, we observed an increase in D-dimer level (P < 0.0001) compared with period A, with a significant correlation between D-dimer levels and gestational age (P < 0.0001). Period A fibrinogen levels (range 3.24-6.43 g/l) were significantly higher (P < 0.0001) than in controls (range 2.31-4.71 g/l), with a further increase in periods B and C. In conclusion, we confirmed a progressive increase in plasma concentrations of fibrin degradation product during normal pregnancy, but D-dimer levels were significantly lower than those reported in the literature for other ELISAs.

Adult↗

PubMed1999

D-dimer assay predicts mortality in critically ill patients without disseminated intravascular coagulation or venous thromboembolic disease.

OBJECTIVE: To determine if D-dimer predicts outcomes in critically ill patients. DESIGN: Observational, cohort study. SETTING: Medical intensive care unit (MICU) of a tertiary care hospital. PATIENTS AND PARTICIPANTS: Seventy-four patients consecutively admitted to the MICU. INTERVENTIONS: D-dimer was measured by latex agglutination within 12 h of admission to the MICU. MEASUREMENTS AND RESULTS: Of the study population, 43.2% had positive D-dimers. The in-hospital mortality rate in D-dimer positive patients was 28.1% as compared to 7.1% in D-dimer negative subjects (p = 0.024). D-dimer positive patients had significantly greater frequencies of venous thromboses (21.9% vs 4.8%, p = 0.035). CONCLUSIONS: The D-dimer assay identifies patients at increased risk for mortality and may be a more sensitive test to determine the presence of underlying microvascular pathology in critically ill patients. A positive D-dimer at admission to the MICU is associated with an increased risk for the later development of a venous thromboembolic event (VTE).

APACHE↗

PubMed2001

Variation of plasma D-dimer following surgery: implications for prediction of postoperative venous thromboembolism.

The prognosis of venous thromboembolism is considerably influenced by an accurate and fast diagnosis. Although the role of D-dimer testing in the diagnosis of suspected venous thromboembolism is well established for outpatients, there is controversial evidence on the clinical usefulness of its measurement in surgical patients. In order to recognize patterns of variation of D-dimer following surgery and identify potential pitfalls in prediction of venous thromboembolic complications, plasma D-dimer was assayed in 30 patients undergoing major elective hip surgery and 20 patients undergoing laparoscopic cholecystectomy for acute cholecystitis. The postoperative variation of plasma D-dimer differed widely between the two subgroups. Patients undergoing laparoscopic cholecystectomy showed D-dimer concentrations persistently increased from the baseline to the 15th postoperative day, whereas patients undergoing hip surgery were characterized by a double peak, on the 1st and 7th postoperative days. Mean inter-individual daily coefficient of variations of plasma D-dimer throughout the postoperative period were 49% (range 39%-61%) for laparoscopic cholecystectomy and 101% (range 72%-156%) for orthopedic surgery. The markedly heterogeneous fluctuation of plasma D-dimer suggests that the postoperative activation of the hemostatic system depends on the type and time since surgery, thus limiting the clinical usefulness of D-dimer testing in the diagnostic approach to postoperative venous thromboembolism.

Arthroplasty, Replacement, Hip↗

PubMed1980

EPR study of dimerization and conformational change of Cu(II)-cytochrome c and its undeca- and octapeptide.

The EPR study of cytochrome c in which FE(III) ion is replaced with Cu(II) shows that there are two types of monomer (a: 4 less than pH less than 6, and b: 6 less than pH less than 11.5) and two types of dimer (A: pH less than 4 and B: pH less than 11.5) formed depending upon the pH value of the solution. Computer simulation of the EPR spectra of the dimers indicates that the structure of the dimer A has a larger lateral shift than in the dimer B. It is also shown that in monomer a, the imidazole nitrogen of 18-His is not bound to Cu(II), while it is bound in the monomer b. In the undeca- and octapeptide of Cu(II)-cytochrome c, polymers are formed in acidic solutions. As the pH is raised, depolymerization proceeds to yield the monomer and the dimer. The structure of the dimer in both peptides is found to be similar to that of the dimer B of Cu(II)-cytochrome c. In the monomer of the peptides, neither the imidazole of 18-His nor the imidazole added in excess is bound to Cu(II) in the entire pH range. It is also concluded that the dimerization in Cu(II)-porphyrins interferes with the apical coordination of basic ligand, or vice versa.

Chemical Phenomena↗

PubMed1993

Utility of high resolution capillary electrophoresis for monitoring peptide homo- and hetero-dimer formation.

The monomer and disulfide-linked homo-dimer of two different peptides, one with an amino-terminal cysteine, the other with a cysteine at the carboxy-terminal, are shown to be baseline resolved by capillary electrophoresis in less than 15 min. Time-course for homo-dimer formation with both peptides, either under mild (air) or stronger (hydrogen peroxide oxidizing conditions, was easily monitored. Confirmation that the second peak appearing under oxidizing conditions was indeed the homo-dimer was obtained with mass spectrometry. The possibility that stronger oxidizing conditions led to the production of the sulfonic acid derivative of the monomeric peptide, was ruled out through generation of the derivative by performic acid oxidation. As expected, the negative charge of the sulfonic acid moiety gives the peptide a slower electrophoretic mobility than both the monomer and the dimer. Moreover, as would be expected with a sulfonic acid derivative, oxidation to the dimeric form was not possible. This was consistent with the observation that the homo-dimer peak could be reduced to monomeric form in the presence of dithiothreitol. Co-oxidization of the amino- and carboxy-terminal peptides led to the expected production of both homo-dimers and the hetero-dimer, all of which were resolved.

Amino Acid Sequence↗

PubMed1996

Intact noncovalent dimer of estrogen receptor ligand-binding domain can be detected by electrospray ionization mass spectrometry.

Electrospray ionization mass spectrometry (ESMS) of the estrogen receptor ligand binding domain (ER LBD) in its estradiol-binding form was performed. A dimeric ER LBD was observed, with a greatly reduced capacity for protonation (major charge state for dimer +16 vs. +23 for a monomer). Peak broadening (probably due to heterogeneity resulting from salt and water adduct formation) adversely affected our ability to distinguish between multiple discreet dimeric species and thus prevented us from establishing an accurate average mass for the dimerized domain. A mixture of species with molecular masses between 57,240 Da and 57,900 Da was observed, which would compare to 57,274 Da, 57,546 Da, and 57,818 Da for the calculated masses of the dimer without estradiol, or with one or two bound ligand molecules, respectively. Hence, nonliganded ER LBD dimer appeared to constitute the major species. The presence of low levels of a singly liganded ER LBD dimer cannot be ruled out, but the data argue against the possibility of the ER LBD dimer carrying two molecules of estradiol. Allowing for current limitations in the technology, our data demonstrate that ESMS on a quadrupole mass spectrometer of limited mass range (4000 Da for singly charged ions) has potential utility for studying ligand-binding proteins. In particular, in future it might be possible to compare spectra obtained from agonist- and antagonist-bound receptors and determine from subtle changes in protonation state possible differences in the higher order structure of those noncovalent protein complexes.

Binding Sites↗

PubMed1990

Oligomerization of herpes simplex virus glycoprotein B occurs in the endoplasmic reticulum and a 102 amino acid cytosolic domain is dispensable for dimer assembly.

Glycoprotein B (gB) is an essential protein specified by herpes simplex virus and a major envelope component of the virions. It is known to assemble into noncovalently associated dimers. The aim of this study was to investigate the role of topogenic domains of gB in dimer assembly and the intracellular location at which gB dimers are assembled. Therefore, dimer analyses were performed on intact gB and its three COOH-terminus-truncated gB derivatives encoding NH2-terminal 772, 586, and 477 amino acids (aa) of the mature gB, using SDS-polyacrylamide gel electrophoresis and sucrose gradient assays. Dimers were detected in gB and in tgB(772 aa), but were absent from tgB(586 aa) and from tgB(477 aa). These results showed that a 102 aa cytosolic domain (aa 773-874) is not required for the assembly of gB dimers. In addition, using endoglycosidase H treatment and dimer analysis of gB synthesized during 7 min pulse-labeling period, we have demonstrated that ER is the subcellular organelle at which gB monomers are assembled into dimeric forms.

Amino Acids↗

PubMed1994

Calcyclin from mouse Ehrlich ascites tumor cells and rabbit lung form non-covalent dimers.

Crosslinking treatments of fresh cytosol from mouse Ehrlich ascites tumor (EAT) cells revealed the existence of calcyclin dimers which were sensitive to SDS, but not to reducing agents, which suggests the existence of non-covalent dimers. In stored EAT cell cytosol and preparations of purified calcyclin dimers were also formed by S-S bridging (covalent dimers). The S-S dimers did not bind to organomercurial Agarose and could be separated from reduced forms of calcyclin that bound to the resin. Calcyclin eluted from the resin with DTT was a mixture of monomers and non-covalent dimers as shown by crosslinking and subsequent immunoblotting. Calcyclin from rabbit lung, lacking a cysteine residue, could also be crosslinked as a dimer. It is suggested that the ability of calcyclin to form non-covalent dimers is of physiological significance.

Animals↗

PubMed2006

D-dimer local expression is increased in symptomatic patients undergoing carotid endarterectomy.

BACKGROUND: Although atherosclerosis is a silent widespread disease, the focal character of the lesions triggering the clinical manifestations is unquestionable. We hypothesized that symptomatic patients with advanced, unstable carotid plaques have increased local intraplaque and circulating levels of fibrin-fibrinogen related products. METHODS: Plaque tissue and plasma samples were studied in 106 patients undergoing endarterectomy for symptomatic and asymptomatic carotid disease. Fibrin-fibrinogen related products were evaluated by ELISA, Western-blotting, and histology. All tested parameters were compared with patient carotid symptomatology, multiple vascular risk factors (VRF), bilateral carotid pathology, ultrasound examination, and previous therapies with statins and/or antiplatelet drugs. RESULTS: In symptomatic patients, plasma D-dimer was elevated in patients with unstable carotid plaques (UNS) compared with stable (STA) ones (857+/-121 vs. 692+/-156 ng/ml, p=0. 026). Furthermore, plasma D-dimer was significantly increased in patients with a coexistence of carotid and coronary artery disease, compared to others (976+/-325 vs. 714+/-197 ng/ml; p<0.001). Intra-plaque D-dimer content was increased in ulcerated-complicated (UC) plaques compared with fibrous non-complicated (F) plaques in symptomatic patients (5.9+/-1 vs. 1.8+/-1, p<0.001), and in patients with hypercholesterolaemia, compared with those with normal cholesterol levels (6.1+/-1 vs. 2.9+/-0.7; p=0.027). However, there was no correlation between D-dimer content in the carotid plaque and plasma D-dimer levels. CONCLUSIONS: Hypercholesterolemia and UC plaques appear to be associated with high fibrin intraplaque turnover as demonstrated by higher intraplaque D-dimer. Plasma markers of fibrin turnover were increased in UNS plaques, and in patients with coexisting carotid and coronary artery disease. Although, both plasma and plaque D-dimers were associated with unstable carotid disease, the usefulness of the measurement of plasma D-dimer in these patients should be confirmed by prospective studies.

Aged↗

PubMed2005

Prospective evaluation of a screening protocol to exclude deep vein thrombosis on the basis of a combination of quantitative D-dimer testing and pretest clinical probability score.

BACKGROUND: Clinical signs and symptoms such as swelling, pain, and redness are unreliable markers of deep vein thrombosis (DVT). Because of this venous duplex scanning (VDS) has been heavily used in DVT detection. The purpose of this study was to determine if a combination of D-dimer testing and pretest clinical score could reduce the use of VDS in symptomatic patients with suspected DVT. STUDY DESIGN: One hundred seventy-four consecutive patients with suspected DVT were prospectively evaluated using pretest clinical probability (PCP) score and D-dimer testing before VDS. After calculating clinical probability scores developed by Wells and associates, patients were divided into low risk ( or=3 points) PCP. RESULTS: One hundred fifty-eight patients were enrolled. The prevalence of DVT in this study was 37%. Thirty-eight patients (24%) were classified as low risk, 64 (41%) as moderate risk, and 56 (35%) as high risk PCP. DVT was identified in only one patient (2.6%) with low risk PCP. In contrast, DVT was found in 22 (34%) with moderate risk, and 35 (63%) with high risk PCP. In the high and moderate risk PCP groups, positive scan patients had a markedly higher value of D-dimer assay than negative scan patients (p=0.0001 and p=0.0057, respectively). In the low risk PCP patients, D-dimer testing provided 100% sensitivity, 46% specificity, 4.8% positive predictive value, and 100% negative predictive value in the diagnosis of DVT. Similarly, in the moderate risk PCP, the D-dimer testing showed 100% sensitivity, 45% specificity, 49% positive predictive value, and 100% negative predictive value. In the high risk group, D-dimer testing achieved 100% sensitivity, 57% specificity, 80% positive predictive value, and 100% negative predictive value in the diagnosis of DVT. These results suggested that 36 of 158 patients who had a non-high PCP (low and moderate PCP) and a normal D-dimer concentration were considered to have no additional investigation, so VDS could have been reduced by 23% (36/158). CONCLUSIONS: A combination of D-dimer testing and clinical probability score may be effective in avoiding unnecessary VDS in suspected symptomatic DVT in the low and moderate PCP patients. The need for VDS could be reduced by 23% despite a relatively high prevalence of DVT.

Adult↗

PubMed2005

Novel monoclonal antibody that recognizes new neoantigenic determinant of D-dimer.

Our novel monoclonal antibody (mAb) B4 reacted with only D-dimer but not intact fibrinogen, or fibrinogen degradation products (FgDP) such as D-monomer, E fragment on ELISA. B4 didn't react with denatured D-dimer, while it reacted well with denatured D-monomer rather than the native form, indicating that B4 recognizes some neoconformational epitope in D-dimer. In our epitope study, B4 recognized the N-terminal (Bbeta134-142) of D-dimer, which corresponds to the most flexible segment of coiled coil backbone. It was confirmed by inhibition assay of B4 binding to D-dimer using the synthesized peptides with this sequence. As the other evidence, B4 didn't bind to some D-dimer species produced from a particular fibrinogen variant. This fibrinogen variant is mutated BbetaLys133 residue to Gln133 thus it doesn't produce the particular N-terminal epitope of D134 approximately by plasmin. Finally, our mAb was useful for clinical application. ELISA using our mAbs was well correlated with other commercial D-dimer ELISAs and in some clinical samples it was preferable to them. These results suggest that the epitope for B4 is another neoantigenic determinant in native D-dimer as distinct from native D-monomer.

Antibodies, Monoclonal↗

PubMed2006

Diagnostic value of D-dimer in patients with suspected pulmonary embolism: results from a multicentre outcome study.

BACKGROUND: D-dimer tests are used in various diagnostic strategies to exclude pulmonary embolism (PE). However, their role as an exclusionary first-line test is still uncertain, mainly because accuracy of the test varies according to the assay and the studied population. METHODS: The aim of this multicentre study was to evaluate the accuracy of D-dimer testing in patients with suspected PE. Diagnosis of PE was based on pre-test clinical probability (PCP) evaluation and both single-detector spiral CT (CT) and lower limbs compression ultrasonography (CUS). Lung scanning and/or pulmonary angiography was mandatory when CT or CUS was inconclusive and when both CT and CUS were normal in a patient with a high PCP. All patients were followed-up for 3 months, looking for VTE recurrence. D-dimers were collected within 24 h of inclusion and stored in each local hematology unit, to be analyzed at the end of all inclusions; physicians in charge of the patient were blinded to D-dimer results. RESULTS: Three hundred and fifty two patients were included in 4 centres. Prevalence of PE was 38.6%. PCP was low in 82 (23.3%), intermediate in 176 (50%) and high in 94 (26.7%) patients. Sensitivity of D-dimer was 96.3% (95% CI: 93-99) and negative predictive value reached 94.4% (95% CI: 90-99). Five patients with a confirmed PE had a D-dimer level below 500 ng/ml (two patients with a high PCP). Among 258 patients with low or intermediate PCP, 80 (31%) had a negative D-dimer test result; three of them had a false negative result and the number needed to test was 3.3. Among 94 patients with a high PCP, 9 had a negative D-dimer test result; two of them had a false negative result and the number needed to test was 13.5. CONCLUSION: These results confirm that rapid assays used in this study can safely exclude PE in first-line testing only in non-high CP patients.

Adult↗

PubMed1998

D-D dimers: a poor correlate of PPIH and subsequent outcomes.

OBJECTIVES: To ascertain the normal range of D-D dimer levels in pregnancy in our population, and whether dimer levels are of value as a correlate of proteinuric pregnancy-induced hypertension (PPIH) or a predictor of adverse outcome. METHODS: Dimer levels were measured in 44 women diagnosed with PPIH after 32 weeks' gestation and 55 controls recruited before 24 weeks' gestation. RESULTS: Mean dimer levels in the second and third trimester of normal pregnancy were 45 ng/ml (+/- 1 S.D., 15-134) and 85 ng/ml (+/- 1 S.D., 40-180), respectively (P < 0.001). Mean dimer level in PPIH was 148 ng/ml (+/- 1 S.D., 76-292), differing significantly from normal pregnancy by ELISA but not by latex particle assay. No correlation was found between dimer levels and adverse outcome, nor between dimer levels and any one particular adverse outcome. CONCLUSION: These results suggest that dimer levels are not a useful correlate of PPIH, nor do they have a useful predictive value for adverse outcome in PPIH.

Female↗

PubMed2001

Diagnostic value of the D-dimer test in deep vein thrombosis: improved results by a new assay method and by using discriminate levels.

Previous studies have suggested that D-dimer testing reliably selects patients for whom duplex sonography should be performed for diagnosis of deep vein thrombosis (DVT). However, the interassay correlation is poor. Therefore, we tested four D-dimer methods for their ability to rule out DVT, including the Miniquant test, a new D-dimer assay method. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were calculated vs. duplex sonography. Twenty-nine of 108 (27%) patients with suspected DVT were diagnosed as having DVT by sonography. The Vidas enzyme-linked immunoabsorbent assay (ELISA) test, the Miniquant turbidimetric test and the latex agglutination test for D-dimer all provided discriminate values for achieving 100% sensitivity and 100% NPV. D-dimer results demonstrated higher specificity and PPV in the outpatient vs. the inpatient group. This probably reflects the higher proportion of inpatients with comorbid conditions, such as malignancy and postsurgery status, in whom D-dimer results show very poor specificity and PPV. The new Miniquant turbidimetric assay performed as well as the more established ELISA method. We conclude that the D-dimer tests were shown to possess the necessary sensitivity and NPV to be useful in screening patients with suspected DVT. A negative D-dimer test in selected patients could be helpful in reducing the number of sonograms performed for diagnosis of DVT.

Adult↗

PubMed2002

Circulating D-dimer and thrombomodulin levels in acute febrile phase of measles.

OBJECTIVES: Circulating D-dimer and thrombomodulin (TM) levels are now routinely measured in clinical laboratories. Plasma levels of D-dimer are used as a marker of fibrin formation and degradation, and serum TM is used to assess the state of endothelial cell injuries. While the levels of circulating D-dimer and TM have been investigated in many diseases, to our knowledge they have not been studied in patients with measles. We measured circulating levels of D-dimer in patients with measles to discuss whether fibrin formation and degradation occur and TM whether endothelial injury occur. METHODS: The plasma levels of D-dimer and serum levels of alanine aminotransferase (ALT) and creatinine were measured of 14 adolescent and adult Japanese patients with measles, and the serum or plasma levels of TM of 10 of these 14 patients were measured in the acute febrile phase and convalescent afebrile phase with commercially available kits. RESULTS: Plasma D-dimer levels were significantly higher in the acute febrile phase than in the convalescent afebrile phase in patients with measles, and no significant difference was shown in serum and plasma TM levels between the two phases. Plasma D-dimer levels were not correlated with serum or plasma TM levels in either phase. No significant differences were identified in the serum ALT and creatinine levels between the acute febrile and convalescent afebrile phases, and the levels of plasma D-dimer were not significantly correlated with the serum ALT levels. CONCLUSIONS: Our results indicate that while clot formation and fibrinolysis may tend to occur in patients with the acute febrile phase of measles, there may be little risk that such patients will suffer endothelial injury.

Acute Disease↗

PubMed1985

The interconversion between monomeric and dimeric bovine heart cytochrome c oxidase.

Monomers and dimers of bovine heart cytochrome c oxidase (EC 1.9.3.1.) were separated by gel filtration chromatography on Ultrogel AcA 34 or by sucrose gradient centrifugation. Factors influencing the interconversion of the two aggregation states of this enzyme were analyzed. At very low ionic strength, in the presence of dodecyl maltoside, monomers were the main species. Salts appeared to stabilize the dimeric form, divalent cations being more efficient than monovalent. High enzyme concentrations favoured the formation of dimers, also at low ionic strength. The type of detergent had a strong influence on the monomer-dimer interconversion; in Triton X-100 and dodecyl maltoside (at high ionic strength) cytochrome c oxidase was homogenously dispersed in its dimeric form, while in Tween-80 gel filtration showed only large particles eluting in the void volume. In cholate monomers and aggregates were observed but no dimers. The aggregation state had an influence on the steady state kinetics of the ferrocytochrome c oxidase activity. Monomers showed linear Eadie-Hofstee plots, whilst the dimeric and aggregated enzyme gave nonlinear Eadie-Hofstee plots. Ionic strength, enzyme concentration and type of detergent were affecting the enzyme's kinetics in a way consistent with the molecular form obtained by the gel filtration or sedimentation analysis. The data support a negative cooperative mechanism for the interaction of cytochrome c with the dimeric enzyme, as proposed earlier (K.A. Nałecz et al., (1983) Biochem. Biophys. Res. Commun., 114, 822-828).

Animals↗