Role of a 5'-enhancer in the transcriptional regulation of the human endothelial cell protein C receptor gene.

The endothelial cell protein C receptor (EPCR) is expressed by endothelial cells of large blood vessels and by hematopoietic stem cells. DNaseI hypersensitive (DH) site mapping across 38 kb of the human EPCR gene (hEPCR) locus identified 3 potential regulatory elements. By itself, the DH region spanning the proximal promoter (PP) was unable to direct cell-specific transcription in transgenic mice. A second DH element, located upstream of PP and termed -5.5HS was hypersensitive only in endothelial cells (ECs) and immature hematopoietic cell lines. Transgenes expressing LacZ under the control of -5.5HS coupled to either PP or the SV40 promoter were able to direct beta-galactosidase activity to the endothelium of large vessels during embryogenesis and adulthood. The -5.5HS exhibited enhancer activity that was conferred by the interplay of transcription factors interacting with conserved Ets and composite GATA/Tal1 motifs. The third DH element, located in intron 2, was primarily hypersensitive in EPCR-negative cells, and capable of initiating antisense transcription, suggesting a role in hEPCR silencing. This study identifies critical elements required for the tissue specificity of hEPCR and suggests a mechanism for endothelial and hematopoietic stem cell-specific transcriptional regulation that reflects the common origin of these cell types.

Proteolytic inactivation of ADAMTS13 by thrombin and plasmin.

The multimeric size and the function of circulating von Willebrand factor are modulated via its proteolytic cleavage by the plasma metalloproteinase, ADAMTS13. It is unclear how ADAMTS13 activity is regulated within the vascular system. In the absence of a regulatory mechanism, ADAMTS13 activity might compromise platelet adhesion at sites of vascular injury. We hypothesized that at sites of vascular injury, ADAMTS13 activity could be regulated locally by coagulation proteinases. Initiation of coagulation in human plasma resulted in the disappearance of added full-length recombinant ADAMTS13. This loss was inhibited by hirudin. Using purified proteins, we showed that ADAMTS13 is proteolyzed at several cleavage sites by thrombin in a time- and concentration-dependent manner. Furthermore, this proteolysis ablated ADAMTS13 activity against purified von Willebrand factor. Preincubation of thrombin with soluble thrombomodulin, but not heparin, inhibited the proteolysis of ADAMTS13, suggesting the involvement of thrombin exosite I (and not exosite II) in ADAMTS13 recognition. Plasmin also cleaved ADAMTS13 into similar fragments, resulting in the loss of ADAMTS13 activity. This study demonstrates the susceptibility of ADAMTS13 to proteolytic inactivation and suggests possible roles for thrombin and plasmin at sites of vascular injury.

Haemostatic gene polymorphisms in venous and arterial thrombosis.

Haemostatic gene polymorphisms are potential risk factors for thrombosis. Considerable attention has been focussed on identifying risk alleles. Progress has undoubtedly been made in venous thrombosis. Factor V Leiden and the prothrombin G20210A substitution are now established risk factors, and a number of other polymorphisms are candidates. The initial promise that genetic risk factors might contribute appreciably to an explanation of the development of arterial thrombotic disorders has largely been unfulfilled and the expectations raised by early reports of positive associations have been tempered by inconsistent results with almost all genes studied. The problems seen in arterial disease are replicated in investigations of other complex diseases. In the optimistic rush to show positive associations of genetic factors with diseases, sight has been lost of the need for stringent study design. Furthermore, the scale of studies needed to produce reproducible conclusions has been underestimated. The lessons learnt from accumulated experience should now enable progress to be made.