Cell surface-dependent generation of angiostatin4.5.

Angiostatin4.5 (AS4.5) is a naturally occurring human angiostatin isoform, consisting of plasminogen kringles 1-4 plus 85% of kringle 5 (amino acids Lys78 to Arg529). Prior studies indicate that plasminogen is converted to AS4.5 in a two-step reaction. First, plasminogen is activated to plasmin. Then plasmin undergoes autoproteolysis within the inner loop of kringle 5, which can be induced by a free sulfhydryl donor or an alkaline pH. We now demonstrate that plasminogen can be converted to AS4.5 in a cell membrane-dependent reaction. Actin was shown previously to be a surface receptor for plasmin(ogen). We now show that beta-actin is present on the extracellular membranes of cancer cells (PC-3, HT1080, and MDA-MB231), and beta-actin can mediate plasmin binding to the cell surface and autoproteolysis to AS4.5. In the presence of beta-actin, no small molecule-free sulfhydryl donor is needed for generation of AS4.5. Antibodies to actin reduced membrane-dependent generation of AS4.5 by 70%. In a cell-free system, addition of actin to in vitro-generated plasmin resulted in stoichiometric conversion to AS4.5. Annexin II and alpha-enolase have been reported to be plasminogen receptors, but we did not demonstrate a role for these proteins in conversion of plasminogen to AS4.5. Our data indicate that membrane-associated beta-actin, documented previously as a plasminogen receptor, is a key cell membrane receptor capable of mediating conversion of plasmin to AS4.5. This conversion may serve an important role in regulating tumor angiogenesis, invasion, and metastasis, and surface beta-actin may also serve as a prognostic marker to predict tumor behavior.

Haemostasis and Thrombosis: Current Clinical Practice: Current Management of Thrombotic Thrombocytopenic Purpura.

Historically, the mortality rate of thrombotic thrombocytopenic purpura (TTP) approached 100%. However, by the 1980's, new therapy was instituted with a vast improvement in survival to 90%. The exact pathogenesis of TTP remains elusive. Yet, despite incomplete understanding of the pathophysiology, outcome has improved due to increased awareness of the symptomatology leading to earlier diagnosis and better supportive care, in addition to effective therapy with plasma exchange. TTP represents a disease in which prompt diagnosis and treatment can lead to a critical difference in clinical outcome.