Thromb Haemost 2003; 90(02): 293-298
DOI: 10.1160/TH02-12-0323
Platelets and Blood Cells
Schattauer GmbH

Intracellular activation of the fibrinolytic cascade in the Quebec Platelet Disorder

Prameet M. Sheth
,
Walter H. A. Kahr
1   Departments of Pathology and Molecular Medicine and Medicine, McMaster University, Hamilton, Ontario, Canada and the Departments of Hematology/Oncology, Hôpital Sainte Justine, Montreal, Quebec, Canada
,
Anwar M. Haq
1   Departments of Pathology and Molecular Medicine and Medicine, McMaster University, Hamilton, Ontario, Canada and the Departments of Hematology/Oncology, Hôpital Sainte Justine, Montreal, Quebec, Canada
,
Dragoslava Kika Veljkovic
1   Departments of Pathology and Molecular Medicine and Medicine, McMaster University, Hamilton, Ontario, Canada and the Departments of Hematology/Oncology, Hôpital Sainte Justine, Montreal, Quebec, Canada
,
Georges E. Rivard
1   Departments of Pathology and Molecular Medicine and Medicine, McMaster University, Hamilton, Ontario, Canada and the Departments of Hematology/Oncology, Hôpital Sainte Justine, Montreal, Quebec, Canada
,
Catherine P. M. Hayward
1   Departments of Pathology and Molecular Medicine and Medicine, McMaster University, Hamilton, Ontario, Canada and the Departments of Hematology/Oncology, Hôpital Sainte Justine, Montreal, Quebec, Canada
› Author Affiliations
Financial support: Supported by grant NA 4379 from the Heart and Stroke Foundation of Ontario (C.P.M.H) and a grant from Bayer Canada (G.E.R.)
Further Information

Publication History

Received 23 December 2002

Accepted after resubmission 07 April 2003

Publication Date:
06 December 2017 (online)

Summary

The Quebec Platelet Disorder (QPD) is an unusual bleeding disorder associated with increased platelet stores of urokinase-type plasminogen activator (u-PA) and proteolysis of platelet α–granule proteins. The increased u-PA and proteolyzed plasmino-gen in QPD platelets led us to investigate possible contributions of intracellular plasmin generation to QPD α-granule proteolysis. ELISA indicated there were normal amounts of plasminogen and plasmin-α2-antiplasmin (PAP) complexes in QPD plasmas. Like normal platelets, QPD platelets contained only a small proportion of the blood plasminogen, however, they contained an increased amount of PAP complexes compared to normal platelets (P < 0.005). The quantities of plasminogen stored in platelets were important to induce QPD-like proteolysis of normal α-granule proteins by two chain u-PA (tcu-PA) in vitro. Moreover, adding supplemental plasminogen to QPD, but not to control, platelet lysates, triggered further α-granule protein proteolysis to forms that comigrated with plasmin degraded proteins. These data suggest the generation of increased but limiting amounts of plasmin within platelets is involved in producing the unique phenotypic changes to α-granule proteins in QPD platelets. The QPD is the only known bleeding disorder associated with chronic, intracellular activation of the fibrinolytic cascade.

 
  • References

  • 1 Francis CW, Marder VJ. Physiologic regulation and pathologic disorders of fibrinolysis. In Coleman RW, Hirsh J, Marder VJ, Clowes AW, George JN. eds Hemostasis and Thrombosis: Basic Principles and Clinical Practice. Philadelphia, Baltimore, New York, London, Buenos Aires, Hong Kong, Sydney, Tokyo: Lippincott Williams and Wilkins; 2001: 975-1002.
  • 2 Bachmann F. Plasminogen-plasmin enzyme system. In: Coleman RW, Hirsh J, Marder VJ, Clowes AW, George JN, eds. Hemostasis and Thrombosis : Basic Principles and Clinical Practice. Philadelphia, Baltimore, New York, London, Buenos Aires, Hong Kong, Sydney, Tokyo: Lippincott Williams and Wilkins; 2001: 275-320.
  • 3 Feinstein DJ, Marder VJ, Coleman RW. Consumptive thrombohemorrhagic disorders. In: Coleman RW, Hirsh J, Marder VJ, Clowes AW, George JN, eds. Thrombosis and Hemostasis: Basic Principles and Clinical Practices. Philadelphia, Baltimore, New York, London, Buenos Aires, Hong Kong, Sydney, Tokyo: Lippincott Williams & Wilkins; 2001: 1197-233.
  • 4 Drew AF, Kaufman AH, Kombrinck KW. et al. Ligneous conjunctivitis in plasminogen-deficient mice. Blood 1998; 91: 1616-24.
  • 5 Henkin J, Marcotte P, Yang H. The plasmino-gen-plasmin system. Progress in Cardiovascular Diseases 1991; 44: 135-64.
  • 6 Hayward CPM, Welch B, Bouchard M, Zheng S, Rivard GE. Fibrinogen degradation products in patients with the Quebec platelet disorder. Br J Haematol 1997; 97: 497-503.
  • 7 Hayward CPM, Rivard GE, Kane WH. et al. An autosomal dominant, qualitative platelet disorder associated with multimerin deficiency, abnormalities in platelet factor V, thrombospondin, von Willebrand factor, and fibrinogen and an epinephrine aggregation defect. Blood 1996; 87: 4967-78.
  • 8 Kahr WHA, Zheng S, Sheth PM. et al. Platelets from patients with the Quebec platelet disorder contain and secrete abnormal amounts of urokinase-type plasminogen activator. Blood 2001; 98: 257-65.
  • 9 Tracy PB, Giles AR, Mann KG, Eide LL, Hoogendorn H, Rivard GE. Factor V (Quebec): a bleeding diathesis associated with a qualitative platelet factor V deficiency. J Clin Invest 1984; 74: 1221-8.
  • 10 Hayward CPM, Cramer EM, Kane WH. et al. Studies of a second family with the Quebec platelet disorder: evidence that the degradation of the alpha-granule membrane and its soluble contents are not secondary to a defect in targeting proteins to alphagranules. Blood 1997; 89: 1243-53.
  • 11 Janeway CM, Rivard GE, Tracy PB, Mann KG. Factor V Quebec revisited. Blood 1996; 87: 3571-8.
  • 12 Hayward CPM, Weiss HJ, Lages B. et al. The storage defects in grey platelet syndrome and alpha delta-storage pool deficiency affect alpha-granule factor V and multimerin storage without altering their proteolytic processing. Br J Haematol 2001; 113: 871-7.
  • 13 Weiss HJ, Lages B, Zheng S, Hayward CPM. Platelet factor V New York: a defect in factor V distinct from that in factor V Quebec resulting in impaired prothrombinase generation. Am J Hematol 2001; 66: 130-9.
  • 14 Hayward CPM. Inherited disorders of platelet α–granules. Platelets 1997; 8: 197-209.
  • 15 Moroi M, Aoki N. Isolation and characterization of α2-plasmin inhibitor from human plasma. J Biol Chem 1976; 251: 5956-65.
  • 16 Holvoet P, Boer AD, Verstreken M, Collen D. An enzyme-linked immunosorbent assay (ELISA) for the measurement of plasmin-α2-antiplasmin complex in human plasma-application to the detection of in vivo activation of the fibrinolytic system. Thromb Hemost 1986; 56: 124-7.
  • 17 Marder VJ, Shulman NR, Caroll QR. High molecular weight derivatives of human fibrinogen produced by plasmin. I. physiochemical and immunological characterization. J Biol Chem 1969; 244: 2111-9.
  • 18 Bonnefoy A, Legrand C. Proteolysis of subendothelial adhesive glycoproteins (fibronectin, thrombospondin, and von Willebrand factor) by plasmin, leukocyte cathepsin G, and elastase. Thromb Res 2000; 98: 323-32.
  • 19 Hamilton KK, Fretto LJ, Grierson DS, McKee PA. Effects of plasmin on von Willebrand factor multimers. Degradation in vitro and stimulation of release in vivo. J Clin Invest 1985; 76: 261-70.
  • 20 Lee CD, Mann KG. Activation/inactivation of human factor V by plasmin. Blood 1989; 73: 185-90.
  • 21 Weitz JI, Leslie B. Urokinase has direct catalytic activity against fibrinogen and renders it less clottable by thrombin. J Clin Invest 1990; 86: 203-12.
  • 22 Amiral J, Brosley M, Mimilla F, Plassart V, Chambrette B. Monoclonal antibodies to different neo-epitopes on fibrinogen and fibrin degradation products. Blood Coagul Fibrinolysis 1990; 1: 447-52.
  • 23 Carmeliet PF. Physiological consequences of over- or under-expression of fibrinolytic system components in transgenic mice. Baillieres Clin Haematol 1995; 8: 391-401.
  • 24 Weitz JI, Hirsh J. New antithrombotic drugs. In: Coleman RW, Hirsh J, Marder VJ, Clowes AW, George JN, eds. Hemostasis and Thrombosis: Basic Principles and Clinical Practice. Philadelphia, Baltimore, New York, London, Buenos Aires, Hong Kong, Sydney, Tokyo: Lippincott Williams and Wilkins; 2001: 1529-44.
  • 25 Plow EF, Collen D. The presence and release of alpha2-antiplasmin from human platelets. Blood 1981; 58: 1069-74.
  • 26 Booth NA, Simpson AJ, Croll A, Bennett B, MacGregor IR. Plasminogen activator inhibitor (PAI-1) in plasma and platelets. Br J Haematol 1988; 70: 327-33.
  • 27 Nachman RL, Harpel PC. Platel et al pha2-macroglobulin and alpha1-antitrypsin. J Biol Chem 1976; 251: 4512-21.
  • 28 Harrison P, Savidge GF, Cramer EM. The origin and physiological relevance of alpha-granule adhesive proteins. Br J Haematol 1990; 74: 125-30.
  • 29 Louache F, Debili N, Cramer EM. Fibrinogen is not synthesized by human megakaryocytes. Blood 1991; 77: 311-6.
  • 30 Harrison P, Wilbourn B, Debili N. et al. Uptake of plasma fibrinogen into the alpha granules of human megakaryocytes and platelets. J Clin Invest 1989; 84: 1320-4.
  • 31 Heckel JL, Sandgren EP, Degen JL, Palmiter RD, Brinster RL. Neonatal bleeding in transgenic mice expressing urokinase-type plasminogen activator. Cell 1990; 62: 447-56.