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2017 ; 16
(ä): 302-311
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Neutrophil Protease Cleavage of Von Willebrand Factor in Glomeruli - An
Anti-thrombotic Mechanism in the Kidney
#MMPMID28139439
Tati R
; Kristoffersson AC
; Manea Hedström M
; Mörgelin M
; Wieslander J
; van Kooten C
; Karpman D
EBioMedicine
2017[Feb]; 16
(ä): 302-311
PMID28139439
show ga
Adequate cleavage of von Willebrand factor (VWF) prevents formation of thrombi.
ADAMTS13 is the main VWF-cleaving protease and its deficiency results in
development of thrombotic microangiopathy. Besides ADAMTS13 other proteases may
also possess VWF-cleaving activity, but their physiological importance in
preventing thrombus formation is unknown. This study investigated if, and which,
proteases could cleave VWF in the glomerulus. The content of the glomerular
basement membrane (GBM) was studied as a reflection of processes occurring in the
subendothelial glomerular space. VWF was incubated with human GBMs and VWF
cleavage was assessed by multimer structure analysis, immunoblotting and mass
spectrometry. VWF was cleaved into the smallest multimers by the GBM, which
contained ADAMTS13 as well as neutrophil proteases, elastase, proteinase 3 (PR3),
cathepsin-G and matrix-metalloproteinase 9. The most potent components of the GBM
capable of VWF cleavage were in the serine protease or metalloprotease category,
but not ADAMTS13. Neutralization of neutrophil serine proteases inhibited
GBM-mediated VWF-cleaving activity, demonstrating a marked contribution of
elastase and/or PR3. VWF-platelet strings formed on the surface of primary
glomerular endothelial cells, in a perfusion system, were cleaved by both
elastase and the GBM, a process blocked by elastase inhibitor. Ultramorphological
studies of the human kidney demonstrated neutrophils releasing elastase into the
GBM. Neutrophil proteases may contribute to VWF cleavage within the
subendothelium, adjacent to the GBM, and thus regulate thrombus size. This
anti-thrombotic mechanism would protect the normal kidney during inflammation and
could also explain why most patients with ADAMTS13 deficiency do not develop
severe kidney failure.