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2018 ; 115
(5
): E982-E991
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PAR1 agonists stimulate APC-like endothelial cytoprotection and confer resistance
to thromboinflammatory injury
#MMPMID29343648
De Ceunynck K
; Peters CG
; Jain A
; Higgins SJ
; Aisiku O
; Fitch-Tewfik JL
; Chaudhry SA
; Dockendorff C
; Parikh SM
; Ingber DE
; Flaumenhaft R
Proc Natl Acad Sci U S A
2018[Jan]; 115
(5
): E982-E991
PMID29343648
show ga
Stimulation of protease-activated receptor 1 (PAR1) on endothelium by activated
protein C (APC) is protective in several animal models of disease, and APC has
been used clinically in severe sepsis and wound healing. Clinical use of APC,
however, is limited by its immunogenicity and its anticoagulant activity. We show
that a class of small molecules termed "parmodulins" that act at the cytosolic
face of PAR1 stimulates APC-like cytoprotective signaling in endothelium.
Parmodulins block thrombin generation in response to inflammatory mediators and
inhibit platelet accumulation on endothelium cultured under flow. Evaluation of
the antithrombotic mechanism showed that parmodulins induce cytoprotective
signaling through G??, activating a PI3K/Akt pathway and eliciting a genetic
program that includes suppression of NF-?B-mediated transcriptional activation
and up-regulation of select cytoprotective transcripts. STC1 is among the
up-regulated transcripts, and knockdown of stanniocalin-1 blocks the protective
effects of both parmodulins and APC. Induction of this signaling pathway in vivo
protects against thromboinflammatory injury in blood vessels. Small-molecule
activation of endothelial cytoprotection through PAR1 represents an approach for
treatment of thromboinflammatory disease and provides proof-of-principle for the
strategy of targeting the cytoplasmic surface of GPCRs to achieve pathway
selective signaling.