IntroductionSeptic shock syndrome resulting from excessive host immune responses induced by infectious organisms is a leading cause of death in hospitalized patients. [1][2][3] Pathophysiologic changes in sepsis involve the pathogen-induced uncontrolled release from immune cells, particularly monocytes and macrophages, of proinflammatory mediators. 4 Gram-negative bacterial infection is one of the major causes of systemic bacterial sepsis. 5 Lipopolysaccharide (LPS), a constituent of the Gram-negative outer membrane, is the leading cause of sepsis. LPS induces a rapid increase of proinflammatory mediators, leading to lethal systemic tissue damage and multiple organ failure, which mimics the inflammatory responses of septic syndrome. 6 In mammals, membrane-bound CD14 and toll-like receptor 4 (TLR4)-MD-2 participate in cellular recognition of LPS. 7 Binding of LPS to TLR4 triggers the activation of members of the mitogen-activated protein kinase (MAPK) pathway including p38, p42/p44 extracellular signal-regulated kinase (ERK1/2), and c-Jun N-terminal kinase (JNK). 8 In resting unstimulated cells, nuclear factor-B (NF-B), a heterodimeric complex composed of 50-and 65-kDa (p50/p65) protein subunits, 9 retains as an inactive complex bound to inhibitory B␣ (IB␣) in the cytoplasm. While the cells are under proinflammatory stimulation by LPS, phosphorylation and degradation of IB␣ permit NF-B nuclear translocation and promote the expression of inflammatory genes including inducible nitric oxide synthase (iNOS), tumor necrosis factor-␣ (TNF-␣), and others. 9Thrombomodulin (TM) is a 557 amino acid type I glycosylated transmembrane protein 10 with an NH 2 -terminal lectinlike region (domain 1; D1) followed by 6 epidermal growth factor (EGF)-like structures (domain 2; D2), an O-glycosylation site-rich domain (domain 3; D3), a transmembrane domain (domain 4; D4), and a cytoplasmic tail domain (domain 5; D5). TM domain 2 (TMD2) EGF-like structures are responsible for the anticoagulant activity of TM via the alteration of thrombin substrate specificity. TMD2-thrombin complex sequentially activates anticoagulant protein C inactivating procoagulant cofactors Va and VIIIa. 11 TM expression also occurs in keratinocytes, 12 polymorphonuclear neutrophils (PMNs), 13 monocytes, 14 and endothelial cells, 15 indicating additional functions of TM besides anticoagulation. 16 Indeed TM domains function as an adhesion molecule, 17 an angiogenic factor, 18 and an anti-inflammatory agent through protein C-dependent and -independent mechanisms. 16,19 Recently, anti-inflammatory activity of TM domain 1 (TMD1) was implied by observing that mice with a deleted TM lectinlike domain (TM LeD/LeD ) become more sensitive to LPS challenge through the suppressed expression of adhesion molecules via NFB and MAPK signaling pathways. 20 Moreover, mice with a mutation in the TM gene (TM pro/pro ) strongly reduce the capacity to generate activated protein C, an anti-inflammatory agent in treatment of sepsis. 21 Mice harboring the latter mutation display an u...

Several peptide fragments of streptokinase (SK) were prepared by incubating SK with immobilized human plasmin (hPlm) and purified by h.p.l.c. with a reverse-phase phenyl column. The N-terminal sequences, amino acid compositions and molecular masses of these peptide fragments were determined. The SK peptide fragment of 36 kDa consisting of Ser60-Lys387 (SK-p), was the only peptide fragment that could be tightly bound to immobilized hPlm. Another three large SK peptide fragments, SK-m, SK-n and SK-o, with molecular masses of 7 kDa, 18 kDa and 30 kDa, and consisting of Ile1-Lys59, Glu148-Lys333, Ser60-Lys333 respectively, were also obtained from the supernatant of the reaction mixture. The purified SK-p had high affinity with hPlm and could activate human plasminogen (hPlg) with a kPlg one-sixth that of the native SK. SK-o had low affinity with hPlm and could also activate hPlg, although the catalytic constant was less than 1% of the native SK. SK-n, as well as SK-m, which is the N-terminal 59 amino acid peptide of the native SK, had no activator activity. However, SK-m could enhance the activator activity of both SK-o and SK-p and increase their second-order rate constants by two- and six-fold respectively. It was concluded from these studies that (1) SK-o, the Ser60-Lys333 peptide of SK, was essential for minimal SK activator activity, (2) the C-terminal peptide of SK-p, Ala334-Lys387, was essential for high affinity with hPlm, and (3) the N-terminal 59-amino-acid peptide was important in maintaining the proper conformation of SK to have its full activator activity.

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SUMMARYBoth mice and rabbits immunized with dengue virus E protein peptide spanning amino acids 100-119 (D4E) produced antibodies that reacted not only with the D4E peptide itself but also with human plasminogen, as shown by ELISA and Western blot. Sera from dengue virus-hyperimmunized mice and dengue patients also contained antibodies against D4E and plasminogen. Furthermore, such sera all contained plasmin inhibitory activity. Using affinity-purified anti-D4E antibodies and free D4E peptide for competitive inhibition, we demonstrated that the inhibition of plasmin activity was due to anti-D4E antibodies rather than other substances in the sera. Taken together, these results suggest dengue virus E protein amino acids 100-119 are a cross-reactive immunogenic region, and antibodies against this region may interfere with human fibrinolysis.

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