Background: Factor XIII (FXIII), a plasma pro-transglutaminase, consists of two A subunits and two B subunits (FXIIIA2B2). Following activation by thrombin, it cross-links fibrin chains at the final step of coagulation. We previously reported that FXIII subunit A (FXIIIA) serves as a protein disulfide isomerase (PDI), and that PDI promotes platelet adhesion and aggregation. Objective: This study sought to examine possible mechanistic effect of FXIII on platelet adhesion to fibrinogen; specifically, the role of its PDI activity. Methods: Ex vivo experiments: Blood platelets derived from five patients with hereditary FXIIIA deficiency before and after treatment with Fibrogammin-P (FXIIIA2B2 concentrate) were washed and incubated on immobilized fibrinogen. Bound platelets were stained and counted by microscopy. In vitro experiments: Platelets derived from patients before treatment and five healthy controls were washed and analyzed for adhesion in the presence or absence of Fibrogammin-P or recombinant FXIII (FXIIIA2 concentrate). Results: In ex vivo experiments, one hour after Fibrogammin-P treatment, mean (±SEM) platelet adhesion to fibrinogen increased by 27±2.32% (pb 0.001). In in vitro experiments, treatment with Fibrogammin-P or recombinant FXIII (10 IU/mL each) enhanced platelet adhesion to fibrinogen (in patients, by 29.95±6.7% and 29.05±5.3%, respectively; in controls, by 26.06±3.24% and 26.91±4.72, respectively; pb 0.04 for all). Iodoacetamide-treated FXIII (I-FXIII), where transglutaminase activity is blocked, showed similar enhanced adhesion as untreated FXIII. By contrast, addition of an antibody that specifically blocks FXIIIA-PDI activity inhibited FXIII-mediated platelet adhesion to fibrinogen by 65%. Conclusion: These findings indicate that FXIII-induced enhancement of platelet adhesion is mediated by FXIII-PDI activity.© 2012 Elsevier Ltd. All rights reserved.
IntroductionCoagulation factor XIII (FXIII) is a plasma pro-transglutaminase. Following activation by thrombin, it cross-links fibrin chains at the final step of coagulation to form a soluble clot [1]. FXIII circulates in plasma as a heterotetramer of two A subunits (FXIIIA2 -the active transglutaminase) and two B subunits (FXIIIB2 -the carrier protein) [1]. Besides its role in hemostasis, FXIII accelerates wound healing [2], probably by its pro-angiogenic effects [3] as well as by stimulation of monocytes and fibroblasts [4]. Several new lines of evidence point to the involvement of FXIII in platelet function as well [5][6][7][8]. FXIII subunit A (FXIIIA) was detected on thrombin-receptor-activated platelets [5], and platelets were found to adhere to FXIII-covered surface [6]; this interaction depended on the intact fibrinogen binding to integrin αIIbβ3 [5,6]. Accordingly, no clot retraction was noted in FXIIIA knock-out mice [7], and patients with FXIII deficiency, a rare hereditary life-long bleeding disorder [8], showed reduced fibrinogen binding to thrombin-stimulated platelets and reduced platelet adhesion to fibrinogen-covered surface ...