The anticoagulant vitamin K-dependent protein S (PS) circulates in plasma in two forms, 30% free and 70% being bound to the complement regulatory protein C4b-binding protein (C4BP). The major C4BP isoform consists of 7 ␣-chains and 1 -chain (C4BP ؉ ), the chains being linked by disulfide bridges.PS binds to the -chain with high affinity. In plasma, PS is in molar excess over C4BP ؉ and due to the high affinity, all C4BP ؉ molecules contain a bound PS. Taken together with the observation that PS-deficient patients have decreased levels of C4BP ؉ , this raises the question of whether PS is important for secretion of the -chain from the cell. To test this hypothesis, HEK293 cells were stably and transiently transfected with -chain cDNA in combinations with cDNAs for PS and/or the ␣-chain. The concentration of -chains in the medium increased after co-transfection with PS cDNA, but not by ␣-chain cDNA, suggesting secretion of the -chains from the cells to be dependent on concomitant synthesis of PS, but not of the ␣-chains. Thus, -chains that were not disulfide-linked to the ␣-chains were secreted in complex with PS, either as monomers or dimers. Pulse-chase demonstrated that the complexes between PS and -chain were formed intracellularly, in the endoplasmic reticulum. In conclusion, our results demonstrate that successful secretion of -chains depends on intracellular complex formation with PS, but not on the ␣-chains. This provides an explanation for the decreased -chain levels observed in PS-deficient patients.
Protein S (PS)2 is an anticoagulant vitamin K-dependent protein functioning as a cofactor to activated protein C in the degradation of coagulation factors Va and VIIIa (1). Recent studies have also identified PS as a cofactor to tissue factor pathway inhibitor (2, 3). Tissue factor pathway inhibitor regulates the tissue factor-dependent initial step of coagulation by inactivating coagulation factors VIIa and Xa. In human plasma, 60 -70% of PS circulates bound to the complement regulator C4b-binding protein (C4BP) (4), and this fraction has impaired anticoagulant functions (5). PS is a 635-amino-acid-long single chain molecule with several distinct domains. The N-terminal Gla domain is followed by a thrombin-sensitive region, four epidermal growth factor (EGF)-like domains, and the large C-terminal sex hormone-binding globulin (SHBG)-like region, which comprises two laminin G-type domains. The binding site in PS for C4BP is located in the SHBG region of PS, and both laminin G domains are required (6). The binding site in PS has not been narrowed down further, even though there are several studies suggesting different regions of the SHBG domain to be of importance (7,8).C4BP acts as a cofactor for the down-regulation of the complement cascade and shares structural features with several other proteins participating in this system. It is composed of multiple disulfide-linked subunits (␣-and -chains), each containing repeats of complement control protein (CCP) domains (9). There are several isoform...