Factor VIII (FVIII) plays a critical role in blood coagulation by forming the tenase complex with factor IXa and calcium ions on a membrane surface containing negatively charged phospholipids. The tenase complex activates factor X during blood coagulation.
Blood coagulation factor VIII (FVIII)2 is synthesized as a single polypeptide chain, including a 19-residue signal peptide.The mature FVIII contains 2,332 amino acid residues arranged within five domains organized as A1-A2-B-A3-C1-C2 (1, 2). FVIII circulates in the blood as a heterodimer: the A1, A2, and variable portions of the B domain forming the heavy chain with a molecular weight varying between 90,000 and 200,000; and the A3, C1 and C2 domains forming the light chain with a molecular weight of 80,000. The noncovalent assembly of the heterodimer is facilitated by divalent metal ions, as revealed by recent crystallographic studies (3, 4). In plasma, FVIII circulates as a complex with von Willebrand factor which stabilizes FVIII by preventing its rapid clearance from the blood circulation (5). During blood coagulation, FVIII is cleaved by thrombin at Arg 372 , Arg 740 , and Arg 1689 (6), which converts it to a fully active cofactor, FVIIIa. FVIIIa dissociates from von Willebrand factor and binds to membrane surfaces where it assembles with the serine protease factor IXa. The presence of FVIIIa enhances the V max for factor X activation by FIXa by 200,000-fold (7). This large amplification requires that the FVIII level in blood be controlled. Mutations of FVIII cause hemophilia A, an X-linked bleeding disorder (8). The molecular mechanisms of FVIII binding to membranes are not fully understood.Several lines of evidence suggest that the light chain of FVIII, in particular the C2 domain, is responsible for the specific binding to membrane surfaces (9, 10). A 1.5-Å x-ray crystal structure of the FVIII C2 domain and a mutagenesis study suggested that two hydrophobic loops formed by Met 2199 -Phe 2200 and Leu 2251 -Leu 2255 play an important role (11,12). Two additional loops formed by Trp 2313 -His 2315 and Gln 2222 -Lys 2227 ) were also proposed to be involved in membrane binding based on an electron microscopy study (13).C2 domain membrane-binding sites were proposed as a drug target to regulate the functional concentrations of coagulation factors, FVIII and FV, that contain a C2 domain (14). A number of small organic molecules were identified that disrupt C2 domain membrane anchoring of FVIII (14) and FV (15). One of these inhibitors, 005B10, identified from in silico screening, was found to inhibit FVIII interaction with negatively charged phospholipids (15). In this study, we report the high resolution crystal structure (1.15 Å) of the human FVIII C2 domain in * This work was supported, in whole or in part, by National Institutes of Health Grant HL086584. This work was also supported by grants from the Natural Science Foundation of China (30811130467 and 30625011), the Ministry of Science and Technology (2006AA02A313 and 2007CB914304), the Chinese Academy ...