Increase in platelet non-integrin type I collagen receptor in patients with systemic sclerosis

Microvascular injury is one of the major pathogenetic processes involved in systemic sclerosis (SSc). Interaction of the platelet types I and III collagen receptors with their respective ligand in the exposed subendothelial stroma as a result of ongoing microvascular injury in SSc patients results in platelet activation and aggregation with the release of mediators, which contribute to vascular damage and inflammation. We have found that there is a twofold increase in radiolabeled type I collagen binding to washed platelets from patients with SSc compared to platelets obtained from normal volunteers. Western blot analyses showed that the non-integrin platelet type I collagen receptor protein (65 kDa) is increased dramatically in lysates of platelet from patients with SSc. However, the integrin (alpha(2)beta(1)) and other non-integrin receptors such as glycoprotein VI, glycoprotein IV, and the platelet receptor for type III collagen remain unchanged. In addition, platelet lysates from rheumatic disease controls (rheumatoid arthritis, osteoarthritis, gout, and systemic lupus erythematosus) do not show any significant increases. There is no nitrotyrosylation on 65 kDa in patients with SSc compared to controls, suggesting this might also contribute to binding of CI to the 65-kDa CIR. These results suggest that there is a specific increase in the number of platelet type I collagen receptors in SSc patient's platelets. In addition, the activity of nitric oxide synthase is decreased in patients' platelet lysates compared to controls. The increase in platelet expression of the 65-kDa non-integrin platelet type I collagen receptor may explain the enhanced aggregation of platelets from patients with SSc to CI in vitro and microvascular thrombosis in the disease in vivo.     

Different role of platelet glycoprotein GP Ia/IIa in platelet contact and activation induced by type I and type III collagens

The role of glycoprotein Ia/IIa was studied during platelet contact and aggregation induced by type I and type III collagen. The anti-glycoprotein Ia/IIa (6F1) antibody inhibited type I collagen-induced aggregation but did not inhibit the first contact between platelets and collagen. In contrast, it was without effect either on type III collagen-induced contact or platelet interaction with the subendothelium in a static assay. Platelet aggregation induced by type III collagen was only slightly slowed down by 6F1 but pp72 spleen tyrosine kinase phosphorylation was not modified even at concentrations of 6F1 that completely blocked platelet activation induced by type I collagen. Our results indicate that glycoprotein Ia/IIa is not a primary binding site for type I or type III collagen on the platelet membrane. This receptor is more specifically involved in type I collagen-induced platelet spreading and aggregation.     

Type III collagen and probably not type I collagen aggregates platelets

Type I collagen and type III collagen were extracted from foetal calf skin and used for inducing platelets aggregation $\text{in vitro}$. When added under its soluble form, type III collagen was found to be a faster and a most powerful platelet aggregating factor. Upon titration of its aggregating property by progressive dilution, it kept this property at a concentration over 50 times lower than type I collagen. Addition of the first inactive dilution of type III collagen to the first inactive dilution of type I collagen restored activity suggesting that type III collagen also present in very small concentration in the type I preparation is the only active type of molecule inducing platelet aggregation.     

Platelet interaction with vessel wall and collagen in pigs with homozygous von Willebrand's disease associated with abnormal collagen aggregation

A subgroup of pigs with von Willebrand's disease from the Mayo Clinic stock shows abnormal platelet aggregation in response to collagen [vWD-Homo(-)], in contrast to the normal aggregation responses observed in the main colony of pigs with homozygous vWD [vWD-Homo(+)]. This subgroup has been characterized at Mayo as a storage pool deficiency due to the reduced levels of ADP and Serotonin in the platelet dense granules. In the present studies, an ex-vivo perfusion chamber was utilized to investigate the deposition of 111In-labeled platelets on aortic subendothelium and collagen type I exposed to blood from vWD-Homo(-), vWD-Homo(+) and normal animals. Both non-anticoagulated and heparinized blood were exposed for wall shear rates ranging from 212 sec-1 to 3380 sec-1 and exposure times as long as 30 min. An enhanced decrease in platelet deposition in the vWD-Homo(-) animals was observed compared to vWD-Homo(+) animals. The decrease was observed primarily at the higher shear rates and was more pronounced in the absence of heparin and on the collagenous substrate. Thus, the abnormality in collagen-induced aggregation, which has been characterized as a storage-pool type defect, results in a decreased platelet deposition compared with that produced by severe vWD alone.     

Platelet interaction with collagen fibrils in flowing blood. I. Reaction of human platelets with alpha chymotrypsin-digested subendothelium

The subendothelial surface of rabbit aorta and alpha chymotrypsin-digested subendothelium were exposed to anticoagulated human blood in an annular flow chamber. The wall shear rate was similar to that observed in large arteries (830 sec-1) and exposure times varied from 2 1/2 to 40 min. The platelet reactive substrate of alpha chymotrypsin-digested subendothelium consists of a three-dimensional meshwork of collagen fibrils which form islands of variable size and height in a matrix of virtually unreactive elastin. Collagen-induced aggregation in the aggregometer was similar with or without prior alpha chymotrypsin-digestion of a highly dispersed preparation of fibrillar collagen. The rate of platelet adhesion was decreased on the fibrallar collagen of alpha chymotrypsin-digested subendothelium as compared to intact subendothelium. On the other hand the rate of aggregation was increased once platelets adhered to the fibrillar collagen. Mural thrombi (aggregates) disappeared on subendothelium whereas they grew progressively on the fibrillar collagen. Thus the fibrillar collagen of alpha chymotrypsin-digested subendothelium appears to be a more thrombogenic surface. It is suggested that physical (loose three-dimensional meshwork versus a comparatively solid surface) and/or chemical (number of platelet reactive sites per unit surface area) differences between the two surfaces may explain the platelet-surface-interaction patterns which are characteristic for each surface.     

The subendothelium of the HMEC-1 cell line supports thrombus formation in the absence of von Willebrand factor and collagen types I, III and VI

The macromolecular composition of the extracellular matrix (ECM) produced by the human microvascular endothelial cell line (HMEC-1) was determined by ELISA and its thrombogenicity was studied in blood perfusion assays. Results were compared with those obtained with the ECM produced by human umbilical vein endothelial cells (HUVEC). The HMEC-1's ECM contains collagen type IV, fibronectin, laminin and thrombospondin, but no detectable levels of collagen types I, III and VI, or von Willebrand factor (vWF), whereas all these components were found in the ECM synthesized by HUVEC. HMEC-1's ECM was perfused with low-molecular-weight heparin-anticoagulated blood at two wall shear rates (650/s and 2,600/s), representative of moderate and high arterial wall shear rates, in parallel plate flow chambers for 5 min. This resulted in the formation of large platelet aggregates, compared to essentially a monolayer of adherent platelets on HUVEC's ECM. Interestingly, large thrombi were formed at 2,600/s when HMEC-1's ECM was perfused with the blood of a patient with severe type III von Willebrand disease lacking both plasma and platelet vWF, indicating that vWF was not absolutely required for thrombus formation on this matrix. Thrombin generated on the HMEC-1's ECM contributed importantly to the large platelet thrombi formed, shown by performing blood perfusion experiments in the presence of thrombin inhibitors. Our results indicate that 1) platelet adhesion and aggregate formation on a subendothelium may occur at a high shear rate (2600/s) without the participation of collagen types I, III and VI, and vWF; and 2) the HMEC-1 cell line may prove useful for in vitro studies of the thrombogenic properties of microvascular subendothelium which in most cases does not contain fibrillar collagens and vWF.     

Platelet collagen receptors

Collagens are important platelet activators in the vascular subendothelium and vessel wall. Since the regulation of platelet activation is a key step in distinguishing normal haemostasis from pathological thrombosis, collagen interactions with platelets are important targets for pharmacological control. Platelets have two major receptors for collagens, the integrin alpha2beta1, with a major role in adhesion and platelet anchoring and the Ig superfamily member, GPVI, principally responsible for signalling and platelet activation. In addition, GPIb-V-IX, can be considered as an indirect collagen receptor acting via von Willebrand factor as bridging molecule and is essential for platelet interactions with collagen at high shear rates. There is some evidence for additional receptors, which may regulate the response to individual collagen types. This review discusses how these receptors work separately with specific agonists and proposes possible mechanisms for how they work together to regulate platelet activation by collagen, which remains controversial and poorly understood.     

Collagen-platelet interaction: Separate receptor sites for types I and III collagen

We have isolated a platelet membrane protein of M_r47 kDa which is responsible for the interaction of platelets with type III collagen. The 47 kDa protein was purified to apparent homogeneity by type III collagen-Sepharose 2B column chromatography and preparative slab gel electrophoreses. The 47 kDa protein blocked the adhesion of platelets to type III but not to type I collagen. Polyclonal antibodies were obtained from rabbits immunized with the purified 47 kDa protein emulsified in complete Freund's adjuvant. The polyclonal antibodies inhibited the type III collagen but not type I collagen-induced platelet aggregation. The inhibitory effect of the antibodies on type III collagen-induced platelet aggregation was dose-dependent. Cross-inhibition on platelet aggregation studies showed that type I collagen receptor antibodies (M_r65 kDa) did not inhibit type III collagen-induced platelet aggregation and type III collagen receptor antibodies did not inhibit type I collagen induced platelet aggregation. These results suggest that type I and type III collagens interact with platelets at separate sites.     

A monoclonal antibody to platelet type III collagen-binding protein (TIIICBP) binds to blood and vascular cells, and inhibits platelet vessel-wall interactions

TIIICBP is a new platelet receptor involved in platelet-type III collagen and platelet-subendothelium interactions. This receptor is composed of a doublet of 72-68 kDa proteins. In this study, the major protein (68 kDa) was purified and used to produce monoclonal antibodies. One of these antibodies, 7F4, binds to platelets as confirmed by flow cytometry. 7F4 inhibited platelet contact, spreading and aggregation induced by type III collagen. Under flow conditions, 7F4 prevented platelet interactions with type III collagen, endothelial cell matrix and the KOGEOGPK type II collagen octapeptide: the specific sequence recognized by TIIICBP. On the other hand, 7F4 had no effect on platelet-type I collagen interactions. TIIICBP was also detected on lymphocytes, granulocytes and monocytes. TIIICBP was expressed on endothelial cells and fibroblasts but not on smooth-muscle cells. These results show that TIIICBP is expressed on several cell types and participates in cell adhesion to the subendothelium.     

Platelet interaction with the extracellular matrix produced by cultured endothelial cells: A model to study the thrombogenicity of isolated subendothelial basal lamina

Cultured bovine endothelial cells produce an extensive underlying extracellular matrix (ECM) which closely resemble the vascular subendothelial basal lamina in its organization and chemical composition. This naturally produced ECM was used to study the interaction of platelets with the subendothelium when exposed or covered with vascular endothelial cells. Incubation of platelet rich plasma with the ECM induced a rapid and massive platelet adherence, aggregation, thromboxane formation and release reaction. These were demonstrated using phase and scanning electron microscopy, Indium-111 or (¹⁴C)-serotonin labelled platelets, and a radioimmunoassay for thromboxane B₂. In contrast to the ECM no platelet activation was induced either by uncoated plastic dishes or ECM covered with a confluent endothelial cell monolayer. Aspirinized platelets failed to undergo aggregation and degranulation, when incubated with the ECM. Culture dishes coated with characteristic constituents of the basal lamina such as collagen type IV and type V or fibronectin induced a much lower platelet reactivity as compared with ECM coated dishes. Digestion of ECM components (collagen, fibronectin, hyaluronic acid, and chondroitin sulphate) by specific enzymes was not associated with a substantial decrease in its platelet reactivity. Furthermore, exposure of ECM to sodium dodecyl sulphate or sodium periodate, or freezing and thawing did not decrease its biological activity. In contrast, platelet activation was completely abolished following heat denaturation or glutaraldehyde fixation of the ECM. The availability of a naturally produced ECM provides an appropriate model to study the interaction of platelets with the subendothelium in a controlled system which is isolated from other components of the vessel wall.     

Role of nitric oxide synthase in collagen-platelet interaction: involvement of platelet nonintegrin collagen receptor nitrotyrosylation

Platelets possess the endothelial isoform of nitric oxide synthase (eNOS), which plays an important role in platelet function. Other laboratories, including ours, have reported that nitric oxide (NO) is released upon exposure of platelets to collagen, but the mechanism of the interaction is not yet established. The objective of this study is to examine the possible role of nonintegrin receptor nitrotyrosylation on collagen-induced platelet aggregation. Results of the study show that two platelet proteins with M(r) of 65- and 23-kDa proteins are nitrotyrosylated in a time-dependent manner after the addition of type I collagen. The M(r) 65-kDa protein is identified as the platelet receptor for type I collagen. The recombinant protein of the platelet receptor for type I collagen can also be nitrotyrosylated. The nitrotyrosylated recombinant protein loses its ability to inhibit type I collagen-induced platelet aggregation. In addition, the polyclonal anti-65 kDa immunoprecipitates eNOS suggesting that the platelet nonintegrin receptor for type I collagen is closely linked to the eNOS. These results demonstrate that the inhibitory effect of NO on collagen-induced platelet aggregation may be mediated by the nitrotyrosylation of the 65-kDa receptor.     

SIN-1 partially and RGDS totally counteracts platelet aggregation as assessed in vitro by two independent whole blood methods

The cyclic GMP stimulant SIN-1 and the GP IIB/IIIA receptor antagonist RGDS were compared with regard to platelet antiaggregatory effects as measured in vitro by filtragometry and by whole blood aggregometry. In filtragometry platelet aggregation is measured as the time to partial occlusion of a filter in the test unit. β-thromboglobulin concentrations increased over the filter (p<0.002) indicating that in filtragometry part of the mechanism of aggregation could be platelet activation across the filter. In whole blood aggregometry platelet aggregation is induced by a chemical stimulant. As tested in blood from healthy volunteers, linear dose-effect relations were found with both methods, for SIN-1 in the 10⁻⁷–10⁻⁶ M range (p<0.02, filtragometry and p<0.05, whole blood aggregometry) and for RGDS in the 10⁻⁵–10⁻⁴ M range (p<0.0001, filtragometry and p<0.02, whole blood aggregometry). At the highest dose RGDS totally counteracted platelet aggregation in both test systems. Maximal SIN-1 platelet antiaggregatory effects were less (p<0.04, filtragometry and p<0.01, whole blood aggregometry) than for RGDS. SIN-1 concentrations in the 10⁻⁴ M range had no further antiaggregatory effects.

In conclusion, with two principally different methods for the assessment of whole blood platelet aggregation, SIN-1 was found to be a partial antagonist while RGDS a total antagonist.     

Type I and type III collagen-platelet interaction: inhibition by type specific receptor peptides

We have previously cloned and characterized a platelet receptor for type III collagen (47 kDa) from a human bone marrow cDNA phage library and defined two active peptides. We also cloned and characterized a platelet receptor for type I collagen (65 kDa) and defined an active peptide. Our objective was to study whether there is type specificity of these active peptides. We have engineered a mutant receptor clone by replacing one of the two active peptides of the platelet receptor for type III collagen with the active peptide of the platelet receptor for type I collagen. The replacement of an active peptide at the amino terminal end (rMIII) of the platelet receptor for type III collagen with the type I collagen active peptide was done without altering the hydrophilicity of the protein. This purified recombinant protein reacts with polyclonal anti-47-kDa and anti-65-kDa active peptide antibodies. The purified recombinant protein inhibits both types I and III collagen-induced platelet aggregation. This rMIII also inhibits the adhesion of washed platelets to rabbit aortic segments (natural matrix) in a dose-dependent manner. The chemically synthesized hybrid peptide of each active peptide of platelet type I and type III collagen receptors inhibits types I and III collagen-induced platelet aggregation in a dose-dependent manner. These results suggest that there is a type specific reactive site on platelets for type I and type III collagens.     

The platelet reactivity of collagen type I: evidence for multiple platelet-reactive sites in the type I collagen molecule

In this study, the ability of peptides, obtained by fragmentation of the collagen type I molecule, to induce platelet aggregation has been examined. In order to satisfy requirements for tertiary and quaternary structure, peptides were first renatured (where necessary) to restore triple-helical configuration and then polymerised. Fragmentation with mammalian collagenase indicated the presence of platelet-reactive sites in both the N-terminal three-quarter and C-terminal one quarter fragment of the collagen molecule. Cleavage with cyanogen bromide indicated the presence in the constituent alpha 1(I)-chain of at least four platelet-reactive sites. Our results suggest a relatively wide distribution of platelet-binding sites situated throughout the length of the collagen (type I) molecule, each probably of relatively low affinity and low structural specificity, at least in terms of amino acid sequence, and probably of a similar nature to those that might be expected to exist in any collagen-like species.     

Binding of collagen by canine blood platelets.

The binding of 125I-collagen (tropocollagen) by canine blood platelets occurred in a concentration-dependent manner but no saturation effect could be observed. The binding of collagen was not entirely specific for platelets since various eucaryotic and procaryotic cells quantitatively bound collagen as well or better. The temporal response to added collagen appeared to be binding, 3H-serotonin release, and finally platelet aggregation. Non-polymerizing salt-soluble tropocollagen was bound as well as acid-soluble tropocollagen, however neither 3H-serotonin release nor platelet aggregation occurred. Furthermore, the binding activity was not destroyed by treatment with collagenase, galactose oxidase and glucose oxidase, nor by periodate oxidation. Platelet aggregation closely paralleled acid soluble collagen polymerization and both events were equally inhibited by arginine; however, arginine did not interfere with collagen binding. Scanning electron microscopy revealed an unusual morphological platelet response to collagen and platelets appeared to be nucleation sites for collagen polymerization.     

Possible role of collagen in transverse myelitis and chymopapain-induced paraplegia

We studied the effect of nucleus pulposus (NP) on platelet aggregation. Our in vitro experiments showed that NP extract produced platelet aggregation and the addition of collagenase to the NP extract abolished this response. It was further shown that chymopapain did not affect the activity of the extract. We assume that collagen is the active platelet aggregant in the NP extract. Intravascular release of collagen may cause platelet aggregation, vascular obstruction, ischemia, and cord necrosis in a patient with acute transverse myelitis. Intradiskal chymopapain is known to cause transverse myelitis and it is possible that collagen released during the action of the enzyme initiates a similar chain of events.     

Role of the recombinant protein of the platelet receptor for type I collagen in the release of nitric oxide during platelet aggregation

Nitric oxide plays an important role in platelet function and platelets possess the endothelial isoform of nitric oxide synthase. Several reports have indicated that nitric oxide is released upon exposure of platelets to collagen. We have reported that a non-integrin platelet protein of 65 kDa is a receptor for type I collagen. By direct measurement of NO release from washed human platelets suspended in Tyrode buffer with a ISO-NO Mark II, World Precision Instruments, Sarasota, FL, USA, p30 sensor, type I collagen, but not ADP and epinephrine, induces the release of NO in a time-dependent manner. The production of NO is inhibited either by preincubation of type I collagen with the platelet type I collagen receptor recombinant protein or by preincubation of platelets with the antibody to the receptor protein, the anti-65 antibody. However, preincubation of platelets with anti-P-selectin and anti-glycoprotein IIb/IIIa did not affect the release of NO by platelets. These results suggest that the 65 kDa platelet receptor for type I collagen is specifically linked to the generation of NO, and that the 65 kDa platelet receptor for type I collagen plays an important new role in platelet function.     

Capillary changes in skeletal muscle of patients with Ullrich's disease with collagen VI deficiency

We examined the capillaries in muscle biopsy specimens from two patients with Ullrich's disease with collagen VI deficiency by light and electron microscopy. Collagen VI plays an important role in platelet aggregation for binding von Willebrand factor. Using immunohistochemistry, collagen VI was shown to be absent on capillaries from patients with Ullrich's disease, while von Willebrand factor, collagen IV, and vascular endothelial growth factor were normally expressed. Electron microscopy revealed narrow lumens, large nuclei in endothelial cells, and fenestration of a capillary. The number of pinocytotic vesicles per unit endothelial cytoplasm was increased. The cytoplasm of endothelial cells was strongly stained with uranyl acetate and lead citrate. Replication of the capillary basement membrane was observed. On the other hand, easy bleeding and coagulation were not observed in the two patients. These findings suggested that the collagen VI deficiency might have caused the electron microscopic changes of capillaries, while the function of the capillaries is apparently retained.     

Glycosaminoglycan inhibition of collagen induced platelet aggregation

Chondroitin 6-sulfate (Ch6-S), a glycosaminoglycan (GAG), has been shown to inhibit collagen fibrillogenesis and collagen induced platelet aggregation. Complexation of soluble microfibrillar collagen with Ch6-S at low pH followed by saline dialysis results in the stabilization of 300Å wide microfibrillar aggregates with no banding in the electron microscope. These structures, which may be intermediates in collagen fibrillogenesis, do not aggregate platelets or cause serotonin release, whereas fibrils formed from uncomplexed microfibrillar collagen induce platelet aggregation and serotonin release. Neutral complexation of microfibrillar collagen with Ch6-S does not inhibit fibril formation or platelet aggregation. Soluble Ch6-S does not interfere with platelet aggregation in response to soluble microfibrillar collagen, indicating that Ch6-S does not block sites on the platelet membrane or on collagen fibrils which may be specifically involved in the collagen-platelet interaction. These results imply that GAG complexes with collagen may be suitable as blood compatible materials.     

Altered expression of collagen type VI in brain vessels of patients with chronic hypertension

Summary The vascular extracellular matrix (ECM) plays an important role in the histopathology of cerebral microcirculation, but its characterization is still incomplete. For that reason we investigated paraffin-embedded and cryostat sections of intracerebral and meningeal vessels from eight normotensive and six hypertensive humans using monospecific affinity-purified polyclonal antibodies against human/monkey amino-terminal procollagen I+III peptide (P I P, P III P), collagen IV (7-S and NC1 domains), VI, and laminin (P 1 fragment) by applying peroxidase-antiperoxidase-and alkaline phosphatase-antialkaline phosphatase techniques. In normotensives, laminin and collagen IV were codistributed in the basal lamina of meningeal and intraparenchymal vessels. Collagen VI was only present in the adventitia of meningeal vessels and larger intraparenchymal arteries and veins, whereas it was absent from cortical vessels including capillaries. Intensive staining for collagen VI was observed in the choroid plexus, the superficial glia and sheath of cranial nerves. In hypertensives, the basement membrane constituents laminin and collagen IV appeared ubiquitously increased. Here, collagen VI was also deposited in the broadened vascular intima and media of larger arteries and in cortical vessels. In both groups collagen VI and P III P appeared to be codistributed. Our results indicate that significant qualitative changes in ECM of cerebral blood vessels are taking place during the development of hypertension, such as (1) an atypical deposition or an increase of collagen VI which by interconnecting collagen fibrils (I and III) might exert a stabilizing (sclerosing) function in the ECM, and (2) a thickening of vascular basement membranes caused by an accumulation of its major components laminin and collagen IV.Supported in part by the Deutsche Forschungsgemeinschaft (Ro 636/2-1)