Plasminogen activators are serine proteases that catalyze the activation of plasmin via proteolytic cleavage of its zymogen form plasminogen. Plasmin is an important factor in fibrinolysis, the breakdown of fibrin polymers formed during blood clotting. There are two main plasminogen activators: urokinase (uPA) and tissue plasminogen activator (tPA). Tissue plasminogen activators are used to treat medical conditions related to blood clotting including embolic or thrombotic stroke, myocardial infarction, and pulmonary embolism.[1]
Plasminogen activators are inhibited by plasminogen activator inhibitor-1, plasminogen activator inhibitor-2, and protein C inhibitor.
Function
editProduced mainly in the liver, plasminogen is the inactive zymogen form of plasmin, and circulates in plasma in a closed conformation that cannot be activated. Binding clots or cell surfaces cause their conformation to change, allowing them to be activated by plasminogen activators. Plasminogen activators do so by cleaving the R561/V562 peptide bond, producing the active protein plasmin, which catalyzes the degradation of fibrin polymers that make up the structure of blood clots.[2]
Inhibition
editThe main inhibitor of tissue plasminogen activator and urokinase is plasminogen activator inhibitor-1 (PAI-1).[3] Plasminogen activator inhibitor-1 is a serine protease, synthesized by endothelial cells, that specifically inhibits tissue plasminogen activator (tPA) and urokinase (uPA). Tissue plasminogen activator and urokinase are the activators of plasminogen and result in the breakdown of blood clots (fibrinolysis).[4]
PAI-1 levels have also been studied in patients and how they influence certain diseases. Elevated serum levels of PAI-1 have been found in obese individuals.[5] Elevated levels of PAI-1 also seem to increase the risk of atherothrombotic events and may also promote vascular disease.[6]
Plasminogen activator inhibitor-2 (PAI-2) is a serine protease that inactivates tPA and uPA. PAI-2 is produced by the placenta and only found in high quantities in the blood during pregnancy.[7]
Factors
editFactor XIa and XIIa are two main factors involved in the plasminogen activator. Factor XI (FXI) is a serine protase produced by the liver and circulates in its inactive form.[8] Deficiency in factor XI is known to cause hemophilia C.[9] Factor XIIa is another plasma protein that is involved in the activation of zymogen factor is activated into factor XIa.[10] This activation is important to the coagulation cascade.
Applications
editDue to its contribution to fibrinolysis, tissue plasminogen activator is used medically to treat blood clot-related disorders including thrombotic or embolic stroke, myocardial infarction, and pulmonary embolism. It is manufactured using recombinant techniques and is sold as alteplase, reteplase, and tenecteplase. Alteplase was the first of these versions to go on the market, and has the same structure as tPA. Reteplase and tenecteplase both received FDA approval after alteplase, and have nonidentical structures to tPA.[1] These recombinant forms of tPA have been shown to have a longer half-life in the blood and greater resistance to inhibition, resulting in an increased capacity to treat thrombolytic diseases.[11]
Urokinase is similarly used in the medical field, specifically for the treatment of pulmonary embolism.[12]
Plasminogen Activator Role in Breast Cancer
edit
Plasminogen activator inhibitor-1 not only functions as an inhibitor, but other roles of PAI-1 could suggest it could contribute to cancer. The other roles of PAI-1 include, cell de-adhesion, cell proliferation, apoptosis, and cell signaling. These roles could suggest that PAI-1 expression in the tumor microenvironment enhances tumor cell progression. Urokinase cleaves the zymogen plasminogen into serine protease plasmin. The elevated levels of uPA are an indicator of cancer which could be found in the carcinoma of the breast. Plasmin can activate matrix metalloproteases (MMP's) in the extracellular matrix (ECM). MMP activation contributes to tumor cell invasion and metastasis by degradation of ECM components.[5]
References
edit- ^ a b Rivera-Bou WL (15 December 2016). "Thrombolytic Therapy". MedScape. Retrieved 28 February 2017.
- ^ Law RH, Caradoc-Davies T, Cowieson N, Horvath AJ, Quek AJ, Encarnacao JA, Steer D, Cowan A, Zhang Q, Lu BG, Pike RN, Smith AI, Coughlin PB, Whisstock JC (March 2012). "The X-ray crystal structure of full-length human plasminogen". Cell Reports. 1 (3): 185–90. doi:10.1016/j.celrep.2012.02.012. PMID 22832192.
- ^ Declerck PJ, Gils A (June 2013). "Three decades of research on plasminogen activator inhibitor-1: a multifaceted serpin". Seminars in Thrombosis and Hemostasis. 39 (4): 356–64. doi:10.1055/s-0033-1334487. PMID 23504606. S2CID 5190211.
- ^ Mimuro J (May 1991). "[Type 1 plasminogen activator inhibitor: its role in biological reactions]". [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology. 32 (5): 487–9. PMID 1870265.
- ^ a b Carter JC, Church FC (2009-01-01). "Obesity and breast cancer: the roles of peroxisome proliferator-activated receptor-γ and plasminogen activator inhibitor-1". PPAR Research. 2009: 345320. doi:10.1155/2009/345320. PMC 2723729. PMID 19672469.
- ^ Vaughan DE (August 2005). "PAI-1 and atherothrombosis". Journal of Thrombosis and Haemostasis. 3 (8): 1879–83. doi:10.1111/j.1538-7836.2005.01420.x. PMID 16102055. S2CID 6651339.
- ^ Mikus P, Urano T, Liljeström P, Ny T (December 1993). "Plasminogen-activator inhibitor type 2 (PAI-2) is a spontaneously polymerising SERPIN. Biochemical characterisation of the recombinant intracellular and extracellular forms". European Journal of Biochemistry. 218 (3): 1071–82. doi:10.1111/j.1432-1033.1993.tb18467.x. PMID 7506655.
- ^ Wu W, Sinha D, Shikov S, Yip CK, Walz T, Billings PC, Lear JD, Walsh PN (July 2008). "Factor XI homodimer structure is essential for normal proteolytic activation by factor XIIa, thrombin, and factor XIa". The Journal of Biological Chemistry. 283 (27): 18655–64. doi:10.1074/jbc.M802275200. PMC 2441546. PMID 18441012.
- ^ Bolton-Maggs PH (June 1996). "Factor XI deficiency". Baillière's Clinical Haematology. 9 (2): 355–68. doi:10.1016/s0950-3536(96)80068-0. PMID 8800510.
- ^ Walsh PN (July 2001). "Roles of platelets and factor XI in the initiation of blood coagulation by thrombin". Thrombosis and Haemostasis. 86 (1): 75–82. doi:10.1055/s-0037-1616203. PMID 11487044. S2CID 32572142.
- ^ Gurman P, Miranda OR, Nathan A, Washington C, Rosen Y, Elman NM (March 2015). "Recombinant tissue plasminogen activators (rtPA): a review". Clinical Pharmacology and Therapeutics. 97 (3): 274–85. doi:10.1002/cpt.33. PMID 25670034. S2CID 19937661.
- ^ "LABEL: KINLYTIC- urokinase injection, powder, lyophilized, for solution". DailyMed: US National Library of Medicine. 8 June 2007.
- ^ a b c GRCh38: Ensembl release 89: ENSG00000122194 – Ensembl, May 2017
- ^ a b c GRCm38: Ensembl release 89: ENSMUSG00000059481 – Ensembl, May 2017
- ^ "Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
- ^ "Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.