Catabolism of the coagulation factor VIII: can we prolong lifetime of f VIII in circulation?

Trends Cardiovasc Med. 2001 Aug;11(6):251-7. doi: 10.1016/s1050-1738(01)00124-4.

Abstract

The coagulation factor VIII is required for normal haemostasis, because deficiency or genetic defects in this molecule cause a life-threatening coagulation disorder known as hemophilia A. While the role of f VIII in the intrinsic pathway of blood coagulation has been extensively studied, the mechanisms responsible for f VIII turnover in circulation have not been characterized until recently. This review focuses on the finding that f VIII catabolism in vitro and in vivo is mediated by low-density lipoprotein receptor-related protein (LRP), representing a hepatic clearance receptor. FVIII interaction with LRP involves two distinct sites localized within the C2 and A2 domains of f VIII. We discuss the contribution of the A2 site (residues 484-509) and the C2 site in f VIII catabolism in the presence and absence of vWf. We present the evidence that LRP-mediated f VIII catabolism is facilitated by cell-surface heparan sulfate proteoglycans (HSPGs), which bind to the A2 residues 558-565 of f VIII. Because both LRP- and HSPGs-binding sites within the A2 domain are potentially exposed in the circulating f VIII/vWf complex, we discuss the possibility of prolongation of the f VIII lifetime in circulation by disrupting these sites employing site-directed mutagenesis. In its turn, generation of a novel recombinant f VIII may be prospective for more efficient hemophilia A therapy.

Publication types

  • Review

MeSH terms

  • Factor VIII / metabolism*
  • Factor VIII / physiology
  • Hemophilia A / blood*
  • Hemophilia A / genetics
  • Heparitin Sulfate / pharmacology
  • Humans
  • LDL-Receptor Related Proteins / metabolism*
  • LDL-Receptor Related Proteins / physiology
  • von Willebrand Factor / physiology

Substances

  • LDL-Receptor Related Proteins
  • von Willebrand Factor
  • Factor VIII
  • Heparitin Sulfate