title: Lactadherin blocks thrombosis and hemostasis in vivo: correlation with platelet phosphatidylserine exposure.
abstract: BACKGROUND
  Platelet membrane phosphatidylserine (PS) is considered to be essential for hemostasis and thrombosis, but the in vivo topography of platelet PS has not been characterized. We hypothesized that platelet PS exposure would be identified on adherent platelets at the site of vascular injury and that blockade of PS would impede hemostasis and thrombosis.
  
  
  OBJECTIVE
  To localize and estimate the extent of platelet PS exposure and evaluate the impact of PS blockade in vivo.
  
  
  METHODS
  Lactadherin, a PS-binding milk protein, was utilized together with annexin V to detect both partial and complete membrane PS exposure on platelets in a mouse model of thrombosis and to evaluate the functional need for PS. Preliminary experiments were performed with synthetic membranes and with purified platelets.
  
  
  RESULTS
  The number of lactadherin-binding sites on synthetic membranes was proportional to PS content, whereas annexin V required a threshold of 2.5-8% PS. Approximately 95% of thrombin-stimulated platelets exposed PS, but the quantity was below the threshold for annexin V binding at physiologic Ca(2+) concentrations. In mice, most adherent and aggregated platelets on the walls of ferric chloride-treated mesenteric veins exposed low levels of PS, rather than having complete exposure. In mice, blockade of PS with lactadherin inhibited platelet prothrombinase and factor Xase activity, and prolonged tail bleeding time and the time to carotid artery thrombosis.
  
  
  CONCLUSIONS
  In vivo PS exposure contributes to both hemostasis and thrombosis. In this model of vascular injury, most platelets exhibit partial rather than complete PS exposure.
authors.affiliation: Department of Medicine, VA Boston Healthcare System, Brigham, Women's Hospital and Harvard Medical School, Boston, MA 02132, USA.
authors.forename: J
authors.initials: J
authors.lastname: Shi
authors.forename: S W
authors.initials: SW
authors.lastname: Pipe
authors.forename: J T
authors.initials: JT
authors.lastname: Rasmussen
authors.forename: C W
authors.initials: CW
authors.lastname: Heegaard
authors.forename: G E
authors.initials: GE
authors.lastname: Gilbert
mesh_terms: D000818:Animals; D017304:Annexin A5; D000954:Antigens, Surface / Q000494:pharmacology*; D001665:Binding Sites; D001792:Blood Platelets / Q000737:chemistry / Q000502:physiology*; D002340:Carotid Artery Diseases; D003546:Cysteine Endopeptidases; D006487:Hemostasis / Q000187:drug effects*; D008642:Mesenteric Veins; D051379:Mice; D008894:Milk Proteins / Q000494:pharmacology*; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors; D010718:Phosphatidylserines / Q000378:metabolism*; D013925:Thromboplastin / Q000037:antagonists & inhibitors; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D017304:Annexin A5; D000954:Antigens, Surface; C490919:Mfge8 protein, mouse; D008894:Milk Proteins; D009363:Neoplasm Proteins; D010718:Phosphatidylserines; D013925:Thromboplastin; D003546:Cysteine Endopeptidases; C030910:cancer procoagulant