title: Selective depletion of plasma prekallikrein or coagulation factor XII inhibits thrombosis in mice without increased risk of bleeding.
abstract: Recent studies indicate that the plasma contact system plays an important role in thrombosis, despite being dispensable for hemostasis. For example, mice deficient in coagulation factor XII (fXII) are protected from arterial thrombosis and cerebral ischemia-reperfusion injury. We demonstrate that selective reduction of prekallikrein (PKK), another member of the contact system, using antisense oligonucleotide (ASO) technology results in an antithrombotic phenotype in mice. The effects of PKK deficiency were compared with those of fXII deficiency produced by specific ASO-mediated reduction of fXII. Mice with reduced PKK had ∼ 3-fold higher plasma levels of fXII, and reduced levels of fXIIa-serpin complexes, consistent with fXII being a substrate for activated PKK in vivo. PKK or fXII deficiency reduced thrombus formation in both arterial and venous thrombosis models, without an apparent effect on hemostasis. The amount of reduction of PKK and fXII required to produce an antithrombotic effect differed between venous and arterial models, suggesting that these factors may regulate thrombus formation by distinct mechanisms. Our results support the concept that fXII and PKK play important and perhaps nonredundant roles in pathogenic thrombus propagation, and highlight a novel, specific and safe pharmaceutical approach to target these contact system proteases.
authors.affiliation: Department of Antisense Drug Discovery, Isis Pharmaceuticals Inc, Carlsbad, CA, USA.
authors.forename: Alexey S
authors.initials: AS
authors.lastname: Revenko
authors.forename: Dacao
authors.initials: D
authors.lastname: Gao
authors.forename: Jeff R
authors.initials: JR
authors.lastname: Crosby
authors.forename: Gourab
authors.initials: G
authors.lastname: Bhattacharjee
authors.forename: Chenguang
authors.initials: C
authors.lastname: Zhao
authors.forename: Chris
authors.initials: C
authors.lastname: May
authors.forename: David
authors.initials: D
authors.lastname: Gailani
authors.forename: Brett P
authors.initials: BP
authors.lastname: Monia
authors.forename: A Robert
authors.initials: AR
authors.lastname: MacLeod
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005174:Factor XII / Q000037:antagonists & inhibitors / Q000235:genetics; D005175:Factor XII Deficiency / Q000097:blood* / Q000235:genetics; D055785:Gene Knockdown Techniques; D006470:Hemorrhage / Q000097:blood* / Q000209:etiology* / Q000235:genetics; D006487:Hemostasis / Q000235:genetics / Q000502:physiology; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008810:Mice, Inbred C57BL; D016376:Oligonucleotides, Antisense / Q000008:administration & dosage / Q000235:genetics; D011288:Prekallikrein / Q000037:antagonists & inhibitors / Q000172:deficiency* / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood* / Q000235:genetics / Q000517:prevention & control*
chemical_list: D016376:Oligonucleotides, Antisense; D012333:RNA, Messenger; D005174:Factor XII; D011288:Prekallikrein