title: An activated factor VII variant with enhanced tissue factor-independent activity speeds wound healing in a mouse hemophilia B model.
abstract: Essentials Disorders of hemostasis can lead to delayed and defective wound healing. In hemophilia B (HB) mice, 7 days of Factor (F)IX or VIIa are needed to normalize wound healing. One dose of a highly active FVIIa variant (DVQ) restored normal wound closure time in HB mice. Coagulation factors with enhanced activity may acquire biological effects not due to hemostasis.
  
  
  
  Introduction We have previously reported that hemophilia B (HB) mice have delayed healing of cutaneous wounds and alterations in wound histology. Administration of a single dose of either factor IX or recombinant activated FVII (rFVIIa) (NovoSeven) prior to wounding did not improve wound closure time or histology. The FVIIa analog DVQ (V158D, E296V and M298Q mutations) was designed to have higher tissue factor-independent activity than rVIIa. We hypothesized that a single dose of DVQ would be more effective in restoring wound healing in HB mice. Methods Cutaneous punch wounds were made on the backs of HB and wild-type mice, and the time to wound closure was monitored. HB mice were treated with a dose of rFVIIa (10 mg kg(-1) ) or DVQ (1 mg kg(-1) ) that corrected the tail bleeding time. Skin samples were taken at various time points after wounding, fixed, and stained, and the histology was examined. Results As previously reported, wound closure times in HB mice given one dose of rFVIIa were not improved over those in untreated HB mice. Surprisingly, healing times in HB mice treated with an equally hemostatic dose of DVQ were normalized to that in wild-type mice. However, DVQ did not correct all histologic abnormalities in HB mice. Conclusions As the doses of DVQ and rFVIIa were chosen to support comparable levels of hemostasis, our data suggest that the improved healing seen with DVQ is not solely attributable to its hemostatic activity. It is possible that the improved wound healing arises through the effect of DVQ on cell signaling mechanisms.
authors.affiliation: Department of Pathology, Duke University and Durham Veterans Affairs Medical Centers, Durham, NC, USA.|Division of Hematology/Oncology, Department of Medicine, The University of North Carolina Medical Center, Chapel Hill, NC, USA.
authors.forename: M
authors.identifier: 0000-0001-7123-0100
authors.initials: M
authors.lastname: Hoffman
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, The University of North Carolina Medical Center, Chapel Hill, NC, USA.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Chang
authors.affiliation: Pharmacology, Novo Nordisk A/S, Måløv, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Ezban
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, The University of North Carolina Medical Center, Chapel Hill, NC, USA.
authors.forename: D M
authors.identifier: 0000-0002-0493-2943
authors.initials: DM
authors.lastname: Monroe
mesh_terms: D000287:Administration, Topical; D000818:Animals; D001760:Bleeding Time; D004195:Disease Models, Animal; D005164:Factor IX / Q000235:genetics; D015942:Factor VIIa / Q000008:administration & dosage* / Q000235:genetics; D014644:Genetic Variation; D002836:Hemophilia B / Q000188:drug therapy* / Q000235:genetics*; D006487:Hemostasis; D006801:Humans; D051379:Mice; D009154:Mutation; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000235:genetics; D013925:Thromboplastin / Q000378:metabolism*; D014945:Wound Healing
chemical_list: D011994:Recombinant Proteins; D005164:Factor IX; D013925:Thromboplastin; C103587:recombinant FVIIa; D015942:Factor VIIa
keywords: angiogenesis inhibitors; epithelium; hemophilia; hemostasis; thrombin