1. Structure of Blood Coagulation Factor VIII in Complex With an Anti-C2 Domain Non-Classical, Pathogenic Antibody Inhibitor
- Author
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Kenneth C. Childers, Pete Lollar, Christopher B. Doering, Estelle K. Ronayne, H. Trent Spencer, P. Clint Spiegel, Shaun C. Peters, Joseph S. Gish, and Celena Wilson
- Subjects
0301 basic medicine ,congenital, hereditary, and neonatal diseases and abnormalities ,Protein Conformation ,Swine ,Recombinant Fusion Proteins ,Immunology ,Cooperativity ,Molecular Dynamics Simulation ,030204 cardiovascular system & hematology ,Crystallography, X-Ray ,Hemophilia A ,Protein Engineering ,blood coagulation ,Antibodies, Monoclonal, Murine-Derived ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Thrombin ,hemic and lymphatic diseases ,medicine ,Animals ,Humans ,Immunology and Allergy ,Protein Interaction Domains and Motifs ,Platelet ,Protein Structure, Quaternary ,x-ray crystallography ,Original Research ,C2 domain ,Factor VIII ,biology ,antibody inhibitors ,Chemistry ,Immunogenicity ,RC581-607 ,Cell biology ,030104 developmental biology ,antibody binding ,biology.protein ,Antibody inhibitor ,Immunologic diseases. Allergy ,Antibody ,medicine.drug ,Tenase - Abstract
Factor VIII (fVIII) is a procoagulant protein that binds to activated factor IX (fIXa) on platelet surfaces to form the intrinsic tenase complex. Due to the high immunogenicity of fVIII, generation of antibody inhibitors is a common occurrence in patients during hemophilia A treatment and spontaneously occurs in acquired hemophilia A patients. Non-classical antibody inhibitors, which block fVIII activation by thrombin and formation of the tenase complex, are the most common anti-C2 domain pathogenic inhibitors in hemophilia A murine models and have been identified in patient plasmas. In this study, we report on the X-ray crystal structure of a B domain-deleted bioengineered fVIII bound to the non-classical antibody inhibitor, G99. While binding to G99 does not disrupt the overall domain architecture of fVIII, the C2 domain undergoes an ~8 Å translocation that is concomitant with breaking multiple domain-domain interactions. Analysis of normalized B-factor values revealed several solvent-exposed loops in the C1 and C2 domains which experience a decrease in thermal motion in the presence of inhibitory antibodies. These results enhance our understanding on the structural nature of binding non-classical inhibitors and provide a structural dynamics-based rationale for cooperativity between anti-C1 and anti-C2 domain inhibitors.
- Published
- 2021
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