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  • 1
    In: Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, Vol. 114, No. 47 ( 2017-11-21), p. 12454-12459
    Abstract: Recombinant factor VIIa (FVIIa) variants with increased activity offer the promise to improve the treatment of bleeding episodes in patients with inhibitor-complicated hemophilia. Here, an approach was adopted to enhance the activity of FVIIa by selectively optimizing substrate turnover at the membrane surface. Under physiological conditions, endogenous FVIIa engages its cell-localized cofactor tissue factor (TF), which stimulates activity through membrane-dependent substrate recognition and allosteric effects. To exploit these properties of TF, a covalent complex between FVIIa and the soluble ectodomain of TF (sTF) was engineered by introduction of a nonperturbing cystine bridge (FVIIa Q64C-sTF G109C) in the interface. Upon coexpression, FVIIa Q64C and sTF G109C spontaneously assembled into a covalent complex with functional properties similar to the noncovalent wild-type complex. Additional introduction of a FVIIa-M306D mutation to uncouple the sTF-mediated allosteric stimulation of FVIIa provided a final complex with FVIIa-like activity in solution, while exhibiting a two to three orders-of-magnitude increase in activity relative to FVIIa upon exposure to a procoagulant membrane. In a mouse model of hemophilia A, the complex normalized hemostasis upon vascular injury at a dose of 0.3 nmol/kg compared with 300 nmol/kg for FVIIa.
    Type of Medium: Online Resource
    ISSN: 0027-8424 , 1091-6490
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    Language: English
    Publisher: Proceedings of the National Academy of Sciences
    Publication Date: 2017
    detail.hit.zdb_id: 209104-5
    detail.hit.zdb_id: 1461794-8
    SSG: 11
    SSG: 12
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  • 2
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 104, No. 07 ( 2010), p. 157-164
    Abstract: The pharmacokinetics and pharmacodynamics of 40k-PEG-rFVIIa, a GlycoPEGylated derivative of recombinant wild-type FVIIa, were compared with rFVIIa in rabbits. The procoagulant effect was determined as the weight of the clot formed in a defined segment of a facial vein. A time course study was conducted where ligation was made 10 minutes, 12 or 24 hours after i.v. injection of equimolar doses of 40k-PEG-FVIIa or rFVIIa (2 mg/kg). This dose was selected based on a dose response study and a duration of effect study with rFVIIa. The clot weight increased with increasing doses of rFVIIa, and the duration of effect correlated with the plasma FVIIa clot activity. The plasma half-life of 40k-PEG-rFVIIa measured as FVIIa clot activity was found to be 25 hours, which was 5–6 times longer than rFVIIa. The aPTT and PT were reduced, and the measured increase in thrombin-antithrombin correlated to the effect on clot formation. Thus, the effect was similar at ligation 10 minutes after administration of 40k-PEG-rFVIIa or rFVIIa. At 12 hours, the effect of rFVIIa was absent while significant effect was seen 12 and 24 hours post dosing with 40k-PEG-rFVIIa. No consumption of platelets or fibrinogen was found and no thrombi formation was seen in histological examination of various organs. In conclusion, 40k-PEG-rFVIIa has shown prolonged duration of effect that correlated to various plasma markers and FVIIa clot activity. In perspective, the data support further clinical development of 40k-PEG-rFVIIa to potentially become a long-acting recombinant treatment option for prophylaxis in haemophilia patients with inhibitors.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2010
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  • 3
    In: Thrombosis Research, Elsevier BV, Vol. 128, No. 2 ( 2011-8), p. 191-195
    Type of Medium: Online Resource
    ISSN: 0049-3848
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2011
    detail.hit.zdb_id: 1500780-7
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  • 4
    In: Blood, American Society of Hematology, Vol. 118, No. 8 ( 2011-08-25), p. 2333-2341
    Abstract: Current management of hemophilia B entails multiple weekly infusions of factor IX (FIX) to prevent bleeding episodes. In an attempt to make a longer acting recombinant FIX (rFIX), we have explored a new releasable protraction concept using the native N-glycans in the activation peptide as sites for attachment of polyethylene glycol (PEG). Release of the activation peptide by physiologic activators converted glycoPEGylated rFIX (N9-GP) to native rFIXa and proceeded with normal kinetics for FXIa, while the Km for activation by FVIIa–tissue factor (TF) was increased by 2-fold. Consistent with minimal perturbation of rFIX by the attached PEG, N9-GP retained 73%-100% specific activity in plasma and whole-blood–based assays and showed efficacy comparable with rFIX in stopping acute bleeds in hemophilia B mice. In animal models N9-GP exhibited up to 2-fold increased in vivo recovery and a markedly prolonged half-life in mini-pig (76 hours) and hemophilia B dog (113 hours) compared with rFIX (16 hours). The extended circulation time of N9-GP was reflected in prolonged correction of coagulation parameters in hemophilia B dog and duration of effect in hemophilia B mice. Collectively, these results suggest that N9-GP has the potential to offer efficacious prophylactic and acute treatment of hemophilia B patients at a reduced dosing frequency.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 5
    Online Resource
    Online Resource
    American Society of Hematology ; 2006
    In:  Blood Vol. 108, No. 11 ( 2006-11-16), p. 4023-4023
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 4023-4023
    Abstract: The practical advantages of using the mouse in pharmacokinetic (PK) studies of human recombinant proteins are many and obvious. However, the relevance of studying human proteins in a mouse model is always questionable. The aims of the present study were i) to investigate if the mouse can be used as a model for PK studies of human FVIIa and FVIIa analogues by comparing the clearance of human recombinant FVIIa (hFVIIa) and murine recombinant FVIIa (mFVIIa), and ii) to study the roles of tissue factor (TF) in clearance of FVIIa. Eighteen NMRI mice were given a single intravenous 1 mg/kg dose of FVIIa or derivative containing trace amounts of iodinated FVIIa or derivative. Eye blood was sampled from anaesthetized mice in the interval of 0–8 h post administration. A sparse sampling schedule was employed in that three blood samples were taken pr. time point and three samples were drawn pr. mouse. The FVIIa plasma concentration was determined from the radioactivity measured by a γ-counter. The PK parameters were calculated by a 2-compartmental method using the WinNonlin software (Pharsight Corporation, USA), and the data was analyzed in one-way ANOVA test. The pharmacokinetic profile for both proteins was best determined by a 2-compartment analysis. The PK parameters obtained for the two proteins were statistically indistinguishable and showed a rapid distribution phase followed by a slower terminal half-life. The following values were obtained for hFVIIa and mFVIIa: T½ (distribution) was 0.38 h for hFVIIa and 0.71 h for mFVIIa, while a T½ (elimination) of 4.85 h was found for hFVIIa and 5.53 h for mFVIIa. Total clearance values of 34.7 ml/kg/h and 32.8 ml/kg/h were obtained for hFVIIa for mFVIIa, respectively. The volumes of distribution for the two proteins were also statistically indistinguishable, being 220.1 ml/kg for hFVIIa and 203.9 ml/kg for mFVIIa. No significant difference was thus observed between hFVIIa and mFVIIa in terms of the PK parameters including the terminal half-lives. These data might indicate that human FVIIa and murine FVIIa are cleared by the same mechanism(s) in mice, suggesting that the mouse is a valid model for PK studies of human FVIIa and derivatives thereof. The similar PK profiles for hFVIIa and mFVIIa observed further indicated a TF-independent clearance mechanism of FVIIa. Relative to mFVIIa the affinity of hFVIIa for mTF is known to be markedly decreased (Petersen LC et. al. Thromb Res.2005;116:75–85). Involvement of TF binding in clearance was therefore expected to result in different PK profiles for the two proteins; hence in a mouse model one would expect hFVIIa to be cleared at a much slower rate than mFVIIa. Since this was not the case, this study suggests a TF-independent mechanism of FVIIa clearance in mice. Our studies suggest that the mice can be used as a model to evaluate the PK profile of human FVIIa, and that TF is not involved in the clearance mechanisms of FVIIa.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
    In: Blood, American Society of Hematology, Vol. 103, No. 8 ( 2004-04-15), p. 3029-3037
    Abstract: Tissue factor (TF), the cellular receptor for factor VIIa (FVIIa), besides initiating blood coagulation, is believed to play an important role in tissue repair, inflammation, angiogenesis, and tumor metastasis. Like TF, the chemokine interleukin-8 (IL-8) is shown to play a critical role in these processes. To elucidate the potential mechanisms by which TF contributes to tumor invasion and metastasis, we investigated the effect of FVIIa on IL-8 expression and cell migration in a breast carcinoma cell line, MDA-MB-231, a cell line that constitutively expresses abundant TF. Expression of IL-8 mRNA in MDA-MB-231 cells was markedly up-regulated by plasma concentrations of FVII or an equivalent concentration of FVIIa (10 nM). Neither thrombin nor other proteases involved in hemostasis were effective in stimulating IL-8 in these cells. Increased transcriptional activation of the IL-8 gene is responsible for increased expression of IL-8 in FVIIa-treated cells. PAR-2–specific antibodies fully attenuated TF-FVIIa–induced IL-8 expression. Additional in vitro experiments showed that TF-FVIIa promoted tumor cell migration and invasion, active site–inactivated FVIIa, and specific antibodies against TF, PAR-2, and IL-8 inhibited TF-FVIIa–induced cell migration. In summary, the studies described herein provide insight into how TF may contribute to tumor invasion. (Blood. 2004;103:3029-3037)
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2004
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 7
    In: Journal of Biological Chemistry, Elsevier BV, Vol. 277, No. 30 ( 2002-07), p. 27065-27072
    Type of Medium: Online Resource
    ISSN: 0021-9258
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2002
    detail.hit.zdb_id: 2141744-1
    detail.hit.zdb_id: 1474604-9
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    American Society of Hematology ; 2007
    In:  Blood Vol. 110, No. 11 ( 2007-11-16), p. 3140-3140
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 3140-3140
    Abstract: Introduction: Prophylaxis is currently not available for hemophilia patients who have developed inhibitors. rFVIIa (NovoSeven®) is approved for on-demand treatment of inhibitor patients; however, due to a half-life of only 2–4 hr it might not represent the optimal option for prophylactic treatment of an inhibitor patient. Consequently, an effective and safe prophylactic treatment option for the inhibitor patient represents a clear medical need and a long-acting rFVIIa molecule could fulfill this need. Pegylation is an established method for prolonging the circulation half life of proteins. Site specific pegylation of the N-glycan of rFVIIa can be achieved by the Neose GlycoPEGylation™ technology. Here we report on the characterization of the activity of two GlycoPEGylated rFVIIa variants using a thrombin generation assay employing activated platelets as well as whole blood coagulation potential as determined by thrombelastography. Methods: PEG molecules of 10 kDa or 40 kDa are attached to the N-glycans of rFVIIa using GlycoPEGylation™ technology. Thrombin generation was evaluated under haemophilia A-like conditions in 1) platelet-rich plasma with a neutralizing anti-FVIII IgG included and 2) a reconstituted model system containing purified platelets and purified coagulation factors VII, IX, X, XI, II, V, ATIII, and TFPI at their plasma concentrations. In both assays, platelets were activated using a PAR-1 agonist peptide in combination with collagen-related peptide. Thrombelastography analysis was performed using citrate-stabilized human whole blood pre-incubated with neutralizing anti-FVIII IgG. Coagulation was initiated by addition of calcium and either kaolin or low amounts of TF (Innovin diluted 1:200,000). Concentrations of rFVIIa, rFVIIa-10K PEG, and rFVIIa-40K PEG were added to 0.005–500 nM. Results: Compared to unmodified rFVIIa, the thrombin generation activity of rFVIIa-10K PEG and rFVIIa-40K PEG was reduced in both the reconstituted model system and in the plasma-based model system. In the reconstituted model system the rate of thrombin generation obtained with rFVIIa-10K PEG was 82 ± 7% of that obtained with rFVIIa, while the rate of thrombin generation obtained with rFVIIa-40K PEG was 65 ± 13% of that obtained with rFVIIa. In the plasma-based model system 100 nM of the two GlycoPEGylated rFVIIa variants gave similar thrombin generation curves as 25 nM unmodified rFVIIa. rFVIIa-10K PEG was slightly more active than rFVIIa-40K PEG. In thrombelastography analyses clot time (R) and clot-development (MTG) were improved in a concentration-dependent manner by adding rFVIIa. The concentration-response curves for rFVIIa-10K PEG and rFVIIa-40K PEG showed the same maximal effect as rFVIIa, however, higher EC50 values indicated a 3–6 fold lower potency of the two GlycoPEGylated rFVIIa variants in this assay. Conclusions: The study demonstrates that GlycoPEGylation reduces the potency of rFVIIa in plasma and whole blood assays; however, the maximal effect on clot formation and strength are maintained for both derivatives. In vivo studies are needed to further characterize these molecules.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 9
    In: Journal of Biological Chemistry, Elsevier BV, Vol. 274, No. 30 ( 1999-07), p. 21349-21354
    Type of Medium: Online Resource
    ISSN: 0021-9258
    Language: English
    Publisher: Elsevier BV
    Publication Date: 1999
    detail.hit.zdb_id: 2141744-1
    detail.hit.zdb_id: 1474604-9
    SSG: 12
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  • 10
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 3935-3935
    Abstract: The endothelial cell-covered vasculature is constantly interacting with the various components of the blood. The exposure to the endothelial cell surface of any compound carried in the bloodstream is thus enormous, making the endothelium a crucial player in the mechanistic action of any drug given intravenously. Coagulopathic conditions arise when inflammatory messengers (e.g. TNF-a) induce the expression of certain endothelial surface receptors like the well known receptor for factor VII (FVII), tissue factor (TF). The interaction between recombinant activated FVII (rFVIIa) and TF on cell surfaces, including stimulated endothelial cells, has been studied extensively. However, little is known about the interaction of rFVIIa with native endothelium that lines the vasculature under normal conditions. Therefore, the binding of rFVIIa to unstimulated human umbilical vein endothelial cells (HUVEC) was investigated in the present study, using iodinated rFVIIa (125I-rFVIIa). ~ 45 fmol rFVIIa/100.000 cells in a time-dependent manner. Competition studies showed that the binding of rFVIIa could be reduced by 50 % with a 100-fold molar excess of unlabeled rFVIIa, suggesting both specific and non-specific binding sites on the surface of HUVEC. The binding could not be inhibited by an anti-TF antibody that blocks rFVIIa binding to TF, which indicates that the binding of rFVIIa to the cell surface of HUVEC is TF-independent. A 100-fold molar excess of gla-domain proteins FIX, prothrombin, protein S and protein Z had no effect on the binding of 125I-rFVIIa to unstimulated HUVEC at 4 °C, indicating a gla-domain independent binding site for rFVIIa on uninduced endothelial cells. However, the other two gla-proteins FX and protein C inhibited 125I-rFVIIa binding to HUVEC by 30 % in a 100-fold molar excess, suggesting that rFVIIa to some extent share binding site(s) on the HUVEC cell-surface with FX and protein C. Furthermore, unlabeled rFVIIa in 5-fold molar excess significantly reduced the binding of 125I-rFVIIa to HUVEC whereas FX and protein C in 5-fold molar excess had no significant effect on 125I-rFVIIa binding to HUVEC. This might indicate that the affinity of the putative binding site(s) on the HUVEC cell-surface is lower for FX and Protein C than for FVIIa. These results point to the presence of mutual specific binding site(s) on unstimulated endothelial cells with different affinity for the three proteins. The ability to compete with rFVIIa for binding to the cell surface was unchanged upon activation of FIX or FX. Thus, FIXa did not inhibit binding, whereas FXa reduced the amount of bound rFVIIa by 30 % as seen with FX. In conclusion, these data indicate the presence of both specific and non-specific binding sites for FVIIa on the surface of HUVEC. Neither binding site(s) appears to be gla-domain dependent since FIX, prothrombin, protein S and protein Z were unable to compete for rFVIIa-binding. There seems to be a common binding site for rFVIIa, FX and protein C.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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