人凝血酶原复合物分离纯化工艺的研究进展

人凝血酶原复合物(PCC)为人血浆中微量蛋白组份,其浓缩制剂由凝血因子II、VII、IX、X组成,在临床上具有治疗乙型血友病等疾病的确切疗效。本文综述了近来PCC及FIX浓缩制剂分离纯化工艺的研究进展及结合蛋白新型分离纯化技术的发展情况,讨论了该产品制备新工艺的开发方向。     

人凝血酶原复合物生产过程中凝血因子活化分析

目的通过比较以组分Ⅲ沉淀和血浆为原料制备人凝血酶原复合物(Prothrombin complex concentrates,PCC)过程中凝血因子活化情况,为选择最适PCC制备原料提供数据支持。方法分别对以组分Ⅲ沉淀和血浆为原料制备PCC过程中中间品的活化的凝血因子活性和人凝血酶活性两个项目进行检定,分析凝血因子的活化情况。观察以组分Ⅲ沉淀为原料制备PCC过程中添加肝素能否抑制PCC中凝血因子的活化。结果以组分Ⅲ沉淀为原料制备的PCC中间品活化的凝血因子活性和人凝血酶活性两个项目均不合格。以组分Ⅲ沉淀为原料制备PCC生产过程中添加肝素后,PCC中间品的活化的凝血因子活性和人凝血酶活性均不合格。以血浆为原料制备的PCC中间品活化的凝血因子活性和人凝血酶活性两个项目均合格。结论组分Ⅲ沉淀为原料制备PCC会增加凝血因子活化的风险,新鲜冰冻血浆可作为制备PCC的原料。     

人凝血酶原复合物离子交换树脂的筛选及吸附性能研究

采用若干种人工合成的大孔阴离子交换树脂,对人血浆中凝血酶原复合物(PCC)的分离纯化性能进行了研究.同时.将DEAE-Sephadex A50时PCC的分离纯化性能与该类人工合成分离纯化材料进行了对比.研究结果表明,在各种人工合成大孔阴离子交换树脂中,CG-6对PCC具有较优的分离纯化性能;并系统研究了CG-6树脂对PCC分离纯化性能.     

重组人活性凝血因子Ⅶ及其应用

人凝血因子Ⅶ(FⅦ)是一种维生素K依赖的单链糖蛋白,在体内凝血过程中发挥着重要的作用。重组人活性凝血因子Ⅶ(rhFⅦa)在血管损伤处与组织因子结合后产生足够的凝血酶,从而触发凝血瀑布。rhFⅦa于1999年由美国FDA批准上市(Novo Seven),尽管结构与血浆提取的FⅦa存在差异,但两的功能是完全一致的。临床研究表明,rhFⅦ对血友病、血小板减少症和血小板功能障碍、严重创伤、大面积外科手术的止血具有令人满意的止血效果。rhFⅦa由于安全有效,成为治疗血友病、外科创伤出血等的替代疗法。     

人凝血酶原复合物在制备过程中凝血因子活性的检测和分析

目的对人凝血酶原复合物在制备工艺中凝血因子效价进行检测和分析。方法对PCC制备过程中的血浆、S/D病毒灭活、冻干工艺、干热病毒灭活前和后分别取样,检测分析凝血因子Ⅱ、Ⅶ、Ⅸ和Ⅹ效价,分别分析S/D病毒灭活、冻干工艺、干热病毒灭活前和后凝血因子效价的变化情况。分析PCC干热病毒灭活后的样品中四种凝血因子的效价比例。结果三批血浆中凝血因子Ⅱ、Ⅶ、Ⅸ和Ⅹ的活性在0.8~1.2 IU/m L之间。S/D病毒灭活前后PCC冻干工艺前后PCC中四种凝血因子活性无明显变化,而干热病毒灭活后PCC中四种凝血因子活性均有明显下降。三批PCC中四种凝血因子的比例基本一致,但是凝血因子Ⅶ效价较低,凝血因子Ⅱ效价偏高。结论通过PCC制备工艺中凝血因子效价的检测和分析可实现良好的质量控制。     

二乙基亚硝胺诱发肝癌的大鼠中维生素K依赖性羧化酶的研究

本文证明DENA诱发的大鼠肝癌结节中维生素K依赖性羧化酶活性显著降低,外源多肽羧化酶活性只有正常大鼠肝脏中的62.6％,而内源蛋白质前体羧化酶活性仅为27％。华法令能在正常大鼠肝脏中诱导羧化酶的合成,而这种诱导能力在诱癌晚期的肝癌大鼠肝脏中明显下降。上述结果说明肝癌细胞中维生素K依赖性羧化酶的合成受阻,造成肝癌组织中羧化酶的缺乏。诱癌过程中大鼠肝脏维生素K依赖性羧化酶活性和血浆异常凝血酶原水平形成良好的对应关系。随着肝癌组织的增大,肝癌细胞分泌入血的异常凝血酶原水平显著升高,诱癌第20周时的大鼠血浆中异常凝血酶原含量为正常大鼠的2.5倍。由此认为,肝癌组织由于不能合成足量的维生素K依赖性羧化酶,导致凝血酶原在成熟过程中羧化受阻,分泌入血形成高水平的异常凝血酶原。     

凝血因子IX基因剔除小鼠的遗传及血液学指标检测

目的　鉴定凝血因子IX基因剔除小鼠。方法　采用PCR扩增检测小鼠的DNA样品以及采用一期法检定小鼠血浆FIX活性和血浆凝血酶原时间 (plasmaprothrombintime ,PT)、白陶土部分凝血活酶时间 (Kaolinpartialthromboplastintime ,KPTT)值。结果　小鼠PCR检测为阳性 ,FIX活性 <5 %。结论　凝血因子IX基因剔除小鼠能稳定遗传 ,鉴定结果提示该小鼠符合人血友病B相应临床症状。     

凝血因子Ⅶ及其重组表达新进展

凝血因子Ⅶ是一种维生素K依赖型的单链糖蛋白,在凝血过程中发挥着极其重要的作用,在临床上有广泛的应用,可用于伴有抑制物的血友病、先天性FⅦ缺乏症、血小板无力症及外科手术或严重外伤导致的创伤出血等止血用途.基因重组技术提供了能够大规模制备人凝血因子Ⅶ的有效途径,近年来已尝试并建立了多种人凝血因子Ⅶ的重组表达系统.对重组人凝...     

凝血因子Ⅸ基因剔除小鼠的遗传及血液学指标检测

目的鉴定凝血因子Ⅸ基因剔除小鼠.方法采用PCR扩增检测小鼠的DNA样品以及采用一期法检定小鼠血浆FIX活性和血浆凝血酶原时间(plasma prothrombin time,PT)、白陶土部分凝血活酶时间(Kaolin partialthromboplastin time,KPTT)值.结果小鼠PCR检测为阳性,FIX活性＜5%.结论凝血因子Ⅸ基因剔除小鼠能稳定遗传,鉴定结果提示该小鼠符合人血友病B相应临床症状.     

血液制品的现状与展望

血液制品特指血浆蛋白制品和相应的重组制品。根据临床应用的效能,血液制品可以分为白蛋白类、免疫球蛋白类、凝血因子类和微量蛋白制品等不同种类。血浆白蛋白制品是最早应用于战伤救治的血液制品,高纯白蛋白、重组白蛋白以及重组白蛋白融合药物的研发和上市开创了血液制品的新局面。肌肉注射用免疫球蛋白因其制备工艺相对简单,使用方便,价格低廉且不良反应可以接受而一直在临床实践中应用;静脉注射用免疫球蛋白随着新的适应症不断发现,其应用范围越来越广;皮下注射用免疫球蛋白的出现使免疫球蛋白的使用更加方便,已经成为静脉注射用免疫球蛋白安全有效的替代品;针对特定病原体的特异性免疫球蛋白在临床上更具有不可替代的作用。凝血因子和重组凝血因子类制品主要用于相应的先天性遗传性缺陷患者,纤维蛋白原、因子Ⅶ、因子Ⅷ、von Willebrand因子复合物、因子Ⅸ和凝血酶原复合物、因子Ⅺ、因子ⅩⅢ等制品的应用取得了良好的治疗效果。因子Ⅶa和活化凝血酶原复合物对于治疗产生凝血因子抑制物的血友病病人具有十分明显的效果。纤维蛋白原类制品和凝血酶在外科止血方面发挥着重要的作用。多种微量血浆蛋白制品已经上市,如蛋白C、抗凝血酶、α1-抗胰蛋白酶和组织纤溶酶原激活剂等。部分微量血浆蛋白制品也在研发和临床试验过程中,如C1-抑制剂、补体系统Ⅰ因子、α2-巨球蛋白、血清胆碱酯酶、铜蓝蛋白以及纤维结合蛋白等。尽管多种重组血浆蛋白制品已经上市,血浆来源的制品仍将具有其不可替代的特殊地位,血浆蛋白新品种的研发仍是热点。目前,我国血液制品的研发与国外存在着较大的差距,我国血液制品企业面临着机遇与挑战。     

PPSB

PPSB, the plasma derivative which contains the vitamin K-dependent clotting factors, was first produced in 1959 at the Centre National de Transfusion Sanguine in Paris under the leadership of Jean-Pierre Soulier. Today over 20 such products are manufactured around the world. All production methods take advantage of the common adsorption and elution properties of all the vitamin K-dependent clotting factors due to the presence of gamma carboxy residues. Although the clinical use of PPSB has been extended to all congenital and acquired deficiencies of the vitamin K-dependent clotting factors and more recently to treat hemorrhagic episodes of hemophilia A patients with antibody to Factor VIII, the major clinical indication remains hemophilia B. The major complication associated with the use of PPSB is the occurrence of viral diseases, particularly non-A, non-B hepatitis of unknown etiology and specifically associated with the use of PPSB is the occurrence in some patients of thromboembolic complications. Current research is oriented toward the production of a safer product.     

A new vitamin K-dependent protein. Purification from bovine plasma and preliminary characterization.

Four proteins active in blood coagulation have long been known to require vitamin K for their proper biosynthesis: factors II, VII, IX, and X. This paper describes the purification of a hitherto unrecognized vitamin K-dependent glycoprotein from bovine plasma. The biosynthesis of this protein is interfered with by the vitamin K antagonist Dicoumarol. The molecular weight of the protein is approximately 56,000 and, like factor X, it has two polypeptide chains. The light chain binds Ca2+. Its NH2-terminal amino acid sequence is homologous to the NH2-terminal sequences of the other vitamin K-dependent proteins and it contains vitamin K-dependent gamma-carboxyglutamic acid residues. The biological function of this protein is unknown.     

A method for systematic purification from bovine plasma of six vitamin K-dependent coagulation factors: prothrombin, factor X, factor IX, protein S, protein C, and protein Z

A systematic purification scheme is presented for the isolation of six vitamin K-dependent coagulation factors from bovine plasma in a functionally and biochemically pure state. The vitamin K-dependent proteins concentrated by the ordinary barium citrate adsorption were first separated into four fractions, fractions A, B, C, and D, by DEAE-Sephadex A-50 chromatography. From the pooled fraction A, protein S, factor IX, and prothrombin were purified by column chromatography on Blue-Sepharose CL-6B. Heparin-Sepharose chromatography of the pooled fraction B provided mainly pure factor IX, in addition to homogeneous prothrombin. A high degree of resolution of protein C and prothrombin from the pooled fraction C was obtained with a Blue-Sepharose column. This dye-ligand chromatographic procedure was also very effective for the separation of protein Z and factor X contained in the pooled fraction D. Thus, these preparative procedures allowed high recovery of milligram and gram quantities of six vitamin K-dependent proteins from 15 liters of plasma in only two chromatographic steps, except for protein S, which required three (the third step was rechromatography on Blue-Sepharose CL-6B).     

The propeptides of the vitamin K-dependent proteins possess different affinities for the vitamin K-dependent carboxylase.

The vitamin K-dependent gamma-glutamyl carboxylase catalyzes the modification of specific glutamates in a number of proteins required for blood coagulation and associated with bone and calcium homeostasis. All known vitamin K-dependent proteins possess a conserved eighteen-amino acid propeptide sequence that is the primary binding site for the carboxylase. We compared the relative affinities of synthetic propeptides of nine human vitamin K-dependent proteins by determining the inhibition constants (Ki) toward a factor IX propeptide/gamma-carboxyglutamic acid domain substrate. The Ki values for six of the propeptides (factor X, matrix Gla protein, factor VII, factor IX, PRGP1, and protein S) were between 2-35 nM, with the factor X propeptide having the tightest affinity. In contrast, the inhibition constants for the propeptides of prothrombin and protein C are approximately 100-fold weaker than the factor X propeptide. The propeptide of bone Gla protein demonstrates severely impaired carboxylase binding with an inhibition constant of at least 200,000-fold weaker than the factor X propeptide. This study demonstrates that the affinities of the propeptides of the vitamin K-dependent proteins vary over a considerable range; this may have important physiological consequences in the levels of vitamin K-dependent proteins and the biochemical mechanism by which these substrates are modified by the carboxylase.     

Gas-6 and protein S: vitamin K-dependent factors and ligands for the TAM tyrosine kinase receptors family

The gamma-carboxyglutamate-containing proteins are a family of secreted vitamin K-dependent proteins in which some glutamyl residues are post-translationally modified to gamma-carboxyglutamic acid residues. A vitamin K-dependent gamma-glutamyl carboxylase enzyme catalyses this post-translational modification. The gamma-carboxylase reaction requires vitamin K in its reduced form, vitamin K hydroquinone, and generates gamma-carboxyglutamate and vitamin K 2,3,-epoxide which is then recycled back to the hydroquinone form by a vitamin K reductase system. Warfarin blocks the vitamin K cycle and hence inhibits the gamma-carboxylase reaction, and this property of Warfarin has led to its wide use in anticoagulant therapy. Until recently, interest in vitamin K-dependent proteins was mostly restricted to the field of hematology. However, the discovery that the anti-coagulant factor protein S and its structural homologue Gas6 (growth arrest-specific gene 6), two vitamin K-dependent proteins, are ligands for the Tyro3/Axl/Mer family of related tyrosine kinase receptors has opened up a new area of research. Moreover, the phenotypes associated with the invalidation of genes encoding vitamin K-dependent proteins or their receptors revealed their implication in regulating phagocytosis during many cell differentiation phenomena such as retinogenesis, neurogenesis, osteogenesis, and spermatogenesis. Additionally, protein S was identified as the major factor responsible for serum-stimulated phagocytosis of apoptotic cells. Therefore, the elucidation of the molecular mechanisms underlying the role of vitamin K-dependent proteins in regulating apoptotic cell phagocytosis may lead to a better understanding of the physiopathology of cell differentiation and could form the framework of new therapeutic strategies aiming at a selective targeting of cell phagocytosis associated pathologies.     

Increased production of functional recombinant human clotting factor IX by baby hamster kidney cells engineered to overexpress VKORC1, the vitamin K 2,3-epoxide-reducing enzyme of the vitamin K cycle

Some recombinant vitamin K-dependent blood coagulation factors (factors VII, IX, and protein C) have become valuable pharmaceuticals in the treatment of bleeding complications and sepsis. Because of their vitamin K-dependent post-translational modification, their synthesis by eukaryotic cells is essential. The eukaryotic cell harbors a vitamin K-dependent gamma-carboxylation system that converts the proteins to gamma-carboxyglutamic acid-containing proteins. However, the system in eukaryotic cells has limited capacity, and cell lines overexpressing vitamin K-dependent clotting factors produce only a fraction of the recombinant proteins as fully gamma-carboxylated, physiologically competent proteins. In this work we have used recombinant human factor IX (r-hFIX)-producing baby hamster kidney (BHK) cells, engineered to stably overexpress various components of the gamma-carboxylation system of the cell, to determine whether increased production of functional r-hFIX can be accomplished. All BHK cell lines secreted r-hFIX into serum-free medium. Overexpression of gamma-carboxylase is shown to inhibit production of functional r-hFIX. On the other hand, cells overexpressing VKORC1, the reduced vitamin K cofactor-producing enzyme of the vitamin K-dependent gamma-carboxylation system, produced 2.9-fold more functional r-hFIX than control BHK cells. The data are consistent with the notion that VKORC1 is the rate-limiting step in the system and is a key regulatory protein in synthesis of active vitamin K-dependent proteins. The data suggest that overexpression of VKORC1 can be utilized for increased cellular production of recombinant vitamin K-dependent proteins.     

Purification of coagulation factor VIII using chromatographic methods. Direct chromatography of plasma in anion exchange resins

Coagulation factor VIII (FVIII) concentrates are used in the treatment of patients with Hemophilia A. Human FVIII was purified directly from plasma using anion exchange chromatography followed by gel filtration. Three Q-Sepharose resins were tested, resulting in 40% recovery of FVIII activity using Q-Sepharose XL resin, about 80% using Q-Sepharose Fast Flow and 70% using the Q-Sepharose Big Beads. The vitamin K-dependent coagulation factors co-eluted with FVIII from the anion exchange columns. In the second step of purification, when Sepharose 6FF was used, 70% of FVIII activity was recovered free from vitamin K-dependent factors.     

Battery of tests for profiling abnormalities of vitamin K-dependent coagulation factors in drug-toxicity studies in rats.

A battery of simple tests for profiling abnormalities of vitamin K-dependent coagulation factors encountered in drug-toxicity studies was verified in rats treated with warfarin (3 and 10 mg/kg, p.o). The thrombotest, or hepaplastin-test, is useful as a follow-up test after routine screening tests for coagulation abnormalities based on PT and APTT, to rule out other coagulation-factor abnormalities. Measurement of coagulation factor activities (factors II, VII, IX and X) using factor-deficient human plasmas provides direct evidence of decreased activities of vitamin K-dependent factors. Furthermore, Echis carinatus venom coagulation time, together with factor II activity, allows us to confirm the generation of PIVKA-II.     

Preparation of vitamin K-dependent proteins,such as clotting factors II,VII, IX and X and clotting inhibitor protein C

A review is given of preparative methods for the isolation of the vitamin K-dependent clotting factors II, VII, IX, X and clotting inhibitor protein C, all derived from human plasma. Factor II, activated factor VII and activated protein C are also obtained from recombinant animal cells. The methods for their purification are described. The problem of difference in posttranslational modifications between plasma derived and recombinant protein is discussed with regard to therapeutic proteins.     

Identification and isolation of vitamin K-dependent proteins by HPLC

Six of the seven known vitamin K-dependent proteins found in plasma were chromatographed on a large-pore propylsilane column using aqueous trifluoroacetic acid/acetonitrile gradients. Prothrombin and Factor VII coeluted, the others were readily resolved. The technique has been used to monitor the purification of protein C and protein S using immobilized anti-protein S. Preliminary evidence is presented which is suggestive of the existence of additional vitamin K-dependent proteins in plasma.