Factor VII-Activating Protease Is Activated in Multiple Trauma Patients and Generates Anaphylatoxin C5a

Department of Medicine, Institute for Biochemistry, Justus Liebig University, D-35392 Giessen, Germany.
The Journal of Immunology (Impact Factor: 4.92). 03/2012; 188(6):2858-65. DOI: 10.4049/jimmunol.1103029
Source: PubMed


Severe tissue injury results in early activation of serine protease systems including the coagulation and complement cascade. In this context, little is known about factor VII-activating protease (FSAP), which is activated by substances released from damaged cells such as histones and nucleosomes. Therefore, we have measured FSAP activation in trauma patients and have identified novel FSAP substrates in human plasma. Mass spectrometry-based methods were used to identify FSAP binding proteins in plasma. Anaphylatoxin generation was measured by ELISA, Western blotting, protein sequencing, and chemotaxis assays. Plasma samples from trauma patients were analyzed for FSAP Ag and activity, nucleosomes, C5a, and C3a. Among others, we found complement components C3 and C5 in FSAP coimmunoprecipitates. C3 and C5 were cleaved by FSAP in a dose- and time-dependent manner generating functional C3a and C5a anaphylatoxins. Activation of endogenous FSAP in plasma led to increased C5a generation, but this was not the case in plasma of a homozygous carrier of Marburg I single nucleotide polymorphism with lower FSAP activity. In multiple trauma patients there was a large increase in circulating FSAP activity and nucleosomes immediately after the injury. A high correlation between FSAP activity and C5a was found. These data suggest that activation of FSAP by tissue injury triggers anaphylatoxin generation and thereby modulates the posttraumatic inflammatory response in vivo. A strong link between C5a, nucleosomes, and FSAP activity indicates that this new principle might be important in the regulation of inflammation.

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Available from: Michael Etscheid, Feb 10, 2015
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    • "Elevated levels of circulating Cfs has been reported in several disease conditions that have included auto-immune disorders [6], and a wide variety of acute and chronic human pathologies, such as severe infection [7], sepsis [8], trauma [9], diabetes [10], stroke [11] and renal failure [10]. Elevated levels of Cfs have been consistently reported in cancer [12] [13], and the levels rise dramatically immediately following chemo-or radiotherapy [14e 17]. "
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