Laminin G1 residues of protein S mediate its TFPI cofactor function and are competitively regulated by C4BP

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Abstract

Protein S is a cofactor in the tissue factor pathway inhibitor (TFPI) anticoagulant pathway. It enhances TFPIa-mediated inhibition of factor (F)Xa activity and generation. The enhancement is dependent on a TFPIa-protein S interaction involving TFPIa Kunitz 3 and protein S laminin G-type (LG)-1. C4b binding protein (C4BP), which binds to protein S LG1, almost completely abolishes its TFPI cofactor function. However, neither the amino acids involved in TFPIa enhancement nor the mechanisms underlying the reduced TFPI cofactor function of C4BP-bound protein S are known. To screen for functionally important regions within protein S LG1, we generated 7 variants with inserted N-linked glycosylation attachment sites. Protein S D253T and Q427N/K429T displayed severely reduced TFPI cofactor function while showing normal activated protein C (APC) cofactor function and C4BP binding. Based on these results, we designed 4 protein S variants in which 4 to 6 surface-exposed charged residues were substituted for alanine. One variant, protein S K255A/E257A/D287A/R410A/K423A/E424A, exhibited either abolished or severely reduced TFPI cofactor function in plasma and FXa inhibition assays, both in the presence or absence of FV-short, but retained normal APC cofactor function and high-affinity C4BP binding. The C4BP b-chain was expressed to determine the mechanisms behind the reduced TFPI cofactor function of C4BP-bound protein S. Like C4BP-bound protein S, C4BP b-chain-bound protein S had severely reduced TFPI cofactor function. These results show that protein S Lys255, Glu257, Asp287, Arg410, Lys423, and Glu424 are critical for protein S-mediated enhancement of TFPIa and that binding of the C4BP b-chain blocks this function.

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Teraz-Orosz, A., Gierula, M., Petri, A., Jones, D., Keniyopoullos, R., Folgado, P. B., … Ahnstrom, J. (2022). Laminin G1 residues of protein S mediate its TFPI cofactor function and are competitively regulated by C4BP. Blood Advances, 6(2), 704–715. https://doi.org/10.1182/bloodadvances.2021005382

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