Neuroprotective activities of activated protein C mutant with reduced anticoagulant activity

Eur J Neurosci. 2009 Mar;29(6):1119-30. doi: 10.1111/j.1460-9568.2009.06664.x.

Abstract

The anticoagulant activated protein C (APC) protects neurons and endothelium via protease activated receptor (PAR)1, PAR3 and endothelial protein C receptor. APC is neuroprotective in stroke models. Bleeding complications may limit the pharmacologic utility of APC. Here, we compared the 3K3A-APC mutant with 80% reduced anticoagulant activity and wild-type (wt)-APC. Murine 3K3A-APC compared with wt-APC protected mouse cortical neurons from N-methyl-D-aspartate-induced apoptosis with twofold greater efficacy and more potently reduced N-methyl-D-aspartate excitotoxic lesions in vivo. Human 3K3A-APC protected human brain endothelial cells (BECs) from oxygen/glucose deprivation with 1.7-fold greater efficacy than wt-APC. 3K3A-APC neuronal protection required PAR1 and PAR3, as shown by using PAR-specific blocking antibodies and PAR1- and PAR3-deficient cells and mice. BEC protection required endothelial protein C receptor and PAR1. In neurons and BECs, 3K3A-APC blocked caspase-9 and -3 activation and induction of p53, and decreased the Bax/Bcl-2 pro-apoptotic ratio. After distal middle cerebral artery occlusion (dMCAO) in mice, murine 3K3A-APC compared with vehicle given 4:00 h after dMCAO improved the functional outcome and reduced the infarction volume by 50% within 3 days. 3K3A-APC compared with wt-APC multi-dosing therapy at 12:00 h, 1, 3, 5 and 7 days after dMCAO significantly improved functional recovery and reduced the infarction volume by 75% and 38%, respectively, within 7 days. The wt-APC, but not 3K3A-APC, significantly increased the risk of intracerebral bleeding as indicated by a 50% increase in hemoglobin levels in the ischemic hemisphere. Thus, 3K3A-APC offers a new approach for safer and more efficacious treatments of neurodegenerative disorders and stroke with APC.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analysis of Variance
  • Animals
  • Antibodies / pharmacology
  • Anticoagulants / metabolism
  • Anticoagulants / therapeutic use*
  • Apoptosis / drug effects
  • Brain / cytology
  • Caspase 3 / metabolism
  • Caspase 9 / metabolism
  • Cells, Cultured
  • Embryo, Mammalian
  • Endothelial Cells / drug effects
  • Enzyme Inhibitors / pharmacology
  • Excitatory Amino Acid Agonists / toxicity
  • Female
  • Glucose / deficiency
  • Hemoglobins / metabolism
  • Humans
  • Hypoxia / drug therapy
  • In Situ Nick-End Labeling / methods
  • Infarction, Middle Cerebral Artery / drug therapy
  • Infarction, Middle Cerebral Artery / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mutation / physiology*
  • N-Methylaspartate / toxicity
  • Neurons / drug effects
  • Neurons / physiology
  • Neuroprotective Agents / metabolism
  • Neuroprotective Agents / therapeutic use*
  • Pregnancy
  • Protein C / chemistry
  • Protein C / genetics*
  • Protein C / immunology
  • Protein C / therapeutic use*
  • Receptors, Proteinase-Activated / genetics
  • Time Factors
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Antibodies
  • Anticoagulants
  • Enzyme Inhibitors
  • Excitatory Amino Acid Agonists
  • Hemoglobins
  • Neuroprotective Agents
  • Protein C
  • Receptors, Proteinase-Activated
  • Tumor Suppressor Protein p53
  • N-Methylaspartate
  • Caspase 3
  • Caspase 9
  • Glucose