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Interaction of certain metal ions with prothrombin and prothrombin fragment 1 has been shown to result in conformational change(s). Self-association of prothrombin and prothrombin fragment 1 in the presence of divalent cations has been reported. The present study has made use of a covalent cross-linking reagent, dithiobis(succinimidylpropionate), to study the self-association of prothrombin in the presence of divalent cations. In the presence of certain divalent cations, prothrombin dimer is the product of such cross-linking. Optimal dimerization of bovine prothrombin requires preincubation with calcium ions prior to the addition of cross-linking reagent. Calcium ions are also required for dimerization after this preincubation period. A similar time dependence is not seen with human prothrombin. The dimerization of bovine prothrombin is also supported by strontium and gadolinium to an extent comparable to that of calcium and to a lesser extent by barium or manganese. Magnesium ions do not support dimerization. The results suggest that certain divalent cations either induce or stabilize a conformation of prothrombin which can self-associate to form dimers. The results further suggest that divalent cations are also necessary for the actual cross-linking process subsequent to this conformational change.

The present study has made use of a covalent cross-linking agent, dithiobis(succinimidylpropionate), to study the self-association of prothrombin and has demonstrated that the covalent dimerization reaction involves the gamma-carboxyglutamic acid region of prothrombin (1-42 of 582). An essential role for the gamma-carboxyglutamic acid residues of prothrombin in the association reaction was demonstrated by experiments that converted gamma-carboxyglutamic acid residues to gamma-methylene glutamic acid or glutamic acid and resulted in a prothrombin species that was inactive in our cross-linking assay. Other experiments showed that very high concentrations of calcium ion inhibit the cross-linkage of prothrombin. This result is most consistent with an essential gamma-carboxyglutamic acid-calcium ion-gamma-carboxyglutamic acid bridge(s) in the calcium-dependent self-associated form of prothrombin.

beta-Thrombin, a product of the limited proteolysis of alpha-thrombin, is characterized by greatly reduced fibrinogen-clotting activity as compared to alpha-thrombin but with unchanged activity toward ester substrates. The present study was designed to elucidate the basis for the changes in the catalytic activity resulting from the conversion of bovine alpha-thrombin to bovine beta-thrombin. Fibrinogen was utilized as a competitive inhibitor in the hydrolysis of a peptide nitroanilide substrate by bovine alpha- and beta-thrombin. The Ki values obtained for fibrinogen in these experiments were similar for alpha- and beta-thrombin (about 10 microM). Similar values for Ki were obtained when fibrinogen was used to inhibit the inactivation of bovine alpha- and beta-thrombin by diisopropylphosphorofluoridate. These experiments suggested that the conversion of bovine alpha- to beta-thrombin does not affect the fibrinogen-binding site on thrombin. Differences in the reactivity of functional groups at the active site were then explored. beta-Thrombin was observed to undergo modification at the active site histidine at a slower rate than that of alpha-thrombin when reacted with either tosyllysyl chloromethyl ketone or diethyl pyrocarbonate. It is suggested that the difference in the fibrinogen-clotting activity of these two forms of thrombin can result from changes in the reactivity of the active site histidine residue.

Diethyl pyrocarbonate (ethoxyformic anhydride) was used to modify histidyl residues in prothrombin. Diethyl pyrocarbonate inactivated the potential fibrinogen-clotting activity of prothrombin with a second-order rate constant of 70 M-1 min-1 at pH 6.0 and 25 degrees C. The difference spectrum of the modified protein had a maximum absorption at 240 nm which is characteristic of N-carbethoxyhistidine. The pH dependence for inactivation suggested the participation of a residue with a pKa of 6.2. Addition of hydroxylamine to ethoxyformylated prothrombin reversed the loss of fibrinogen-clotting activity. No structural differences were detected between the native and modified proteins using fluorescence emission and high-performance size-exclusion chromatography. The tyrosine and tryptophan content was not altered, but approximately 1-2 amino groups were modified. Statistical analysis of residual enzyme activity and extent of modification indicates that among 7 histidyl residues modified per molecule, there is 1 essential histidine (not in the active site) involved in the potential fibrinogen-clotting activity of prothrombin. To further examine its properties, the modified prothrombin was activated to thrombin using Echis carinatus venom protease. There was no difference in the catalytic activity of thrombin obtained from either native or ethoxyformylated prothrombin, as measured by H-D-Phe-pipecolyl-Arg-p-nitroanilide (D-Phe-Pip-Arg-NA) hydrolysis. However, thrombin produced from the modified protein showed a loss of fibrinogen-clotting activity but had a comparable apparent Ki value (about 20 microM) to thrombin from native prothrombin when fibrinogen was used as a competitive inhibitor during D-Phe-Pip-Arg-NA hydrolysis. The similarity in Ki values indicated that thrombin derived from diethyl pyrocarbonate-modified prothrombin does not have an altered fibrinogen-binding site. Although the histidyl residue involved during inactivation has not been identified, the results suggest that a histidyl residue in the thrombin portion of prothrombin is essential for interaction with fibrinogen.

The interaction of metal ions with prothrombin fragment 1 has been shown by other investigators to result in conformational change(s). Previous studies based on hydrodynamic measurements from other laboratories have suggested that prothrombin fragment 1 will, in addition to undergoing conformational change, self-associate in the presence of metal ions but there is a question regarding the specificity and role of metal ions in this process. The present study has made use of a covalent cross-linking agent, dithiobis(succinimidylpropionate), to study the self-association of prothrombin fragment 1 and has focused on factors influencing the covalent dimerization of bovine prothrombin fragment 1 during reaction with this reagent. Optimal dimerization of bovine prothrombin fragment 1 required the involvement of cations in two separable processes. The “first role” is probably a reflection of a slow conformational change in the bovine prothrombin fragment 1 representing isomerization of a proline-containing peptide bond (Marsh, H. C., Scott, M. E., Hiskey, R. G., and Koehler, K. A. (1979) Biochem. J. 183, 513-517). The “second role” most likely reflects ion bridging with another prothrombin fragment 1 molecule. The ion specificities of these two roles are clearly different. Ions stabilizing the proper conformation (first role) are Ca2+, Sr2+, Mg2+, Mn2+, with Ba2+ having less capability in filling this role. Ions which have activity in the second role (ion bridge formation) are Ca2+, Sr2+, and Ba2+. Mn2+ and Mg2+ cannot fulfill the requirements of this second role and actually inhibit the function of Ca2+.

Previous studies from several laboratories have shown that thrombin is inactivated by tetranitromethane with the formation of nitrotyrosine. The inactivation is characterized by an apparently greater loss of fibrinogen-clotting activity than activity toward synthetic ester substrates, suggesting that the residues modified by tetranitromethane are involved in the interaction of thrombin with fibrinogen. This study was designed 1) to determine the effect of solvent conditions on the rate of modification and the stoichiometry of the reaction of tetranitromethane with bovine alpha-thrombin; 2) to identify the residue(s) modified; and 3) to characterize the modified enzyme with respect to its interaction with peptide nitroanilide substrates and fibrinogen. The inactivation of thrombin by tetranitromethane proceeded more rapidly in 50 mM Tris, pH 8.0, than in 50 mM sodium phosphate, 100 mM NaCl, pH 8.0. Approximately 10% fibrinogen-clotting activity remained at maximal inactivation. A study of the effect of tetranitromethane concentration on the rate of inactivation suggested that the loss of activity was the result of the modification of 1 mol of tyrosine/mol of thrombin. A similar result was obtained from the analysis of the extent of inactivation as a function of the extent of protein modification. Structural analysis of the modified protein showed substantial modification at both Tyr71 and Tyr85. Enzyme kinetic studies were performed with the modified protein and a control thrombin with N2-tosylglycylprolylarginine p-nitroanilide. H-D-phenylalanylpipecolylarginine p-nitronailide, and purified bovine fibrinogen. With all three substrates, a substantial decrease in kcat was observed, whereas there was essentially no change in Km. These results suggest that, contrary to previous suggestions, the modification of Tyr71 and Tyr85 in thrombin does not influence the binding of substrates, but rather influences active site reactivity.

The lysoplate and turbidimetric assays have often been used to measure lysozyme in biological fluids, such as blood and saliva. When the same purified lysozyme standard is used in both assays, results obtained with the lysoplate assay are much higher than those obtained for the same sample in the turbidimetric assay. It is likely, therefore, that other components in the biological fluid sample influence the expression of lysozyme activity in one or both assays to produce such divergent results. Certain amines or polyamines are found in various biological fluids and have the potential to influence the reactions in these two assay systems. It was the purpose of this study to incorporate selected amines and polyamines into purified lysozyme preparations and saliva or into the assay preparations to compare their effects on observed lysozyme activity between the two assay systems. Results showed that when the amine or polyamine was included in the purified sample, lysozyme activity was considerably greater than that of controls in the lysoplate assay, whereas a negligible effect was observed in the turbidimetric assay. If the amine or polyamine was incorporated into the assay preparation, results were more dramatic, with large increases in activity in the lysoplate assay and concomitant inhibition in the turbidimetric assay. Similar effects were observed in the assay of lysozyme in saliva, suggesting a potential mechanism by which the two assay systems produce markedly different results for the same sample.

The use of different assay conditions has complicated the evaluation of studies relating salivary lysozyme levels to oral or systemic disease. The purpose of this study was to compare values obtained for lysozyme activity in mixed saliva of 104 healthy subjects by using two assay techniques and four variations in sample preparation. Lysozyme activity was assayed by the turbidimetric and lysoplate methods with human colostrum lysozyme as the standard. Lysozyme activity in saliva samples made 0.5 M with respect to NaCl was compared with that in untreated samples with and without centrifugation. Mean values for lysozyme concentration in centrifuged saliva were 2.2 micrograms/ml with the turbidimetric assay and 5.9 micrograms/ml with the lysoplate assay. In samples which were salt treated before centrifugation, mean concentrations increased to 17.3 and 72.9 micrograms/ml, respectively. The results for uncentrifuged saliva were four to five times higher than the results for centrifuged saliva in each of the assay systems. Salt treatment without centrifugation produced values comparable to those obtained with centrifugation. The addition of salt to human colostrum or hen egg white lysozyme generally resulted in a 20 to 25% increase in expressed activity. These results indicate that the measurement of lysozyme in the supernatant of centrifuged saliva is of questionable value, most of the lysozyme in whole saliva is inactive and may be activated by markedly increasing the ionic strength, and values for lysozyme activity in whole saliva are much greater in the lysoplate assay than in the turbidimetric assay when the same standard is used.

So much has been written on the injection treatment of varicose veins during the past three years that we hesitate to add more to the already extensive literature. New ideas, however, are always welcome and we take the liberty of presenting this paper, hoping that the reader may find something worthy of his attention.The injection treatment of varicose veins has long been accepted as the most rational method of caring for this malady. It is now used by most of the profession. When one considers the disability, the length of hospitalization, the pain, the expense, the scarring, and the mortality risk involved in the operative treatment of the past, one can readily see why the injection treatment is so universally accepted.The one most commonly discussed shortcoming of the injection treatment is the percentage of recurrences.1 It is granted that varices in veins actually removed by surgical operation

Background: Deep sternal wound/mediastinitis is a rare but feared complication in coronary artery bypass grafting (CABG) patients and seems to increase the risk of cardiac death, and is also associated with the risk of early internal mammary artery (IMA) graft obstruction. The pathological mechanism explaining the link between mediastinitis and IMA graft obstruction and the impact on mortality is complex, multifactorial, and not fully investigated., Objectives: Mediastinitis has been associated with increased concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) at mid-term follow-up, representing persistent low-grade myocardial injury and impaired cardiac function. However, whether mediastinitis is associated with all-cause mortality, or whether the association is driven by these cardiac-specific biomarkers (NT-proBNP and TnT), is not investigated., Methods: The present study provides the longest and most complete follow-up data in 82 patients undergoing CABG, including 41 with post-sternotomy mediastinitis., Results: The annualized incidence rate of mediastinitis was 0.14%/year and remained stable at 0.14% throughout the study period. During a mean follow-up of 12.7 ± 3.5 years, a total of 42 deaths occurred (27 [65.9%] in mediastinitis and 15 [36.6%] in non-mediastinitis group, p = 0.008). No association was found between IMA or saphenous vein graft obstruction with all-cause mortality. Mediastinitis was associated with a 1.9-fold increased risk of all-cause mortality. However, in the multivariable-adjusted models, age and higher TnT and NT-proBNP levels, but not mediastinitis per se were associated with all-cause mortality., Conclusions: Mediastinitis after CABG surgery was associated with a poor prognosis during a 15-year follow-up, showing a nearly two-fold higher frequency of all-cause mortality compared with non-mediastinitis group, with the differences in mortality rate occurring primarily after 10 years. The association between mediastinitis and all-cause mortality was modulated by subclinical myocardial damage and stretch, reflected by elevated TnT and NT-proBNP, measured at 2.7-year follow-up, underscoring that these could represent prognostic markers in CABG patients., (© 2023 S. Karger AG, Basel.)