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Originally published In Press as doi:10.1074/jbc.M203415200 on May 14, 2002
J. Biol. Chem., Vol. 277, Issue 30, 27232-27239, July 26, 2002
Low Molecular Weight Peptides Restore the Procoagulant
Activity of Factor VIII in the Presence of the Potent Inhibitor
Antibody ESH8*
Sylvie
Villard,
Dominique
Piquer,
Sanjee
Raut ,
Jean-Paul
Léonetti,
Jean-Marie
Saint-Remy§, and
Claude
Granier¶
From the Unité Mixte de Recherche, CNRS 5094, Faculté
de Pharmacie, BP 14491, 34093 Montpellier, France,
the Division of Haematology, National Institute for
Biological Standards and Control, Blanche Lane, South Mimms, Potters
Bar, Hertfordshire EN6 3QG, United Kingdom, and the § Center
for Molecular and Vascular Biology, University of Leuven,
3000 Leuven, Belgium
Following repeated administration of factor VIII
(FVIII), a significant number of hemophilia A patients develop
antibodies (Abs), inhibiting the procoagulant activity of infused
FVIII. We have designed an approach based on the blocking of the
deleterious activity of these Abs by peptide decoys mimicking the
anti-FVIII Ab epitopes. Here, the well characterized inhibitory
monoclonal Ab ESH8 served as a model. Several phage peptide
libraries were screened for specific binding to ESH8. Seven constrained
dodecapeptide sequences were obtained. Six sequences carried the
consensus motif, hydrophobic-(Y/F)GKTXL. This motif
showed a certain similarity with the
2231QVDFQKTMKV2240 sequence of the
C2 domain. In the seventh sequence, YCNPSIGDKNCR, the
residues GDKN are similar to the sequence
2267DGHQ2270. Upon inspection of the
C2 domain crystallographic structure, the two stretches
QVDFQKTMKV and DGHQ appeared close together in space and might
constitute a discontinuous epitope. Corresponding synthetic peptides
were able to inhibit the binding of ESH8 to FVIII in a specific and
dose-dependent manner. Moreover, the ability of the
selected peptides to neutralize the inhibitory activity of ESH8 was
demonstrated in functional tests as well as in vivo in a murine model of hemophilia A. This study demonstrates the potential of this approach to neutralize the activity of potent inhibitory Abs.
*
This work was partly supported by a grant from Wyeth.The costs of publication of this
article were defrayed in part by the payment of page charges. The article
must therefore be hereby marked
"advertisement" in
accordance with 18 U.S.C. Section
1734 solely to indicate this fact.
¶
To whom correspondence should be addressed: UMR CNRS 5094, Faculté de Pharmacie, BP 14491, 15 Ave. Charles Flahault, 34093 Montpellier Cedex 5, France. Tel.: 33-4-67-54-86-02; Fax:
33-4-67-54-86-10; E-mail:
claude.granier@ibph.pharma.univ-montp1.fr.
Copyright © 2002 by The American Society for Biochemistry and Molecular Biology, Inc.

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Copyright © 2002 by the American Society for Biochemistry and Molecular Biology.
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