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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
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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 RautDagger , 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, Dagger  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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