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J. Biol. Chem., Vol. 282, Issue 12, 9288-9296, March 23, 2007
Mechanism of Inactivation of Plasminogen Activator Inhibitor-1 by a Small Molecule Inhibitor* 1 1![]() 2
From the
Received for publication, December 19, 2006 , and in revised form, February 2, 2007.
The inactivation of plasminogen activator inhibitor-1 (PAI-1) by the small molecule PAI-1 inhibitor PAI-039 (tiplaxtinin) has been investigated using enzymatic analysis, direct binding studies, site-directed mutagenesis, and molecular modeling studies. Previously PAI-039 has been shown to exhibit in vivo activity in various animal models, but the mechanism of inhibition is unknown. PAI-039 bound specifically to the active conformation of PAI-1 and exhibited reversible inactivation of PAI-1 in vitro. SDS-PAGE indicated that PAI-039 inactivated PAI-1 predominantly through induction of PAI-1 substrate behavior. Preincubation of PAI-1 with vitronectin, but not bovine serum albumin, blocked PAI-039 activity while analysis of the reciprocal experiment demonstrated that preincubation of PAI-1 with PAI-039 blocked the binding of PAI-1 to vitronectin. Together, these data suggest that the site of interaction of the drug on PAI-1 is inaccessible when PAI-1 is bound to vitronectin and may overlap with the PAI-1 vitronectin binding domain. This was confirmed by site-directed mutagenesis and molecular modeling studies, which suggest that the binding epitope for PAI-039 is localized adjacent to the previously identified interaction site for vitronectin. Thus, these studies provide a detailed characterization of the mechanism of inhibition of PAI-1 by PAI-039 against free, but not vitronectin-bound PAI-1, suggesting for the first time a novel pool of PAI-1 exists that is vulnerable to inhibition by inactivators that bind at the vitronectin binding site.
Plasminogen activator inhibitor-1 (PAI-1)3 is a member of the serine protease inhibitor (serpin) gene family and is the principal inhibitor of both urokinase type plasminogen activator (uPA) and tissue type PA (tPA) (1-3). In healthy individuals, PAI-1 expression is low and generally confined to vascular smooth muscle cells, adipocytes, and the platelet precursor, megakaryocytes (4-7). However, its expression in many other cell types, including vascular endothelial cells, hepatocytes, and the stromal cells surrounding tumors, can be strongly up-regulated by a number of stimuli, including cytokines, growth factors, and endotoxin (6-11). PAI-1 is also stored in platelet -granules where it can be released upon platelet activation (12). Thus, its local concentration at sites of vascular injury or inflammation can be very high relative to normal plasma levels (13, 14).
Structurally, PAI-1 represents an example of the general serpin property of conformational plasticity. PAI-1 exists in multiple conformational states, including active, latent, proteasecomplexed, and cleaved forms (15). Active PAI-1 decays to the latent form with a half-life of 1-2 h at 37 °C, and exposure to denaturants can partially return the latent form to the active state (16). The biological significance of the latent form remains unknown. Like latent PAI-1, the cleaved form is also inactive, but unlike latent PAI-1 this form cannot be reactivated. The labile nature of PAI-1 appears to be critical for its function as a protease inhibitor, and like other serpins, PAI-1 acts as a "suicide inhibitor" that reacts only once with a target protease. This is because during serpin inhibition the protease cleaves the serpin reactive center loop (RCL) to the point of an acyl·enzyme intermediate, and this cleavage is coupled with a major conformational rearrangement of the serpin involving RCL insertion into In addition to uPA and tPA, PAI-1 also interacts with a number of non-protease ligands (1). These include heparin, the cell adhesion protein vitronectin, and members of the endocytic low density lipoprotein receptor family, such as the low density lipoprotein receptor-related protein, GP330/Megalin, and the very low density lipoprotein receptor (20-26). These non-protease interactions are important for both PAI-1 localization and for its function (27-32). High plasma PAI-1 levels are associated with both acute diseases such as sepsis and myocardial infarction (8, 33), and with chronic disorders, including cancer, atherosclerosis, and type 2 diabetes mellitus (34-37). The association of PAI-1 with these syndromes has led to the suggestion that PAI-1 may contribute to the pathology of disease. However, the mechanistic role that PAI-1 plays in disease development is not clear and is likely to be complex, because PAI-1 can act through at least two distinctly different pathways, either by modulating fibrinolysis through the regulation of plasminogen activators, or by influencing tissue remodeling through the direct regulation of cell migration (31, 38-41). The possibility that PAI-1 plays a direct role in a variety of diseases makes it an attractive target for small molecule drug development; however, the structural complexity of PAI-1 has made the identification and development of small molecule PAI-1-inactivating agents challenging (42-45). Recently, a novel, orally active small molecule PAI-1 inhibitor, PAI-039, also called tiplaxtinin, has been described and examined in several animal models of disease where PAI-1 is thought to play a role (46-52). These studies indicate that inhibition of PAI-1 activity is efficacious; however, the mechanism of action of this clinically relevant small molecule PAI-1 inactivating drug was not shown. Using PAI-039 as a molecular tool to investigate the inactivation of PAI-1, we have identified a mechanism suggesting the existence of a novel pool of PAI-1 vulnerable to inhibition by compounds that interact at the vitronectin binding domain.
PAI-039 was synthesized and characterized for chemical identity and purity at Wyeth Research (Collegeville, PA). Stock solutions were prepared in 100% Me2SO prior to dilution in assay buffer. Human native vitronectin, recombinant human wild-type PAI-1 (either non-glycosylated, expressed, and isolated from Escherichia coli or glycosylated, expressed, and isolated from insect cells), and rabbit polyclonal antibodies directed against human PAI-1 were from Molecular Innovations (Southfield, MI). High molecular weight human uPA was from Laboratories Serono S.A. (Aubonne, Switzerland). The chromogenic uPA substrate, pGlu-Gly-Arg-p-nitroanilide, was from Sigma, and the chromogenic tPA substrate, Pefachrome tPA, was from Centerchem Inc. (Norwalk, CT). Polystyrene 96-well Microtest Falcon plates were from BD Biosciences. All supplies and reagents for SDS-PAGE were from Bio-Rad. All supplies and buffers for binding assays with Biacore 3000® sensor chips were from Biacore AB (Uppsala, Sweden). All other chemical reagents used in the study were from Fisher Scientific (Pittsburgh, PA).
Direct PAI-1 Activity Assay with Chromogenic tPA/uPA SubstratesAll direct chromogenic assays with purified human PAI-1 and site-directed mutants were performed as described previously (53, 54). For determination of the effect of vitronectin on drug activity, 40 nM PAI-1 was incubated in 200 µl of assay buffer, either alone (control), or with 200 nM vitronectin, or 4 µM bovine serum albumin for 30 min at 23 °C, after which 10 µl of each sample was added to microtiter plate wells containing 80 µl of PAI-039 in assay buffer for final concentrations before substrate addition of either 80, 60, 40, 30, 20, 10, 5, or 0 µM PAI-039. The assay plate was briefly mixed on the plate reader, and then the mixture was incubated at 23 °C for 15 min. Next 10 µl of 50 nM uPA was added to each well, the plate was mixed briefly again, and the mixture was incubated for 5 min at 37 °C before adding 100 µl of substrate. The plate was then incubated at 37 °C for 5 min before reading
Surface Plasmon Resonance AnalysisDirect binding of PAI-039 to PAI-1 and PAI-1 to native human vitronectin was monitored using a Biacore 3000® optical biosensor (Biacore AB, Uppsala, Sweden). Purified recombinant human latent and active PAI-1 were immobilized at the level of
Reversibility AssayPAI-1 (9 nM) was incubated in an assay plate, with 80 µM PAI-039 or vehicle in assay buffer (10 mM HEPES, pH 7.4, 150 mM NaCl, 0.05% Tween 20) at 23 °C for 15 min prior to dilution. The concentrated PAI-1-PAI-039 or PAI-1-vehicle solutions were then serially diluted, 2-fold in parallel, in assay buffer. UPA (10 µl of 100 nM) was then added to each well after dilution of PAI-1-PAI-039 (final volume 100 µl), and the assay plate was incubated at 37 °C for 5 min before adding substrate. After substrate addition the assay plate was incubated at 37 °C for 5 min before reading
SDS-PAGE Analysis16 µl of vehicle or PAI-039 (10, 20, 40, and 80 µM final concentration) diluted in assay buffer were incubated with 2 µl of PAI-1 (500 nM final concentration) for 15 min before addition of 2 µl of uPA or tPA (400 nM final concentration). Samples were then reacted for 5 min at 37 °C, after which 40 µl of Laemmli sample buffer (Bio-Rad) with -mercaptoethanol was added to each sample. The samples were boiled for 3 min and separated by SDS-PAGE on a 10% gel run at 200 v for 45 min. The gels were rinsed three times in dH2O prior to Coomassie staining and destaining in dH2O. Gels were scanned using an Epson Expression 1680 flatbed scanner. Molecular DockingThe previously determined structure for the active form of PAI-1 (PDB code: 1B3K [PDB] ) was used as an initial template. This is a stable mutant of PAI-1 that has four mutated residues N150H, K154T, Q319L, and M354I (55). All hydrogens and the four mutated residues were first minimized using the AMBER force field (56). Next PAI-039 was docked to PAI-1 using the induced fit docking protocol developed by Schrodinger. Induced fit docking is based on the docking program Glide with the refinement module in Prime (Schrodinger, Inc.), which was reported to accurately predict ligand binding modes and concomitant structural changes in a receptor. Compounds were initially docked using Standard Precision Glide at reduced van der Waals scaling against three types of proteins: (i) R1, original active form of PAI-1; (ii) R2, the active form of PAI-1 with Arg-76 mutated to Ala; or (iii) R3, the active form of PAI-1 with Arg-118 mutated to Ala. After initial docking, prime refinement and scoring were performed on the initial constructed protein-ligand complex. The residues with in 5 Å of ligand poses were treated as being flexible. Both protonation states of carboxylic acids were considered for PAI-039. Site-directed MutagenesisTo identify the PAI-1 binding site for PAI-039, a variety of site-directed mutants was constructed using the QuikChange® site-directed mutagenesis kit from Stratagene (La Jolla, CA) as described before (53). Based upon computer modeling, the following amino acid residues were chosen for substitution by alanine: Arg-76, Tyr-79, Lys-80, Thr-93, Thr-94, Asp-95, Phe-114, Arg-118, Thr-120, Lys-122, and His-143. All mutations were confirmed by sequencing throughout the entire PAI-1 coding region of mutant plasmids isolated from three clones of each individual mutant. The functional characterization of these mutants was based on the IC50 of PAI-039 determined by direct chromogenic assay and by SPR analysis of vitronectin binding.
PAI-039 Binds to PAI-1 and Inhibits Its Anti-proteolytic Activity against Both tPA and uPATo examine the capacity of PAI-039 to block PAI-1 inhibitory activity, single step chromogenic assays were performed. For this analysis, purified recombinant PAI-1, either glycosylated or non-glycosylated, was preincubated with increasing concentrations of PAI-039 followed by the addition of uPA or tPA, and the remaining PAI-1 inhibitory activity was determined. These data are shown in Fig. 1, which demonstrates a dose-dependent inhibition of PAI-1 activity by PAI-039 with calculated IC50 values for PAI-1 inactivation by PAI-039 from 9 to 12 µM in this assay system (Table 1). The inhibition profile was similar regardless of the PAI-1 target enzyme, or the glycosylation state of PAI-1, indicating that the effect is specific for PAI-1 and independent of the protease.
Direct binding studies of the interaction between PAI-1 and PAI-039 were also performed using SPR analysis. For these studies PAI-1 in either the active or latent conformation was coupled to a sensor chip, and the binding of PAI-039 was determined in a Biacore 3000®. These data indicate that PAI-039 binds to PAI-1 in the active conformation (Fig. 2A); however, no specific binding is observed with PAI-1 in the latent conformation (inset, Fig. 2A). Fig. 2A shows the SPR binding curves for PAI-039 to PAI-1, and Fig. 2B shows a plot of the maximal binding of PAI-039 at equilibrium versus the PAI-039 concentration. Fitting the data in panel B with a single binding site model yields an apparent Kd for the binding of PAI-039 to active PAI-1 of 15 µM. PAI-039 Binding to PAI-1 Is ReversibleThe SPR data in Fig. 2A also demonstrate that the binding of PAI-039 to PAI-1 is reversible, because the drug rapidly dissociates from PAI-1 during the wash phase. Therefore, to determine if the inactivation of PAI-1 by PAI-039 is also reversible, experiments were performed where PAI-1 was incubated with PAI-039 in the absence of plasminogen activators at a concentration that fully inactivates PAI-1 when plasminogen activators are present. After this preincubation step, the samples were diluted to the PAI-039 concentrations indicated in Fig. 3 and reacted with uPA. The restoration of PAI-1 anti-protease activity was then determined in a chromogenic assay as in Fig. 1. These studies demonstrate that the dilution of PAI-039 in the reaction mixtures restored PAI-1 inhibitory activity to levels consistent with the final concentration of drug in each sample (Fig. 3). This indicates that, like the binding of PAI-039 to PAI-1, its ability to block PAI-1 activity is also reversible in the absence of plasminogen activators.
PAI-039 Blocks Covalent Complex Formation and Converts PAI-1 to a Substrate for PAsIn the absence of drug, PAI-1 forms stable covalent complexes with uPA or tPA of 93-105 kDa, respectively (Fig. 4, A and B). After pretreatment with increasing concentrations of PAI-039, the intensity of these higher molecular mass bands with both PAs decreased, indicating a reduction in complex formation due to drug-induced PAI-1 inactivation (Fig. 4, A and B). Associated with the loss of high molecular weight complexes is a concomitant increase in the intensity of the band representing the cleaved, substrate form of PAI-1. This suggests that the predominant mechanism of inactivation by PAI-039 is to block productive inhibition of PAs by inducing turnover of the complex and cleavage of PAI-1 by the PAs as a substrate. At the highest PAI-039 concentration tested (80 µM) there was a reduction in the cleaved PAI-1 band compared with the 40 µM dose. This suggests that at high PAI-039 concentrations, well above the IC50 and Kd values, PAI-039 blocks PAI-1 activity by an alternate mechanism. The nature of this secondary mechanism is not clear; however, it is unlikely that this was due to the induction of a conformational change in PAI-1 to the latent form by the drug at these concentrations, because the data in Fig. 3 above indicated that even at these high concentrations of PAI-039 the inactivation of PAI-1 was reversible, whereas the conversion of PAI-1 to the latent conformation was not reversible under these conditions. Taken together, these data suggest the mechanistic basis for PAI-1 inactivation by PAI-039 is induction of substrate behavior. Thus, PAI-1 inactivation by the drug would remain reversible until the drugbound PAI-1 is reacted with a plasminogen activator where upon PAI-1 is cleaved as a substrate and the inactivation becomes irreversible. Consistent with this interpretation, no PAI-1 activity was restored in reversibility experiments similar to those shown in Fig. 3 when plasminogen activator was added prior to dilution of the drug-treated samples (data not shown).
PAI-1 Binding to PAI-039 or Vitronectin Is Mutually ExclusiveIn blood, PAI-1 circulates bound to vitronectin, and this high affinity binding also facilitates the localization of PAI-1 within the tissue matrix. To determine if PAI-039 binding to PAI-1 could influence PAI-1 association with vitronectin, SPR experiments were performed with immobilized vitronectin. PAI-1 was first preincubated with increasing concentrations of PAI-039 followed by SPR analysis of PAI-1 binding to vitronectin. Fig. 5 shows the results of these studies; panel A demonstrates that the binding of PAI-1 to vitronectin is reduced as the PAI-039 concentration increases, and panel B shows the inhibition binding curves calculated from the slopes of the association phase of both glycosylated and non-glycosylated PAI-1 binding to vitronectin. The IC50 values calculated for the inhibition of PAI-1 binding to vitronectin by PAI-039 ( 13-17 µM) were very similar to both the IC50s for inhibition reported above and to the Kd for PAI-039 binding to PAI-1. This indicates that PAI-039 not only inhibits PAI-1 anti-protease activity but also blocks its association with vitronectin.
We also examined if the prior association of PAI-1 with vitronectin could influence the activity of PAI-039 on PAI-1. For these studies PAI-1 was preincubated with either vitronectin or bovine serum albumin, and the inactivation of PAI-1 by PAI-039 was examined by the chromogenic assay for PAI-1 activity. These results indicated that a 5x molar excess of vitronectin completely prevented the drug-induced inactivation of PAI-1, whereas preincubation of PAI-1 with a 100x molar excess of bovine serum albumin had no effect on the ability of PAI-039 to inhibit PAI-1 activity (Fig. 5C). This implies that PAI-1 bound to vitronectin is protected from inactivation by PAI-039, and together with the data in A and B, these results suggest that the binding of PAI-039 or vitronectin to PAI-1 is mutually exclusive. We can speculate from these results that PAI-039 may bind near the PAI-1-vitronectin binding site and that, when bound, PAI-039 sterically blocks vitronectin binding to PAI-1. Likewise, if the order of addition is reversed and PAI-1 is first permitted to associate with vitronectin, then PAI-1 is protected from PAI-039 inactivation, possibly because the PAI-039 binding site is blocked by vitronectin.
Modeling of PAI-039 Binding to PAI-1 and Mapping of the Binding Site by MutagenesisMolecular modeling studies were next performed to search for potential binding sites on PAI-1 for PAI-039. The potential sites were searched based on the shape of the protein with the aid of "LigandFit" module of Cerius 2 (Accelrys, San Diego, CA). The method employs a cavity detection algorithm (57) for detecting invaginations in the protein as candidate binding site regions. With the additional information on the physicochemical properties, charge, hydrophobicity, and the ligand interactions, a hypothetical conformational binding site for PAI-039 in PAI-1 was identified in a cleft on the PAI-1 structure in the region of helices D and E,
To examine the predictive value of the model, we performed extensive site-directed mutagenesis in this region, and the efficacy of PAI-039 toward each of these mutants was examined in Escherichia coli cell extracts. However, before performing analysis of the mutants we first examined the activity of PAI-039 against PAI-1 in E. coli cell extracts and compared this to its activity against purified PAI-1 (Fig. 7). These data demonstrated that the IC50 of PAI-039 in cell extracts from E. coli expressing wild-type PAI-1 was identical to the IC50 of PAI-039 against purified PAI-1. This indicated that we could examine the activity of PAI-039 against a large number of PAI-1 mutants without the need to individually purify each mutant. The results of these experiments are shown in Table 2, and a representative titration with one of the site-directed mutants (D95A) is shown in Fig. 7. These data demonstrate that several mutations in and around the proposed binding site increased the IC50 of PAI-039 by >20%, suggesting that these mutants did not interact as strongly with PAI-039 as did wild-type PAI-1. These residues were R76A and Y79A in helix D and T93A, T94A, and D95A in -strand 2A. The three most severely affected residues were R76A, T94A, and D95A, which all showed increases in IC50 values of 50%. Interestingly, two mutations actually reduced the IC50 of PAI-039. These were T120A and K122A in the surface loop connecting helix E to -strand 1A. Neither of these residues was predicted to interact directly with PAI-039 in our modeling studies, but they are located immediately adjacent to the cleft and may alter the conformation of the binding cleft. Alternatively, the larger side chains on the wild-type residues may partially shield access to the cleft by PAI-039 in wild-type PAI-1. Thus, comparison of the mutagenesis data with the modeling analysis in Fig. 6 suggests that the model likely represents a close approximation of the binding interaction; however, the precise orientation of the PAI-039 may be slightly different than shown, because the mutation of the Arg-118 has little effect on PAI-039 activity. Furthermore, the relatively modest effect of each mutation suggests that the drug binds to PAI-1 largely through hydrophobic interactions, because mutations that disrupt hydrogen bonds or ionic interactions would be expected to show significantly greater increases in IC50 values. This result is also consistent with the hydrophobic nature of PAI-039.
PAI-1 inhibits the serine proteases tPA and uPA, and thereby regulates fibrinolysis and tissue remodeling, affecting diverse pathologies, including thrombosis and atherosclerosis. PAI-1 has therefore been termed a common denominator in cardiovascular and metabolic disease, not only because it occupies a central mechanistic position regulating the initiation of proteolysis, but also due to its significant synthesis by platelets, smooth muscle cells, and adipocytes. Thus, PAI-1 inhibitors could have potential therapeutic benefit in many diseases where plasma and tissue levels of PAI-1 are elevated, including deep vein thrombosis, cancer, and type 2 diabetes. Monoclonal antibody inhibitors of PAI-1 have been characterized (58), but their demonstrated efficacy in preclinical models of disease is limited, and use in humans is often excluded because of poor pharmacological and immunological properties. Therefore, the development of effective small molecule PAI-1 inactivating agents with oral bioavailability and oral efficacy will greatly improve the potential for targeting PAI-1 for therapeutic intervention. Previously we described the characterization of a benzofuran derivative, WAY-140312, which was the first small molecule PAI-1 inhibitor to exhibit oral efficacy (45). A different chemical scaffold was used to develop a second generation of molecules, of which PAI-039 (tiplaxtinin) is representative.
PAI-1 initially forms a reversible Michaelis complex with its target protease, followed by irreversible inactivation induced by insertion of the PAI-1 RCL into Our experiments have also extensively characterized other novel aspects of the interactions of PAI-039 with PAI-1. For example, we show that inhibition occurs equally with non-glycosylated and glycosylated PAI-1. We also found that PAI-039 bound reversibly, and its activity was affected by the presence of vitronectin. The effect of vitronectin was specific, because 100-fold molar excess of bovine serum albumin had no effect on the interaction with PAI-1. In their analysis, Egelund et al. (43) hypothesized that the vitronectin-neutralizing effect seen with the compounds that they used could hamper in vivo activity, because most PAI-1 circulates bound to vitronectin. Consistent with this logical hypothesis we found that preincubation of PAI-1 in plasma from PAI-1 null mice protected the PAI-1 from inactivation by PAI-039, whereas PAI-1 preincubated in plasma from double vitronectin/PAI-1 null mice was not protected (not shown). Nevertheless, PAI-039 has been shown to exhibit potent efficacy in vivo, with a hemostatic profile of normal coagulation, but with accelerated fibrinolysis, which is similar to that observed following vascular injury in PAI-1 knockout mice (46, 47, 50, 51). PAI-039 has also been shown to block the inhibition of cell adhesion and migration by PAI-1 in cell culture systems and to inhibit angiogenesis in vivo in a PAI-1-dependent manner (52). Although there is always a possibility that PAI-039 is working through some as yet undiscovered mechanism, it is clear that it is a potent in vitro inhibitor of free PAI-1 that exhibits excellent properties for a drug candidate. Therefore, an alternative explanation of the observed in vivo activity could be based upon the dynamic interaction between PAI-1 and vitronectin and the fact that normal turnover creates a novel pool of PAI-1 susceptible to attack by PAI-039. This is similar to what has been shown in vivo by infusion of a dominant negative PAI-1 capable of binding vitronectin but without the ability to inhibit its target proteases (62-64). Treatment with this mutant PAI-1 showed a significant in vivo effect in a model of severe renal fibrosis by competing vitronectin-bound active PAI-1 with vitronectin-bound inactive PAI-1, indicating that wild-type PAI-1 activity can be blocked in vivo even in the presence of normal vitronectin levels. These data suggest that the PAI-1 vitronectin interaction is dynamic in vivo and thus that PAI-1 is susceptible to inactivation in vivo. These data are further supported by studies in human adipose tissue, which is considered the largest tissue source of PAI-1. Human adipocytes actively synthesize PAI-1, but not vitronectin, implying that PAI-1 is secreted from these cells in the free conformation (65). Thus, we speculate that, in normal individuals where tissue synthesis of PAI-1 is low, and plasma PAI-1 circulates in complex with vitronectin at sub-nanomolar levels, the drug would be expected to have a minimal effect on PAI-1 activity; however, in situations where PAI-1 synthesis is elevated in tissues, such as adipose, as for example in type 2 diabetes (66), the drug would be expected to produce a significant inhibitory effect. Although this hypothesis of an adipose tissue-specific micro-environment for susceptible PAI-1 is novel, the concept is similar to that proposed by Rosenberg and Aird for the vascular-bed-specific regulation of hemostasis (67). Our studies suggest that a similar concept may apply to the interaction of PAI-1 and vitronectin in the local tissue milieu. Finally, it is worth noting that the interaction of PAI-1 with PAI-039 is also dynamic, and PAI-039 binds active PAI-1 reversibly. This suggests that if the binding of PAI-039 to PAI-1 remains reversible in the presence of a protease, while the inactivation becomes irreversible due to the cleavage of the PAI-1 RCL by the protease, then this unique mechanism of reversible binding and irreversible inactivation may permit PAI-039 to act catalytically against multiple PAI-1 molecules.
* This work was supported by National Institutes of Health Grants HL55374, HL55747, and P01HL54710 and by Wyeth Research. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 Both authors contributed equally to this work. 2 To whom correspondence should be addressed: Dept. of Internal Medicine, University of Michigan Medical School, 7301 MSRB III, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-0644. Tel.: 734-763-7838; Fax: 734-936-2641; E-mail dlawrenc{at}umich.edu.
3 The abbreviations used are: PAI-1, plasminogen activator inhibitor-1; PAI-039, tiplaxtinin; serpin, serine protease inhibitor; uPA, urokinase type plasminogen activator; tPA, tissue type PA; RCL, reactive center loop; SPR, surface plasmon resonance; RU, response units; SAR, structure activity relationship.
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