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Glycated albumin modulates the contact system with implications for the kallikrein-kinin and intrinsic coagulation systems.


ABSTRACT:

Background

Human serum albumin (HSA) is the most abundant plasma protein and is sensitive to glycation in vivo. The chronic hyperglycemic conditions in patients with diabetes mellitus (DM) induce a nonenzymatic Maillard reaction that denatures plasma proteins and forms advanced glycation end products (AGEs). HSA-AGE is a prevalent misfolded protein in patients with DM and is associated with factor XII activation and downstream proinflammatory kallikrein-kinin system activity without any associated procoagulant activity of the intrinsic pathway.

Objectives

This study aimed to determine the relevance of HSA-AGE toward diabetic pathophysiology.

Methods

The plasma obtained from patients with DM and euglycemic volunteers was probed for activation of FXII, prekallikrein (PK), and cleaved high-molecular-weight kininogen by immunoblotting. Constitutive plasma kallikrein activity was determined via chromogenic assay. Activation and kinetic modulation of FXII, PK, FXI, FIX, and FX via in vitro-generated HSA-AGE were explored using chromogenic assays, plasma-clotting assays, and an in vitro flow model using whole blood.

Results

Plasma obtained from patients with DM contained increased plasma AGEs, activated FXIIa, and resultant cleaved cleaved high-molecular-weight kininogen. Elevated constitutive plasma kallikrein enzymatic activity was identified, which positively correlated with glycated hemoglobin levels, representing the first evidence of this phenomenon. HSA-AGE, generated in vitro, triggered FXIIa-dependent PK activation but limited the intrinsic coagulation pathway activation by inhibiting FXIa and FIXa-dependent FX activation in plasma.

Conclusion

These data indicate a proinflammatory role of HSA-AGEs in the pathophysiology of DM via FXII and kallikrein-kinin system activation. A procoagulant effect of FXII activation was lost through the inhibition of FXIa and FIXa-dependent FX activation by HSA-AGEs.

SUBMITTER: Hardy LJ 

PROVIDER: S-EPMC10242648 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Glycated albumin modulates the contact system with implications for the kallikrein-kinin and intrinsic coagulation systems.

Hardy Lewis J LJ   Bohinc Dillon D   Bane Kara L KL   Heal Samantha L SL   Hethershaw Emma E   Ali Majid M   Palmer-Dench Thomas T   Foster Richard R   Longstaff Colin C   Renné Thomas T   Stavrou Evi X EX   Philippou Helen H  

Journal of thrombosis and haemostasis : JTH 20221227 4


<h4>Background</h4>Human serum albumin (HSA) is the most abundant plasma protein and is sensitive to glycation in vivo. The chronic hyperglycemic conditions in patients with diabetes mellitus (DM) induce a nonenzymatic Maillard reaction that denatures plasma proteins and forms advanced glycation end products (AGEs). HSA-AGE is a prevalent misfolded protein in patients with DM and is associated with factor XII activation and downstream proinflammatory kallikrein-kinin system activity without any  ...[more]

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