Rapid Publication Protease Nexin-2/Amyloid ft Protein Precursor A Tight-binding Inhibitor of Coagulation Factor IXa

Protease nexin-2/amyloid 6 protein precursor (PN-2/A#PP) is an abundant, secreted platelet protein which is a potent inhibitor of coagulation Factor XIa. We examined other potential anticoagulant activities of PN-2/Ai8PP. Purified Kunitz protease inhibitor domain of PN-2/A8PP and PN-2/ABPP itself were found to prolong the coagulation time of plasma and pure Factor IXa. The Kunitz protease inhibitor domain also inhibited the ability of Factor IXa to activate Factor X. PN-2/AAPP inhibited Factor IXa with a K1 of 7.9 to 3.9 X 10-1 M in the absence and presence of heparin, respectively. When the second-order rate constant of PN-2/AO8PP's inhibition of Factor IXa (2.7 X 108 M-'min-') was compared to that of antithrombin III (3.8 X 106 M-'min-'), PN-2/AfiPP was at least a 71-fold more potent inhibitor of Factor IXa than antithrombin III. PN-2/AfiPP formed a complex with Factor IXa as detected by gel filtration and ELISA. The finding that PN-2/ AfiPP is a potent inhibitor of Factor IXa could help to explain the spontaneous intracerebral hemorrhages seen in patients with hereditary cerebral hemorrhage with amyloidosis Dutchtype where there is an extensive accumulation of PN-2 /A46PP in their cerebral blood vessels. (J. Clin. Invest. 1993.92:25402545.)