© 1997 American Heart Association, Inc.
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Effect of Advanced Glycation End Product–Modified Albumin on Tissue Factor Expression by Monocytes
Role of Oxidant Stress and Protein Tyrosine Kinase Activation
From INSERM U294 and Service d'Hématologie et d'Immunologie biologiques, CHU Xavier Bichat, Paris, France.
Correspondence to D. de Prost, Service d'Hématologie et d'Immunologie and INSERM (U294), CHU Bichat-Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France.
Abstract Diabetes is associated with a hypercoagulable state that contributes to macrovascular complications, including cardiovascular events. The glycation reaction, a consequence of chronic hyperglycemia, has also been implicated in the pathogenesis of diabetic complications. Glycated proteins have receptors on monocytes and generate reactive oxygen species that can regulate the expression of a number of genes. As abnormal monocyte expression of tissue factor (TF), the main initiator of the coagulation cascade, is responsible for thrombosis in a number of clinical settings, we studied the effect of glycated albumin on monocyte TF expression. Mononuclear cells were incubated with glycated albumin for 24 hours, and monocyte TF activity was measured with a plasma recalcification time assay; TF antigen was measured by ELISA and TF mRNA by RT-PCR. Glycated albumin induced blood monocyte expression of the procoagulant protein TF at the mRNA level. Oxidative stress appeared to be involved in this effect, as the antioxidant N-acetylcysteine diminished TF mRNA accumulation in stimulated monocytes. Hydroxyl radicals, which may be generated inside cells from H2O2 via the Fenton reaction, also appeared to be involved in this effect, as hydroxyl radical scavengers downregulated TF activity and antigen levels (but not TF mRNA). Finally, the involvement of activated protein tyrosine kinase in the transmission of the signal from the membrane to the nucleus was suggested by the inhibitory effect of herbimycin A. These results point to a new mechanism for the hypercoagulability often described in diabetic patients and suggest that antioxidants or protein tyrosine kinase inhibitors might be of therapeutic value in this setting.
Key Words: glycation • oxidant stress • tissue factor • monocyte • thrombosis
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