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Publication : The polyphosphate-factor XII pathway drives coagulation in prostate cancer-associated thrombosis.

First Author  Nickel KF Year  2015
Journal  Blood Volume  126
Issue  11 Pages  1379-89
PubMed ID  26153520 Mgi Jnum  J:226441
Mgi Id  MGI:5697264 Doi  10.1182/blood-2015-01-622811
Citation  Nickel KF, et al. (2015) The polyphosphate-factor XII pathway drives coagulation in prostate cancer-associated thrombosis. Blood 126(11):1379-89
abstractText  Cancer is a leading cause of thrombosis. We identify a new procoagulant mechanism that contributes to thromboembolism in prostate cancer and allows for safe anticoagulation therapy development. Prostate cancer-mediated procoagulant activity was reduced in plasma in the absence of factor XII or its substrate of the intrinsic coagulation pathway factor XI. Prostate cancer cells and secreted prostasomes expose long chain polyphosphate on their surface that colocalized with active factor XII and initiated coagulation in a factor XII-dependent manner. Polyphosphate content correlated with the procoagulant activity of prostasomes. Inherited deficiency in factor XI or XII or high-molecular-weight kininogen, but not plasma kallikrein, protected mice from prostasome-induced lethal pulmonary embolism. Targeting polyphosphate or factor XII conferred resistance to prostate cancer-driven thrombosis in mice, without increasing bleeding. Inhibition of factor XII with recombinant 3F7 antibody reduced the increased prostasome-mediated procoagulant activity in patient plasma. The data illustrate a critical role for polyphosphate/factor XII-triggered coagulation in prostate cancer-associated thrombosis with implications for anticoagulation without therapy-associated bleeding in malignancies.
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