Determinants of PF4/heparin immunogenicity

S Suvarna, B Espinasse, R Qi, R Lubica… - Blood, The Journal …, 2007 - ashpublications.org
Blood, The Journal of the American Society of Hematology, 2007ashpublications.org
Heparin-induced thrombocytopenia (HIT) is an antibody-mediated disorder that occurs with
variable frequency in patients exposed to heparin. HIT antibodies preferentially recognize
large macromolecular complexes formed between PF4 and heparin over a narrow range of
molar ratios, but the biophysical properties of complexes that initiate antibody production are
unknown. To identify structural determinants underlying PF4/heparin immunogenicity, we
characterized the in vitro interactions of murine PF4 (mPF4) and heparin with respect to light …
Heparin-induced thrombocytopenia (HIT) is an antibody-mediated disorder that occurs with variable frequency in patients exposed to heparin. HIT antibodies preferentially recognize large macromolecular complexes formed between PF4 and heparin over a narrow range of molar ratios, but the biophysical properties of complexes that initiate antibody production are unknown. To identify structural determinants underlying PF4/heparin immunogenicity, we characterized the in vitro interactions of murine PF4 (mPF4) and heparin with respect to light absorption, size, and surface charge (zeta potential). We show that PF4/heparin macromolecular assembly occurs through colloidal interactions, wherein heparin facilitates the growth of complexes through charge neutralization. The size of PF4/heparin macromolecules is governed by the molar ratios of the reactants. Maximal complex size occurs at molar ratios of PF4/heparin at which surface charge is neutral. When mice are immunized with complexes that differ in size and/or zeta potential, antibody formation varies inversely with heparin concentration and is most robust in animals immunized with complexes displaying a net positive zeta-potential. These studies suggest that the clinical heterogeneity in the HIT immune response may be due in part to requirements for specific biophysical parameters of the PF4/heparin complexes that occur in settings of intense platelet activation and PF4 release.
ashpublications.org