Factor XIII (FXIII) is a heterotetramer composed of two catalytic A subunits (FXIII-A) and two B subunits (FXIII-B). FXIII-B has 10 Sushi domains. To explore the structure-function relationship of FXIII-B, we looked for domains in FXIII-B responsible for its homodimer and heterotetramer assembly with FXIII-A. Full-length recombinant human FXIII-B (rFXIII-B) and truncated rFXIII-Bs with various numbers of Sushi domains (rFXIII-B x- y ) were expressed in a baculovirus expression system. rFXIII-B was indistinguishable from purified human plasma FXIII-B, in terms of the molecular weight (after being deglycosylated by glycosidases) and the ability to form complexes between the two subunits. rFXIII-B was in dimer form and produced a heterotetramer complex with FXIII-A. Gel-filtration and FXIII-A binding analysis of the various truncated forms of rFXIII-B x- y revealed that the first Sushi domain was responsible for the binding of FXIII-B to FXIII-A and that the fourth and ninth Sushi domains were involved in the FXIII-B homodimer assembly. rFXIII-B and rFXIII-B 1-9, which formed a heterotetramer complex with FXIII-A, protected FXIII-A from proteolytic digestion. These findings suggest that only full-length or nearly full-length FXIII-B is large enough to cover the exposed surface of FXIII-A. In conclusion, at least 3 out of the 10 Sushi domains of FXIII-B have the distinct function of forming a homodimer and a heterotetramer, which should be ascribed to the differences in their amino acid sequences. The present studies, however, do not exclude the possibility that additional Sushi domains may also support either or both functions.

This method can be readily performed, requires no special treatment, and appears to have adequate pain-relieving effects.

The a subunit of coagulation factor XIII lacks a hydrophobic signal sequence for secretion from cells, while the b subunit has a typical signal sequence. To determine whether the a subunit can be synthesized and released, expression vectors containing the cDNA for either subunit were transfected into baby hamster kidney (BHK) cells. Western blotting analysis and gel filtration chromatography demonstrated that the recombinant a and b subunits (rXIIIa and rXIIIb) had the same molecular weights and subunit structures (a2, b2, and a2b2) as the native molecules. rXIIIa was enzymatically active when activated by thrombin. Most rXIIIb was secreted as measured by ELISA, while most rXIIIa was detected in the cytosol by subcellular fractionation. Co-expression with rXIIIb in the same cells did not promote the release of rXIIIa. Treatment of the cells with brefeldin A, a potent inhibitor of protein transportation, blocked the secretion of rXIIIb, although it had no effect on the release of rXIIIa. Several drugs and heat stress induced the release of rXIIIa, which correlated directly with that of cytoplasmic lactate dehydrogenase. These results suggest that the a subunit is released from cells as a consequence of cell injury, which is independent of the classical secretory pathway.

The eficacy of diltiazem in the attenuation ofthe cardiovascular response to laryngoscopy and tracheal intubation was studied in patients who received 0.2 or 0.3 mg/kg diltiazem 60 seconds before the start of laryngoscopy. These data were cornpared with a control group who received saline. Each group consisted of I0 patients who had elective surgery. Patients who received saline showed a sign$cant increase in mean arterial pressure and rate pressure product associated with tracheal intubation. These increases after tracheal intubation were reduced in diltiazem-treated patients compared with those of the control group (p < 0.0s). The data suggest that a bolus injection of diltiazem is a simple, practical and efective method to attenuate the hypertensive response to laryngoscopy and tracheal intubation.