To cite this article: Akiyama M, Kokame K, Miyata T. ADAMTS13 P475S polymorphism causes a lowered enzymatic activity and urea lability in vitro. J Thromb Haemost 2008; 6: 1830-2.von Willebrand factor (VWF) is a plasma glycoprotein synthesized primarily in vascular endothelial cells and megakaryocytes [1]. VWF is released into plasma as ultra-large multimeric forms that are highly active in platelet aggregation. A plasma metalloprotease ADAMTS13 specifically cleaves the Tyr 1605 -Met 1606 peptidyl bond within the A2 domain of VWF [2]. Deficiency of the ADAMTS13 enzymatic activity, caused by genetic mutations or acquired autoantibodies against ADAMTS13, results in the accumulation of ultra-large VWF multimers in plasma that lead to the hyper-aggregation of platelets. This prothrombotic condition can cause thrombotic thrombocytopenic purpura (TTP) [3]. A number of nonsynonymous mutations and polymorphisms of ADAMTS13 have been identified [4,5]. Among them, the P475S (c.1423C > T) polymorphism is noteworthy.The allele frequency of ADAMTS13 P475S was 5.1% in Japanese subjects [6], 4.0% in Koreans [7], and 1.5% in Chinese [8], but absent in Caucasians [9]. The recombinant P475S mutant was normally secreted from cultured cells but showed greatly reduced enzymatic activity (10%) in the VWFmultimer assay [6]. Recently, we have developed a quantitative ADAMTS13 activity assay using a synthetic fluorogenic substrate FRETS-VWF73 [10] and it is now widely utilized [11][12][13][14]. The assay can be performed in the absence of urea that is required for the VWF-multimer assay. In this study, we evaluated the activity of the P475S mutant using FRETS-VWF73 and found that the mutant exhibited the more profound loss of activity than the wild-type in the presence of urea.We have prepared four forms of recombinant ADAMTS13 using a transient expression system of HeLa cells: the fulllength form (Met ) with the wild-type sequence (MDTCS) or with the P475S polymorphism (MDTCS-P475S). FL and FL-P475S were tagged by the C-terminal FLAG sequence. MDTCS and MDTCS-P475S were tagged by the C-terminal 6xHis sequence. The culture media of cells expressing FL and FL-P475S were collected and concentrated 5-fold by centrifugal filtration (Ultrafree-MC; Millippore, Billerica, MA, USA). The media of cells expressing MDTCS and MDTCS-P475S were collected, and the recombinant proteins were purified by the Ni-NTA column chromatography. The relative amounts of the recombinant proteins were adjusted by their band intensities of Western blotting analysis using anti-FLAG or anti-6xHis antibodies, within the linear detection range. Enzymatic activity of each protein was measured by the FRETS-VWF73 assay [10] in the absence or presence of urea.First, we compared the enzymatic activities between FL and FL-P475S in the absence of urea, and found that FL-P475S showed 71 ± 3.6% (n = 3) activity of FL. We previously reported that FL-P475S showed only approximately 10% activity of FL in the VWF-multimer assay [6]. This paradoxical observation led us to further stud...