Protein C is activated by thrombin with a value of k cat /K m ؍ 0.11mM ؊1 s ؊1 that increases 1700-fold in the presence of the cofactor thrombomodulin. The molecular origin of this effect triggering an important feedback loop in the coagulation cascade remains elusive. Acidic residues in the activation domain of protein C are thought to electrostatically clash with the active site of thrombin. However, functional and structural data reported here support an alternative scenario. The thrombin precursor prethrombin-2 has R15 at the site of activation in ionic interaction with E14e, D14l, and E18, instead of being exposed to solvent for proteolytic attack. Residues E160, D167, and D172 around the site of activation at R169 of protein C occupy the same positions as E14e, D14l, and E18 in prethrombin-2. Caging of R169 by E160, D167, and D172 is responsible for much of the poor activity of thrombin toward protein C. The E160A/D167A/D172A mutant is activated by thrombin 63-fold faster than wild-type in the absence of thrombomodulin and, over a slower time scale, spontaneously converts to activated protein C. These findings establish a new paradigm for cofactor-assisted reactions in the coagulation cascade. (Blood. 2012;120(3): 664-670)
IntroductionTrypsin-like proteases are responsible for digestion, blood coagulation, fibrinolysis, development, fertilization, apoptosis, and immunity and remain major targets of therapeutic intervention. 1 Nearly all members of this family are expressed as inactive zymogens and converted to the mature enzyme by proteolytic cleavage at the conserved residue R15 (chymotrypsinogen numbering). The cleavage generates a new N-terminus that relocates within the protein and orchestrates alignment of the catalytic triad and optimal architecture of the oxyanion hole and primary specificity pocket required for substrate binding and catalysis. A common theme in the blood coagulation and complement cascades involves cofactorassisted zymogen activation, 2,3 where the cofactor corrects defects in the enzyme and promotes efficient activation of zymogen acting as substrate. The well-established conformational selection of the trypsin fold, enabling a switch of the enzyme from the inactive E* form when free to the active E form when bound to cofactors, 4 provides a molecular framework for the effect. For example, complement factors B and C2 are mostly inactive until binding of complement factors C3b and C4b enables catalytic activity at the site where amplification of C3 activation leads to formation of the membrane attack complex. 3,5,6 Complement factor D assumes an inactive conformation with a distorted catalytic triad 7,8 until binding to C3b and factor B promote substrate binding and catalytic activity. 9,10 Clotting factor VIIa circulates in the blood as a poorly active protease but acquires full catalytic activity on interaction with tissue factor exposed to the bloodstream on vascular injury. 11 Clotting factor Xa requires the action of factor Va on a membrane surface to efficiently convert pro...