Мембранные реакции системы свертывания крови: классический взгляд и современные представления

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Аннотация

Для остановки кровопотери при повреждении кровеносного сосуда в живых организмах существует сложный механизм, называемый гемостазом. В этом процессе условно выделяют два тесно взаимосвязанных звена – сосудисто-тромбоцитарный и плазменный гемостаз. Плазменный гемостаз представляет собой систему протеолитических реакций, в которых участвуют белки плазмы крови, называемые факторами свертывания. Ключевой особенностью этой системы является протекание большинства ферментативных реакций на поверхности фосфолипидных мембран, что увеличивает их скорость до 5 порядков. В данном обзоре описываются основные механизмы связывания факторов свертывания с фосфолипидными мембранами, пути сборки комплексов и реакций активации, обсуждается роль мембран в этом процессе, их состав и источники. Связывание факторов свертывания с прокоагулянтными мембранами приводит не только к ускорению процессов свертывания, но также к их избирательному протеканию в определенных областях и защите от смывания потоком. Эффективность реакций свертывания регулируется составом внешнего слоя мембраны, преимущественно через специальный механизм митохондриально-управляемой некротической смерти тромбоцитов.

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Т. А. Коваленко

Центp теоpетичеcкиx пpоблем физико-xимичеcкой фаpмакологии PАН; Национальный медицинcкий иccледовательcкий центp детcкой гематологии, онкологии и иммунологии имени Д. Pогачева

Автор, ответственный за переписку.
Email: after-ten@yandex.ru
Россия, Москва, 109029; Моcква, 117997

М. А. Пантелеев

Центp теоpетичеcкиx пpоблем физико-xимичеcкой фаpмакологии PАН; Национальный медицинcкий иccледовательcкий центp детcкой гематологии, онкологии и иммунологии имени Д. Pогачева; Моcковcкий гоcудаpcтвенный унивеpcитет имени М.В. Ломоноcова

Email: after-ten@yandex.ru

Моcковcкий гоcудаpcтвенный унивеpcитет имени М.В. Ломоноcова, физичеcкий факультет

Россия, Москва, 109029; Моcква, 117997; Моcква, 119991

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2. Рис. 1. Упрощенная схема реакций свертывания крови. Римскими цифрами обозначены факторы свертывания (V, VII, VIII, IX, X, XI, XII), суффикс «а» используется для обозначения активной формы. II – протромбин, Fb – фибриноген, Fg – фибрин, TFPI – ингибитор пути тканевого фактора, TF – тканевый фактор, S, Z – белки S и Z, PCa – активированный белок С. Двойная черная линия – схематическое изображение мембраны. Черные стрелки – каталитическая активация, черные пунктирные стрелки – формирование комплексов, серые градиентные стрелки – действие ферментативного комплекса или фермента на субстрат, ▬| – ингибирование. Во избежание перегруженности на схеме не указано ингибирование факторов свертывания антитромбином и медленные реакции активации факторов энзимами без кофакторов.

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3. Рис. 2. Структура белков системы свертывания крови. а – Схема доменного состава отдельных белков. Gla – Gla-домен; EGF1-4 – EGF1-4-домен; Serine Protease – протеазный домен; TSR – тромбин-чувствительная область; LG – ламинин G-подобные домены; KR – крингл-домены; А1-3 – А1-3-домен; С1,2 – С1,2-домен; В – В-домен; I – внутриклеточный домен; Tr – трансмембранный домен; N, C – N- и C-концевые внеклеточные домены. б – Структура фактора VIIa. Визуализирована в VMD, PDB 1dan [59]. Цвета в соответствии с вторичной структурой белка. Голубой – поворот; желтый – β-лист; фиолетовый – α-спираль; синий – 310-спираль; белый – нерегулярная структура; рыжий – ионы Са2+. в – Gla-домены фактора VIIa человека (цвета в соответствии с вторичной структурой как на панели б, PDB 1dan) и протромбина быка (желтый, PDB 1nl2 [58]). Структуры выровнены в VMD, RMSD (среднеквадратичное отклонение между соответствующими атомами основных цепей) = 3.31 Å. У фактора VIIa визуализированы остатки γ-карбоксиглутамата, связанные с ионами Са2+.

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4. Рис. 3. Концентрирование факторов свертывания в «шапке» тромбоцита. ДИК – изображение, полученное методом дифференциально-интерференционного контраста; в центре (Фактор Х) – эпифлуоресцентное изображение в канале фактора Х, справа (Наложение) – наложение первых двух изображений. Желтая стрелка отмечает «шапку» [115].

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5. Рис. 4. Структуры ферментативных комплексов. а – Внешняя теназа. Зеленый – фактор VIIa; синий – TF. Визуализирована в VMD, PDB 1dan [59]. б – Протромбиназа. Серый – фактор Va; красный – фактор Ха. Визуализирована в VMD, PDB 7tpq [13].

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