The Generation of An Aptamer Inhibitor of Murine Von Willebrand Factor (VWF) Mediated Platelet Aggregation

Abstract 4312

Venous thromboembolism (VTE) is a national health concern, with an occurrence of over 900,000 cases per year and over 300,000 deaths per year. The total number of cases of VTE and the incidence of VTE-related deaths exceeds those related to both myocardial infarction and stroke. With an aging population, the incidence of VTE has also been increasing. Current treatment of venous thromboembolism with anti-coagulation is not optimal. There is a risk of bleeding, thrombus extension, pain and swelling as well as a recurrence rate of 3–9%. A significant inflammatory response occurs with venous thromboembolism. This inflammation can influence the extent of thrombosis, vein wall fibrosis and valve damage in the thrombosed vein. In a high percentage of VTE patients a condition of venous insufficiency known as post-thrombotic syndrome (PTS) can develop. PTS is associated with stasis ulceration, dermatitis and edema. Venous thrombogenesis is influenced by platelet (PLT) and leukocyte (WBC) adhesion as well as interactions between these cells. There is growing evidence to suggest that VWF interactions with PLT GPIbα can mediate some of these early events. This is evidenced by the reduction in PLT/WBC recruitment and reduced thrombus growth seen in either VWF or GPIbα deficient mice. These data point to a role for VWF in VTE. We sought to develop an aptamer to mouse VWF that would inhibit its interactions with platelet GPIbα. The availability of this tool would support investigations into the role of VWF in mouse models of VTE.

Aptamers are oligonucleotides that fold into three-dimensional structures and specifically bind to ligands with high affinity. Aptamers bound to proteins can modify and/or inhibit protein-protein interactions. Using an in vitro selection method known as Systematic Evolution of Ligands by EXponential enrichment (SELEX), we generated aptamers that bind to murine VWF (mVWF) from a modified RNA pool. Nine of these aptamers bind to mVWF with single-digit or sub- nanomolar affinity. A subset of these aptamers also binds to human VWF (hVWF). The aptamers that bind to hVWF inhibit platelet adhesion/aggregation in human whole blood. Further in vitro characterization has demonstrated that five of these aptamers specifically inhibit the interaction between mVWF and recombinant human GPIbα, but do not interfere with the binding of mVWF to collagen. These five aptamers were also active in vivo in a FeCl₃-induced thrombosis model in mice. Intravenous injection of the anti-mVWF aptamers prolonged time to occlusion from a baseline of 10–15 minutes to either 25–35 minutes or >40 minutes in this model, depending on the aptamer.

These results demonstrate that we have identified high affinity aptamers to mVWF that specifically disrupt mVWF binding to platelets and have an antithrombotic effect in an in vivo mouse model of thrombosis. These aptamers will allow us to investigate the role of VWF in murine models of venous thrombosis. This project was supported by Award Number R01HL095091 from the National Heart, Lung, And Blood Institute.