Soluble endoglin reduces thrombus formation and platelet aggregation via interaction with IIb3 integrin

Background: The circulating form of human endoglin (sEng) is a cleavage product of membrane-bound endoglin present on endothelial cells. Because sEng encompasses an RGD motif involved in integrin binding, we hypothesized that sEng would be able to bind integrin alpha IIb beta 3, thereby compromising platelet binding to fibrinogen and thrombus stability.Methods: In vitro human platelet aggregation, thrombus retraction, and secretion-competition assays were performed in the presence of sEng. Surface plasmon resonance (SPR) binding and computational (docking) analyses were carried out to evaluate protein-protein interactions. A transgenic mouse overexpressing human sEng (hsEng+) was used to measure bleeding/rebleeding, prothrombin time (PT), blood stream, and embolus formation after FeCl3-induced injury of the carotid artery.Results: Under flow conditions, supplementation of human whole blood with sEng led to a smaller thrombus size. sEng inhibited platelet aggregation and thrombus retraction, interfering with fibrinogen binding, but did not affect platelet activation. SPR binding studies demonstrated that the specific interaction between alpha IIb beta 3 and sEng and molecular modeling showed a good fitting between alpha IIb beta 3 and sEng structures involving the endoglin RGD motif, suggesting the possible formation of a highly stable alpha IIb beta 3/ sEng. hsEng+ mice showed increased bleeding time and number of rebleedings compared to wild-type mice. No differences in PT were denoted between genotypes. After FeCl3 injury, the number of released emboli in hsEng+ mice was higher and the occlusion was slower compared to controls.Conclusions: Our results demonstrate that sEng interferes with thrombus formation and stabilization, likely via its binding to platelet alpha IIb beta 3, suggesting its involvement in primary hemostasis control.