Projects / Programmes source: ARRS

Role of Calcium and lipid membranes in survival of critically ill patients

Research activity

Code Science Field Subfield
3.06.00  Medical sciences  Cardiovascular system   

Code Science Field
B007  Biomedical sciences  Medicine (human and vertebrates) 

Code Science Field
3.02  Medical and Health Sciences  Clinical medicine 
blood coagulation, factor Xa, dimerization, lipid membranes rich in phosphatidylserine, calcium, blood clots, artificial blood vessel, EPR, NMR, optical microscopy
Evaluation (rules)
source: COBISS
Researchers (14)
no. Code Name and surname Research area Role Period No. of publications
1.  20208  PhD Zoran Arsov  Biotechnology  Researcher  2014 - 2017  133 
2.  07630  PhD Aleš Blinc  Cardiovascular system  Researcher  2014 - 2017  475 
3.  27577  PhD Andrej Fabjan  Neurobiology  Researcher  2014 - 2017  54 
4.  21546  PhD Tilen Koklič  Physics  Principal Researcher  2014 - 2017  132 
5.  33075  Alma Mehle    Technician  2014  11 
6.  14574  PhD Mojca Urška Mikac  Physics  Researcher  2014 - 2017  147 
7.  12056  PhD Igor Serša  Physics  Researcher  2014 - 2017  457 
8.  04341  PhD Vito Starc  Cardiovascular system  Researcher  2014  265 
9.  08094  PhD Mirza Šabovič  Cardiovascular system  Researcher  2014 - 2017  404 
10.  18273  PhD Janez Štrancar  Physics  Researcher  2014 - 2017  359 
11.  21359  PhD Gregor Tratar  Cardiovascular system  Researcher  2014 - 2017  92 
12.  32057  PhD Iztok Urbančič  Physics  Researcher  2014 - 2017  115 
13.  28490  PhD Jernej Vidmar  Cardiovascular system  Researcher  2014 - 2017  84 
14.  30871  PhD Maja Zorc  Physics  Technician  2014 - 2017  57 
Organisations (3)
no. Code Research organisation City Registration number No. of publications
1.  0106  Jožef Stefan Institute  Ljubljana  5051606000  85,620 
2.  0312  University Medical Centre Ljubljana  Ljubljana  5057272000  73,422 
3.  0381  University of Ljubljana, Faculty of Medicine  Ljubljana  1627066  44,835 
Role of calcium and lipid membranes in survival of critically ill patients   The Problem Critical illness is a life-threatening multi-system process with high mortality. It is common for critically ill patients to suffer from abnormalities in blood coagulation, ranging from isolated thrombocytopenia to complex defects, such as disseminated intravascular coagulation (DIC). DIC is proposed to result from insufficient physiologic anticoagulation pathways, although the exact etiology is not yet defined.   State of the Art Blood coagulation abnormalities in critically ill patients are commonly accompanied by: 1) low calcium (Ca2+) concentration (hypocalcaemia), and by 2) increased concentrations of various forms of phosphatidylserine-containing membranes (PS-containing membranes), such as endothelial micro particles, in blood.   The existing literature suggested a link between Ca2+ and the availability of PS-containing membranes in regulating blood coagulation; however, the biochemical nature of this link has not been defined yet (Figure 1, yellow triangle).   Research Goal & Potential Effects of the Results The proposed project is therefore aimed at clarifying the biochemical nature of the possible link among low concentration of Ca2+, increased concentration of PS-containing membranes, and initial phase of blood coagulation. In this way we hope to contribute to the development of new therapeutic methods which will improve survival of critically ill patients.     The search for the possible missing link will be based on our previous work on factor Xa (fXa) (Koklic & Majumder, 2009 & 2013, Biochemistry), which is one of the key enzymes in initiating blood coagulation. fXa requires calcium and PS-containing membranes to reach physiologically significant activity. However, only recently we have shown that PS-containing membranes can also inhibit fXa activity, but only at high Ca2+ and low concentration of PS-containing membranes. This is just the opposite of conditions observed in critical illness, suggesting that fXa might not be sufficiently inhibited in critical illness. The inhibition is a consequence of formation of inactive fXa dimers on membranes at higher than normal concentration of Ca2+. These findings present a key question of how Ca2+ and PS-containing membranes regulate fXa activity, especially at physiological conditions.   Figure 1. Proposed etiology of critical illness, which will be explored in the proposed project. Hypothesis In this project we will investigate formation of inactive fXa dimers on PS-containing membrane surfaces at different concentrations of calcium (Figure 2 in next State of the art section) to answer whether regulation of fXa by calcium and PS-containing membranes could have a role in preventing uncontrolled systemic activation of blood coagulation, which might be the case in critically ill patients. Methods, Project Organization & Novelty of Expected Results The originality of the proposed project is in precise control of both Ca2+ and PS-membrane concentration, which was typically overlooked in previous research. In this project we will investigate heretofore poorly understood processes of fXa binding, dimerization and subsequent inactivation of fXa on PS-containing membranes. Since these processes represent a complex system, its characterization requires numerical data analysis of several independent experimental data sets, which will be obtained using different experimental techniques, such as: EPR, NMR, and different optical microscopy techniques. The likelihood of successful implementation of the project is high, since the leader of the proposed project has been collaborating already for several years with top researchers in hematology from the School of Medicine, University of North Carolina, and with the recipient of the Nobel Prize for Physiology or Medicine for 2007. The proposed project also includes active patricipation of researchers from Facu
Significance for science
In the proposed project we clarified yet unknown molecular mechanisms of factor Xa regulation which influence initiation of blood coagulation. This contributed to the development of the blood coagulation field and added missing pieces of basic knowledge about the coagulation cascade. We continued development of recently developed method of fluorescence microspectroscopy, work on this project therefore also contributed to the development of new experimental methods.
Significance for the country
Results of our research are published in prestigious Biochemical journal and were presented at international conferences, universities and institutes. This contributed to the international promotion of Slovenia. Researchers of the project group collaborated with two research groups from the USA, thus researchers, especially young ones, gained access to the knowledge and expertise of dr. Lentz’s group as well as to the knowledge of dr. Smithies, who is known to unselfishly shares his expertise. The project facilitated education of young scientists, which gained experience in interdisciplinary field of natural sciences and physiology. Professor Oliver Smithies and his wife Nobuyo Maeda visited us between 8th and 11th September 2014 in the framework of our scientific collaboration between laboratory of biophysics at Solid state physics department at IJS and University of North Carolina at Chapel Hill. Professor Smithies is a Nobel laureate for medicine for the year 2007, he had a lecture at Wednesday Colloquium at IJS with a title “Where do ideas come from”. He also visited prime minister of the Republic of Slovenia and minister of science, where he argued for greater support of science.
Most important scientific results Annual report 2014, 2015, final report
Most important socioeconomically and culturally relevant results Final report
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