Accumulation of misfolded protein within the endoplasmic reticulum (ER) is a central event leading to cell death that contributes to disease pathogenesis. Although proteins exhibit oxidative damage in diverse disease states, the relationship between protein misfolding and oxidative stress has not been explored. To elucidate the relationship between protein misfolding and oxidative stress, we have analyzed expression of the clotting factor VIII (FVIII), the protein deficient in hemophilia A and prone to misfolding. Although hemophilia A patients are treated by frequent infusions of plasma-derived or recombinant-derived FVIII, significant limitations remain. It is hoped that FVIII gene therapy will solve these problems. Unfortunately, limited clinical studies have not demonstrated expression of FVIII at therapeutic levels. At the cellular level FVIII expression is limited due to protein misfolding and retention in the ER. As a consequence, FVIII expression induces transcription of ER stress response genes, through an intracellular signaling pathway called the unfolded protein response (UPR). Our studies have shown that the chronic unresolved accumulation of unfolded FVIII in the ER leads to apoptosis in a manner that requires the proapoptotic transcription factor C/EBP homologous protein CHOP. Recently, we have demonstrated that FVIII misfolding causes oxidative stress and induces an inflammatory response. In addition, oxidative stress causes FVIII misfolding, thereby creating a vicious cycle between FVIII misfolding and oxidative stress. Profoundly, anti-oxidant treatment to reduce oxidative stress improves FVIII secretion and reduces apoptosis. These findings provide the basis of the proposed research to elucidate how FVIII induces apoptotic, oxidative, and inflammatory response pathways. The studies will test the hypothesis that FVIII expression is limited due to induction of these stress responses. Studies will test whether intervention to prevent these toxic responses may improve therapeutic efficacy in FVIII gene delivery for hemophilia A. The findings from the proposed studies will provide fundamental new insights toward elucidating how protein misfolding in the ER signals a cell death response and should have impact on a number of disease states associated with ER stress.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Program Projects (P01)
Project #
Application #
Study Section
Heart, Lung, and Blood Initial Review Group (HLBP)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Michigan Ann Arbor
Ann Arbor
United States
Zip Code
Ji, Yan; Weng, Zhen; Fish, Philip et al. (2016) Pharmacological Targeting of Plasminogen Activator Inhibitor-1 Decreases Vascular Smooth Muscle Cell Migration and Neointima Formation. Arterioscler Thromb Vasc Biol 36:2167-2175
Khoriaty, Rami; Everett, Lesley; Chase, Jennifer et al. (2016) Pancreatic SEC23B deficiency is sufficient to explain the perinatal lethality of germline SEC23B deficiency in mice. Sci Rep 6:27802
Xu, Xianjin; Ma, Zhiwei; Sun, Hongmin et al. (2016) SM-TF: A structural database of small molecule-transcription factor complexes. J Comput Chem 37:1559-64
Emmer, Brian T; Ginsburg, David; Desch, Karl C (2016) Von Willebrand Factor and ADAMTS13: Too Much or Too Little of a Good Thing? Arterioscler Thromb Vasc Biol 36:2281-2282
Khoobchandani, Menka; Katti, Kavita; Maxwell, Adam et al. (2016) Laminin Receptor-Avid Nanotherapeutic EGCg-AuNPs as a Potential Alternative Therapeutic Approach to Prevent Restenosis. Int J Mol Sci 17:316
Tomberg, Kärt; Khoriaty, Rami; Westrick, Randal J et al. (2016) Spontaneous 8bp Deletion in Nbeal2 Recapitulates the Gray Platelet Syndrome in Mice. PLoS One 11:e0150852
Fribley, Andrew M; Miller, Justin R; Brownell, Amy L et al. (2015) Celastrol induces unfolded protein response-dependent cell death in head and neck cancer. Exp Cell Res 330:412-22
Wu, Jianbo; Strawn, Tammy L; Luo, Mao et al. (2015) Plasminogen activator inhibitor-1 inhibits angiogenic signaling by uncoupling vascular endothelial growth factor receptor-2-αVβ3 integrin cross talk. Arterioscler Thromb Vasc Biol 35:111-20
Sun, Hongmin (2015) Factor V: an active player in inflammation. Blood 126:2352-3
Kretz, Colin A; Dai, Manhong; Soylemez, Onuralp et al. (2015) Massively parallel enzyme kinetics reveals the substrate recognition landscape of the metalloprotease ADAMTS13. Proc Natl Acad Sci U S A 112:9328-33

Showing the most recent 10 out of 180 publications