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Article
Nature Medicine 14, 648 - 655 (2008)
Published online: 18 May 2008 | doi:10.1038/nm1760
The Ashwell receptor mitigates the lethal coagulopathy of sepsis
Prabhjit K Grewal1, Satoshi Uchiyama2, David Ditto3, Nissi Varki3, Dzung T Le3, Victor Nizet2,4 & Jamey D Marth1
Abstract
The Ashwell receptor, the major lectin of hepatocytes, rapidly clears from blood circulation glycoproteins bearing glycan ligands that include galactose and N-acetylgalactosamine. This asialoglycoprotein receptor activity remains a key factor in the development and administration of glycoprotein pharmaceuticals, yet a biological purpose of the Ashwell receptor has remained elusive. We have identified endogenous ligands of the Ashwell receptor as glycoproteins and regulatory components in blood coagulation and thrombosis that include von Willebrand factor (vWF) and platelets. The Ashwell receptor normally modulates vWF homeostasis and is responsible for thrombocytopenia during systemic Streptococcus pneumoniae infection by eliminating platelets desialylated by the bacterium's neuraminidase. Hemostatic adaptation by the Ashwell receptor moderates the onset and severity of disseminated intravascular coagulation during sepsis and improves the probability of host survival.
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