Event Abstract Back to Event Activation of blood clotting on cationic biomaterials via factor VII activating protease (FSAP) Claudia Sperling1*, Marion Fischer1, Manfred F. Maitz1*, Simona Grasso2*, Carsten Werner1* and Sandip M. Kanse2 1 Leibniz-Institut fuer Polymerforschung Dresden e.V., Institute Biofunctional Polymer Materials, Max Bergmann Center of Biomaterials, Germany 2 University of Oslo, Department of Biochemistry, Institute of Basic Medical Sciences, Norway Introduction: Factor VII activating protease (FSAP), a serine protease involved in coagulation[1], fibrinolysis and inflammatory processes[2] is known to be auto-activated on charged macromolecules. It is highly homologous to Factor XII, a main initiator of coagulation on negatively charged biomaterials. We hypothesize similar activation processes for FSAP on material surfaces with impact on biomaterial related thrombogenicity. Materials and Methods: Materials with varied surface charge were prepared, characterized and incubated with either fresh human whole blood or plasma to detect activation of FSAP as well as blood activation processes: 1. PEI (Poly(ethyleneimine) spin-coated on argon-plasma treated teflon AF, cationic); 2. SAM-COOH (self assembled monolayers with terminal carboxylic groups, anionic); 3. Glass (anionic); 4. Teflon-AF (spincoated on glass, no ionizable groups on surface). Blood from healthy donors was heparinized and incubated in a customized set-up for 3 hours. For additional FSAP inhibition experiments the inhibitory antibody mab570 was used. Subsequently blood and surfaces were analyzed for FSAP activity as well as for specific blood activation parameters: thrombin and fibrin formation (F1+2, FPA), platelet activation (PF4, cell adhesion) and immunologic reactions (CD11b, C5a, cell adhesion). Results and Discussion: Different activation processes on negatively and positively charged surfaces were observed: FSAP was exclusively activated on cationic PEI surfaces, not on anionic or hydrophobic, uncharged surfaces (Table 1) while contact activation was only detectable on anionic surfaces (glass, SAM-COOH). Table 1: FSAP activity in blood after 3 h incubation detected using a direct activity assay as well as FSAP inhibitor complexes [arb. units] Substantial coagulation activation (thrombin/fibrin formation) occurred on FSAP activating PEI and on FXII activating glass but not on Teflon-AF or SAM-COOH (Figure 1) due to a missing coagulation initiation on Teflon and missing platelet supported coagulation amplification on SAM-COOH[3]. The strong coagulation propagation on PEI was confirmed to be FSAP dependent with the implementation of an FSAP inhibitory antibody that diminished thrombin formation. Figure 1: Coagulation activation and fibrin formation on surfaces. Coagulation activation measured as TAT (Thrombin-antithrombin-complex, grey bars) and fibrin formation measured as FPA (fibrinopeptide A, white bars) Statistics: *: significantly different to all other samples. Insets: SEM photographs of surfaces (magnification 4000x; ESEM XL 30 FEG, FEI-Philips, Eindhoven, The Netherlands) Conclusion: We present a new hypothesis on blood activation claiming that on cationic surfaces FSAP gets activated and mediates thrombin amplification. Our experiments are relevant for the interaction of blood with surfaces but also for the role of FSAP in coagulation and immunology.