[Disintegrins: potent inhibitors of platelet aggregation]

Disintegrins are a family of highly homologous polypeptides purified from snake venoms, which contain the arginine-glycine-aspartic acid (RGD) sequence. The RGD tripeptide acts as an integrin recognition sequence; it is also present on several proteins involved in cell adhesion such as fibrinogen, fibronectin, von Willebrand factor, and collagen. Disintegrins can therefore competitively inhibit integrin-ligand interactions: they block fibrinogen binding to its platelet receptor, alpha IIb beta 3: hence they are potent platelet aggregation inhibitors. Disintegrins are up to 2000 times more potent than short synthetic linear RGD-containing peptides in blocking fibrinogen-dependent platelet aggregation. Likely, the amino acids surrounding the RGD sequence and intrachain disulphide bridges force the RGD sequence in an appropriate conformation which accounts for the high, but variable, platelet inhibitory activity exhibited by disintegrin molecules. Disintegrins block the adhesive functions of the RGD-dependent integrins present on different cell types in different tissues: for this reason they are not alpha IIb beta 3-specific. A single disintegrin polypeptide, barbourin, was found to be a specific alpha IIb beta 3 antagonist: unlike all other disintegrins it contains the lysine-glycine-aspartic acid (KGD) sequence instead of the RGD one, which solely imparts alpha IIb beta 3 specificity to the molecule. This finding led to the synthesis of small, conformationally constrained KGD-containing peptides, which proven to be specific and potent inhibitors of alpha IIb beta 3 function; these compounds are presently undergoing evaluation in clinical trials as antithrombotic agents.