Phosphomannomutase 2 (
PMM2) deficiency is the most prevalent
congenital disorder of glycosylation. It is associated with coagulopathy, including
protein C deficiency. Since all components of the
anticoagulant and cytoprotective
protein C system are glycosylated, we sought to investigate the impact of an N-glycosylation deficiency on this system as a whole. To this end, we developed a PMM2 knockdown model in the brain endothelial cell line hCMEC/D3. The resulting PMM2low cells were less able to generate activated
protein C (APC), due to lower surface expression of
thrombomodulin and
endothelial protein C receptor. The low
protein levels were due to downregulated transcription of the corresponding genes (THBD and
PROCR, respectively), which itself was related to downregulation of transcription regulators Krüppel-like factors 2 and 4 and forkhead box C2. PMM2 knockdown was also associated with impaired integrity of the endothelial cell monolayer-partly due to an alteration in the structure of
VE-cadherin in adherens junctions. The expression of
protease-activated receptor 1 (involved in the cytoprotective effects of APC on the endothelium) was not affected by PMM2 knockdown.
Thrombin stimulation induced hyperpermeability in PMM2low cells. However, pretreatment of cells with APC before
thrombin simulation was still associated with a barrier-protecting effect. Taken as a whole, our results show that the partial loss of PMM2 in hCMEC/D3 cells is associated with impaired activation of
protein C and a relative increase in barrier permeability.