Biological Assembly 1  

 3D View: Structure | Electron Density | Ligand Interaction

Global Symmetry: Asymmetric - C1 
Global Stoichiometry: Hetero 2-mer - A1B 

Biological assembly 1 generated by PISA (software)

Macromolecule Content

• Total Structure Weight: 47.82 kDa 
• Atom Count: 3391 
• Residue Count: 426 
• Unique protein chains: 2

5ALC

Ticagrelor antidote candidate Fab 72 in complex with ticagrelor

• DOI: 10.2210/pdb5ALC/pdb

• Classification: IMMUNE SYSTEM
• Organism(s): Homo sapiens
• Expression System: Cricetulus griseus
• Mutation(s): No 


• Deposited: 2015-03-07 Released: 2015-04-01 
• Deposition Author(s): Buchanan, A., Newton, P., Pehrsson, S., Inghardt, T., Antonsson, T., Svensson, P., Sjogren, T., Oster, L., Janefeldt, A., Sandinge, A., Keyes, F., Austin, M., Spooner, J., Penney, M., Howells, G., Vaughan, T., Nylander, S.

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Experimental Data Snapshot

• Method: X-RAY DIFFRACTION
• Resolution: 1.70 Å
• R-Value Free: 0.237 
• R-Value Work: 0.198 
• R-Value Observed: 0.200 

Literature

Structural and Functional Characterisation of a Specific Antidote for Ticagrelor.

Buchanan, A., Newton, P., Pehrsson, S., Inghardt, T., Antonsson, T., Svensson, P., Sjogren, T., Oster, L., Janefeldt, A., Sandinge, A., Keyes, F., Austin, M., Spooner, J., Gennemark, P., Penney, M., Howells, G., Vaughan, T., Nylander, S.

(2015) Blood 125: 3484

• PubMed: 25788700 
• DOI: 10.1182/blood-2015-01-622928
• Structures With Same Primary Citation


• PubMed Abstract: 
  

Ticagrelor is a direct-acting reversibly binding P2Y12 antagonist and is widely used as an antiplatelet therapy for the prevention of cardiovascular events in acute coronary syndrome patients. However, antiplatelet therapy can be associated with an increased risk of bleeding. Here, we present data on the identification and the in vitro and in vivo pharmacology of an antigen-binding fragment (Fab) antidote for ticagrelor. The Fab has a 20 pM affinity for ticagrelor, which is 100 times stronger than ticagrelor's affinity for its target, P2Y12. Despite ticagrelor's structural similarities to adenosine, the Fab is highly specific and does not bind to adenosine, adenosine triphosphate, adenosine 5'-diphosphate, or structurally related drugs. The antidote concentration-dependently neutralized the free fraction of ticagrelor and reversed its antiplatelet activity both in vitro in human platelet-rich plasma and in vivo in mice. Lastly, the antidote proved effective in normalizing ticagrelor-dependent bleeding in a mouse model of acute surgery. This specific antidote for ticagrelor may prove valuable as an agent for patients who require emergency procedures.

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Organizational Affiliation: 

AstraZeneca R&D Mölndal, Mölndal, Sweden; and.

Macromolecules

Entity ID: 2
Molecule	Chains	Sequence Length	Organism	Details
ANTI-TICAGRELOR FAB 72, LIGHT CHAIN	L	216	Homo sapiens	Mutation(s): 0

Entity ID: 1
Molecule	Chains	Sequence Length	Organism	Details
ANTI-TICAGRELOR FAB 72, HEAVY CHAIN	H	234	Homo sapiens	Mutation(s): 0

Small Molecules

Ligands 1 Unique
ID	Chains	Name / Formula / InChI Key	2D Diagram
TIQ	L	Ticagrelor C23 H28 F2 N6 O4 S OEKWJQXRCDYSHL-FNOIDJSQSA-N

Experimental Data & Validation

Experimental Data

• Method: X-RAY DIFFRACTION
• Resolution: 1.70 Å
• R-Value Free: 0.237 
• R-Value Work: 0.198 
• R-Value Observed: 0.200 
• Space Group: P 1 2₁ 1

Unit Cell:

Length ( Å )	Angle ( ˚ )
a = 41.23	α = 90
b = 72.567	β = 98.92
c = 67.765	γ = 90

Software Package:

Software Name	Purpose
BUSTER	refinement
XDS	data reduction
Aimless	data scaling
MOLREP	phasing

Structure Validation

Entry History 

Deposition Data

• Deposited Date: 2015-03-07 
• Released Date: 2015-04-01 
Deposition Author(s): Buchanan, A., Newton, P., Pehrsson, S., Inghardt, T., Antonsson, T., Svensson, P., Sjogren, T., Oster, L., Janefeldt, A., Sandinge, A., Keyes, F., Austin, M., Spooner, J., Penney, M., Howells, G., Vaughan, T., Nylander, S.

Revision History 

• Version 1.0: 2015-04-01
  Type: Initial release
  
• Version 1.1: 2015-06-10
  Changes: Database references