Effect of anticoagulation and thrombolysis on circulation endothelial cells and endothelial function after acute inferior vena cava thrombosis in rats

Abstract

To explore the functions and adhesive properties of circulating endothelial cells after acute thrombosis in rats. The inferior caval venous thrombosis model were treated with heparin (n = 45), urokinase (n = 45) and a combination of heparin and urokinase (n = 45) respectively. The sham group was treated similarly (n = 30). The thrombosed caval veins were harvested at Days 1, 3, 7, 14 and 28 post-thrombosis. Structural integrity and intimal hyperplasia were observed by light microscope. Scanning electron microscopy was used to assess the damage of endothelial cells in inferior caval vein wall. The level of thrombotic adhesion was measured in different phases. At Day 28, endothelial cell layer was observed under scanning electron microscope. Measurements were taken for circulating endothelial cells count, CEPC (circulating endothelial progenitor cell) count and CEPC adhesive capacity. The adhesion to caval vein wall was lower in groups B and C than that in group A at Day 3 post-thrombosis (all P < 0.01). The endothelial damage in group A was more serious than groups B and C at Day 7 (P < 0.05). And the endothelial damage was less severe in group C at Day 28 (P < 0.05). For the rats in A, B, C, SH groups, the numbers of circulating endothelial cell [(6.3 ± 2.2)×10(6), (4.76 ± 3.1)×10(6), (1.9 ± 0.8)×10(6), (0.91 ± 0.3)×10(6)], CEPC count (18.9 ± 5.33, 37.4 ± 6.0, 55.4 ± 8.0, 64.1 ± 3.2) and CEPC adhesion (9.6 ± 2.9, 17.5 ± 3.2, 22.1 ± 4.4, 28.3 ± 2.0) increased successively. There was statistical significance. A combination of heparin and urokinase for the treatment of acute inferior caval venous thrombosis may effectively maintain the endothelial integrity of vein wall and decrease the fibroblast proliferation of thrombosed vein. Adhesion to caval vein wall is relatively lower during an early post-thrombotic period.