Antithrombotic Effect Of Heparin Research Articles

Platelet Factor 4 Enables Platelets to Suppress Early Parasite Growth in a Mouse Model of Blood Stage Malarial Infection

Platelets are best known for their roles in hemostasis, but there is accumulating evidence for their importance in immunity and host defence against infection. We have shown that platelets are required for host protection during malarial infection and are a major determinant for survival. Platelets control the growth of intraerythrocytic Plasmodium parasites by directly binding to infected erythrocytes and killing the parasite inside 1. We 2 and others 3 have also described the parasite killing mechanism exerted by platelets. Upon binding to parasite-infected red cells, platelets release a protein with dual chemokine and antimicrobial functions called platelet factor 4 (PF4). PF4 binds to the red cell Duffy antigen chemokine receptor, and is then absorbed into the parasite where it lyses the parasite food vacuole and kills the parasite.This work aimed to further investigate the role of PF4 in vivo using mice a PF4 knockout mouse strain (Pf4tm1Mako/tm1Mako; 4) and blood stage infection with a murine malaria model parasite, P. chabaudi. We confirmed that the homozygous mutant mice did not produce any PF4 protein. Following challenge with P. chabaudi (1 x 104 parasites administered intravenously), rates of survival amongst cohorts of age and sex matched wild type and homozygous mice (both on a C57BL/6 background) were not significantly different (approximately 30% for females and 10% for males). However, a deficiency of PF4 resulted in significant differences in parasite growth during the pre-peak parasitemia phase of the infection. Between days 5 and 8 following infection, proportions of parasite-infected red cells in the circulation of PF4-null mice were double those in wild-type mice. This coincided with a 50-60% reduction in the frequency of growth arrested or dead parasites (detected using terminal deoxynucleotidyl transferase dUTP nick end labelling, also known as TUNEL labelling).Together these data indicate that platelet-derived PF4 has an important in vivo malaria-protective role. The protein is necessary for the platelet to control parasite growth during the early stage of erythrocytic malarial infection. However, the highly virulent nature of the P. chabaudi strain used in these experiments precluded detection of any predicted survival disadvantage in the PF4-null mice. 1.McMorran BJ, Marshall VM, de Graaf C, et al. Platelets kill intraerythrocytic malarial parasites and mediate survival to infection. Science. 2009;323(5915):797-800.2.McMorran BJ, Wieczorski L, Drysdale KE, et al. Platelet factor 4 and Duffy antigen required for platelet killing of Plasmodium falciparum. Science. 2012;338(6112):1348-1351.3.Love MS, Millholland MG, Mishra S, et al. Platelet Factor 4 Activity against P. falciparum and Its Translation to Nonpeptidic Mimics as Antimalarials. Cell host & microbe. 2012;12(6):815-823.4.Eslin DE, Zhang C, Samuels KJ, et al. Transgenic mice studies demonstrate a role for platelet factor 4 in thrombosis: dissociation between anticoagulant and antithrombotic effect of heparin. Blood. 2004;104(10):3173-3180. DisclosuresNo relevant conflicts of interest to declare.

Developmental hemostasis: recommendations for laboratories reporting pediatric samples

Developmental hemostasis: recommendations for laboratories reporting pediatric samples

Transgenic mice studies demonstrate a role for platelet factor 4 in thrombosis: dissociation between anticoagulant and antithrombotic effect of heparin

AbstractThe platelet-specific chemokine platelet factor 4 (PF4) is released in large amounts at sites of vascular injury. PF4 binds to heparin with high affinity, but its in vivo biologic role has not been defined. We studied the role of PF4 in thrombosis using heterozygote and homozygote PF4 knock-out mice (mPF4+/– and mPF4–/–, respectively) and transgenic mice overexpressing human PF4 (hPF4+). None of these lines had an overt bleeding diathesis, but in a FeCl3 carotid artery thrombosis model, all showed impaired thrombus formation. This defect in thrombus formation in the mPF4–/– animals was corrected by infusing hPF4 over a narrow concentration range. The thrombotic defect in the mPF4+/– and mPF4–/– animals was particularly sensitive to infusions of the negatively charged anticoagulant heparin. However, the same amount of heparin paradoxically normalized thrombus formation in the hPF4+ animals, although these animals were anticoagulated systemically. Upon infusion of the positively charged protein, protamine sulfate, the reverse was observed with mPF4+/– and mPF4–/– animals having improved thrombosis, with the hPF4+ animals having worsened thrombus formation. These studies support an important role for PF4 in thrombosis, and show that neutralization of PF4 is an important component of heparin's anticoagulant effect. The mechanisms underlying these observations of PF4 biology and their clinical implications remain to be determined.

The Heparin Binding Properties of Heparin Cofactor II Suggest an Antithrombin-like Activation Mechanism

The serpin heparin cofactor II (HCII) is a glycosaminoglycan-activated inhibitor of thrombin that circulates at a high concentration in the blood. The antithrombotic effect of heparin, however, is due primarily to the specific interaction of a fraction of heparin chains with the related serpin antithrombin (AT). What currently prevents selective therapeutic activation of HCII is the lack of knowledge of the determinants of glycosaminoglycan binding specificity. In this report we investigate the heparin binding properties of HCII and conclude that binding is nonspecific with a minimal heparin length of 13 monosaccharide units required and affinity critically dependent on ionic strength. Rapid kinetics of heparin binding indicate an induced fit mechanism that involves a conformational change in HCII. Thus, HCII binds to heparin in a manner analogous to the interaction of AT with low affinity heparin. A fully allosteric 2000-fold heparin activation of thrombin inhibition by HCII is demonstrated for heparin chains up to 26 monosaccharide units in length. We conclude that the heparin-binding mechanism of HCII is closely analogous to that of AT and that the induced fit mechanism suggests the potential design or discovery of specific HCII agonists.

The Effect of Unfractionated vs. Low Molecular Weight Heparin on Tissue Factor Pathway Inhibitor Levels in Hospital Inpatients

Although heparin is widely used as an antithrombotic agent, its multiple mechanisms of action are not fully defined. Recent work has suggested that tissue factor pathway inhibitor (TFPI) may contribute to the antithrombotic activity of heparin by inhibiting the extrinsic pathway of coagulation. We have investigated the effect of heparin on TFPI and have found that when unfractionated heparin is given by continuous intravenous infusion to hospitalized inpatients, TFPI levels increase 2.3-fold and remain high as long as heparin is continued, but return to baseline levels soon after the infusion is stopped. In contrast, therapeutic doses of the low molecular weight heparin, dalteparin, resulted in significantly less TFPI induction. Given the increasing number of studies establishing the clinical efficacy of low molecular weight heparins as antithrombotic agents, these results suggest that TFPI may not be a major contributor to the antithrombotic effect of heparin.

Antithrombotic efficacy of RPR208566, a novel factor Xa inhibitor, in a rat model of carotid artery thrombosis

Coagulation factor Xa is the sole enzyme responsible for activating the zymogen prothrombin to thrombin, resulting in fibrin generation, platelet activation, and subsequent thrombus formation. Our objective was to evaluate the antithrombotic efficacy of the novel factor Xa inhibitor, 2-(3-carbamimidoyl-benzyl)-3-[(3′,4′dimethoxy-biphenyl-4-carbonyl)-amino]-butyric acid methyl ester-trifluoroacetate (RPR208566), in a well-established rat model of arterial thrombosis, and to compare the results with those obtained with argatroban and heparin, direct and indirect inhibitors of thrombin, respectively. Thrombus formation was initiated by placing a filter paper saturated with FeCl 2 on the adventia of the carotid artery for 10 min. Time-to-occlusion was measured from initiation of injury until blood flow reached zero. Formed thrombi were removed and weighed 60 min after the placement of the filter paper. RPR208566, heparin, and argatroban dose-dependently increased time-to-occlusion and reduced thrombus mass. When administered at 500 μg/kg+50 μg/kg/min, RPR208566 prolonged time-to-occlusion to 56±4 min (vs. 18±2 min for vehicle) and reduced thrombus mass to 3.0±0.7 mg (vs. 7.3±0.6 mg for vehicle). The highest doses of argatroban (500 μg/kg+50 μg/kg/min) and heparin (300 U/kg+10 U/kg/min) increased time-to-occlusion to the maximum of 60 min and decreased thrombus mass to 5.5±0.8 and 2.6±0.3, respectively. The antithrombotic effects of heparin and argatroban at these doses were associated with increases in activated partial thromboplastin time of 5.6±0.9- and 2.9±0.3-fold over baseline, respectively. However, the highest dose of RPR208566 produced a modest 1.3±0.1-fold increase in activated partial thromboplastin time. These results indicate that factor Xa inhibition with compounds such as RPR208566 may be an attractive mechanism for novel antithrombotic drug therapy.

Comparison of the Antithrombotic Effects of Heparin, Hirudin and Clopidogrel according to the Nature of the Thrombogenic Surface in an Arterioarterial Shunt in Rats

Comparison of the Antithrombotic Effects of Heparin, Hirudin and Clopidogrel according to the Nature of the Thrombogenic Surface in an Arterioarterial Shunt in Rats -

Is tissue factor pathway inhibitor involved in the antithrombotic effect of heparins? Biochemical considerations.

Tissue factor pathway inhibitor (TFPI) is released into the circulation after intravenous or subcutaneous injection of heparin or low-molecular-weight heparin (Logiparin) in humans. The plasma concentration of TFPI is increased 2- to 4-fold by a prophylactic dose of Logiparin, and this excess TFPI remains in the circulation only in the presence of the heparin. TFPI and heparin show strong synergism in clotting assays at concentrations obtained after heparin injection in humans. Animal studies have demonstrated that TFPI by itself has antithrombotic properties. It is concluded that the release of TFPI may contribute significantly to the antithrombotic effect of heparin.

Effects of immuno-potent drugs and their association with an unfractionated heparin on an experimental venous thrombosis

Immuno-potent drugs are largely used in human medicine. The aim of this study was to determine the role of two immuno-modulators (sodium diethyl-dithiocarbamate, RU 41 740) and two immuno-suppressors (methylprednisolone, cyclosporin A) alone or in association with an unfractionated heparin (Calciparin R), on an experimental venous thrombosis made by vena cava ligation in male Wistar rats. Each immuno-potent drug was administered for six days before the thrombus induction at the same dosage (10mg/kg b.w.), and the Calciparin R, used as treatment of the thrombosis, was administered two hours after the thrombus induction at the dose of lmg/kg b.w. Immuno-treatment potentiated thrombus formation: the increase in thrombus weight was greater with immuno-modulators (43% on average in comparison with placebo) than with immuno-suppressors (20%). In association with Calciparin R the antithrombotic effect was also potentiated and more marked with the immuno-modulators than with immuno-suppressors. An increase in circulating monocytes was observed in all groups whether Calciparin R was present or not. Coagulation tests were not affected by immuno-therapy. However, immuno-modulators led to an inhibition of platelet aggregation. In conclusion, this trial seems to show a probable effect of immunological cells in thrombosis and in the antithrombotic effect of heparin, but the mechanism involved is not yet determined.

Heparin Prevents Stasis-Induced Thrombosis through Protection of the Venous Endothelial Cells: An Electron Microscopic Study in Rabbits

This study was performed to see whether or not protection of the endothelial cells contributes to the antithrombotic effects of heparin. New Zealand albino rabbits were subjected to jugular vein stasis by single caudal ligation for 2 h. Three treatments were given: saline (control group), heparin (0.2 mg/kg) 5 or 45 min before ligature of the vein. Groups of 6-8 animals were killed at 0, 5, 15, 30 and 120 min. The following parameters were determined: (1) involution and damage of the endothelial cells by scanning and transmission electron microscopy; (2) incidence and weight of thrombi in the lumens of the veins after 2 h stasis, and (3) effects of heparin on APTT and anti-Xa activity. In the control group, stasis caused a considerable involution of the endothelial cells in the first 30 min, followed by fibrin deposition and thrombus generation. Heparin strongly reduced the damage to the endothelial cells, with very evident protection of the cell membranes, and prevented thrombus generation: there were significant decreases in both incidence and weight of thrombi. These effects of heparin were evident both shortly after (maximal anticoagulant effect) and long after (no anticoagulant effect) pretreatment. We think that, under the experimental conditions we used, heparin prevented venous thrombosis at least partially by protection of the endothelial cells, through unknown mechanisms.

Washout of Vessels with Heparin Does Not Improve Patency Following Severe Microarterial Trauma: An Experimental Study

The antithrombotic effect of heparin used as a wash-out solution in small arteries has been evaluated following severe vessel trauma (arteriotomy/intimectomy). Twenty-three central arteries of rabbit ears were prepared and platelets labeled with phosphorus-32 injected intraaortically. The arteries were positioned in double vascular clamps and opened by arteriotomy, and intimectomy was performed. After reestablishing blood flow, arteriotomic bleeding times, platelet accumulation in vivo, patency, and the amounts of intraluminal red thrombotic material were recorded. The rabbits were divided into two groups. In group A (12 vessels) the vessel interior was flushed with 2 ml of saline or Ringer's lactate solution. Group B (11 vessels) was similar except that the vessels were flushed with 2 ml of heparin, 100 IU/ml, in Ringer's lactate solution. In the control group (A) the bleeding time was 5 +/- 2 min, while in group B bleeding was so profuse that extra sutures had to be used in 6 of the vessels. Although significantly fewer platelets accumulated in heparin-treated animals, the patency frequencies and amounts of thrombotic material observed in both groups were similar. The final volume of thrombus formed is thus not always proportional to the degree of platelet accumulation. Washout of small traumatized arteries with heparin is thus not beneficial.

Antithrombotic Properties of Heparin in a Neonatal Piglet Model of Thrombin-Induced Thrombosis

The relative deficiency of antithrombin III (AT III) in neonatal plasma results in lower recovery of heparin in some assay systems. It is uncertain whether low AT III levels also limit the antithrombotic effects of heparin in this age group. We therefore compared the antithrombotic properties of heparin in mature pigs and newborn piglets, whose coagulation and inhibitor system closely resembles that of the human neonate. Animals were pretreated with saline, 10 or 25 U/kg heparin (n greater than or equal to 16 per age group and dose). Following an injection of 100 U/kg thrombin, systemic 125I-fibrinogen consumption and local 125I-fibrinogen incorporation into jugular venous stasis thrombi were measured. Significantly more 125I-fibrinogen was consumed in piglets than in pigs systemically (p less than 0.0001), as well as within the occluded vein segment (p = 0.0112), largely because heparin was less effective in piglets than in pigs. This neonatal resistance to heparin could not be explained by lower heparin levels in the newborn animals. However, pretreatment with AT III concentrate significantly improved the antithrombotic properties of heparin in this age group (p less than 0.0001). We conclude that physiologically low AT III levels reduce the efficacy of heparin in neutralizing thrombin activity in newborn piglets. We speculate that AT III deficiency may also limit the antithrombotic properties of heparin in newborn infants with thrombotic disease.

What is the best plasmatic activity which could be correlated with the antithrombotic effect of heparin and a low molecular weight heparin fragment?

What is the best plasmatic activity which could be correlated with the antithrombotic effect of heparin and a low molecular weight heparin fragment?

Heparin: Do We Understand Its Antithrombotic Actions?

Heparin: Do We Understand Its Antithrombotic Actions?

Anticoagulant and antithrombotic effects of heparin and low molecular weight heparin fragments in rabbits.

Heparin and heparin fragments of different molecular weight and with different anti-factor Xa/APTT activity ratios were studied with respect to their ability to inhibit thrombus formation in an animal model. It is concluded that: a) Neither anti-factor Xa nor the APTT activity alone is a good reflector of the antithrombotic activity. b) Anti-factor Xa active fragments must have a minimum molecular weight in order to elicit good antithrombotic activity. c) High affinity for antithrombin III is important for good antithrombotic activity. d) A heparin fragment of molecular weight 4 000 has the same antithrombotic activity as heparin but less effect on the clotting time.

Heparin inhibits the formation of endoperoxide metabolites in rat platelets: aspirin-like activity

Amounts of thromboxane A 2 (TXA 2) synthesized during the collagen-induced aggregation was much higher in citrated PRP than in heaprinized PRP implying that heparin might inhibit the synthesis of endoperoxide metabolites besides its anticoagulant action. Preincubation of citrated PRP with heparin resulted in dose dependent inhibition of the formation of TXA 2 and PGE 2. At the high concentration, heparin also inhibited the aggregation of citrated platelets induced by collagen indicating that heparin possesses aspirin-like activity. The significance of this finding is that the antithrombotic effect of heparin is probably due to not only its anticoagulant effect but also inhibition of the formation of arachidonic acid metabolites by platelets.