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Comparative effects of synthetic pentasaccharide, low‐molecular‐weight heparin, unfractionated heparin and recombinant hirudin on the generation of factor VIIa and prothrombin activation after coagulation of human plasma

 

作者: G. Gerotziafas,   L. Bara,   M. Bloch,   P. Makris,   M. Samama,  

 

期刊: Blood Coagulation and Fibrinolysis  (OVID Available online 1998)
卷期: Volume 9, issue 7  

页码: 571-580

 

ISSN:0957-5235

 

年代: 1998

 

出版商: OVID

 

关键词: factor VII;factor VII activation;factor VIIa;UFH;LMWH;pentasaccharide;hirudin;prothrombin activation

 

数据来源: OVID

 

摘要:

We studied the effect of synthetic pentasaccharide, a low-molecular-weight heparin (enoxaparin), unfractionated heparin and recombinant hirudin on the generation of factor VIIa (FVIIa) and prothrombin activation after in-vitro clotting of human platelet-poor plasma. FVIIa was measured with a new clotting assay that uses recombinant tissue factor truncated to interact only with FVIIa. Residual prothrombin was measured using the conventional clotting assay. FVIIa and residual FII were measured in the liquid - called pseudo-serum (Ψ-serum) - obtained 1 h after clotting of normal platelet-poor plasma. A kinetic study of the generation of FVIIa was also performed. Coagulation was initiated by triggering the extrinsic, the intrinsic and both associated clotting pathways. Levels of FVIIa in the Ψ-sera (55 ± 15, 258 ± 18, and 164 ± 18 ng/ml, in the extrinsic, intrinsic and intrinsic + thromboplastin Ψ-serum respectively; values are means ± SEM) were significantly increased compared with those in the platelet-poor plasma (3 ng/ml). Pentasaccharide, low-molecular-weight heparin and unfractionated heparin inhibited the generation of factor VIIa or its activity, or both, in a dose-dependent manner in all the experimental systems (60–90% inhibition). A kinetic study revealed that the inhibition of the generation of FVIIa by pentasaccharide and heparins starts 1 min after triggering either the extrinsic or the intrinsic clotting pathway. The downregulation of FVIIa by heparins was effected mainly by their anti-Xa activity, but also by their inhibitory effect on the generation of prothrombinase. Pentasaccharide, enoxaparin and unfractionated heparin significantly inhibited prothrombin activation in both extrinsic and intrinsic experimental system. Hirudin had no inhibitory effect either on the generation of FVIIa or on prothrombin activation in any experimental system.

 

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