Niimi Y, Ichinose F, Ishiguro Y, Terui K, Uezono S, Morita S, Yamane S
Department of Anesthesiology, Teikyo University School of Medicine, Ichihara Hospital, Chiba, Japan.
Anesth Analg. 1999 Sep;89(3):573-9. doi: 10.1097/00000539-199909000-00006.
Platelet adhesion on the cardiopulmonary bypass oxygenator membrane is associated with impaired hemostasis. We investigated the effects of heparin coating of the oxygenator membrane on protein adsorption and platelet adhesion on the surface. Noncoated and heparin-coated polypropylene membranes were incubated in whole blood with small- (1 U/mL) or large-dose (5 U/mL) heparin as an anticoagulant for 3 h at 37 degrees C. The amount of platelets adhering on each fiber was assessed by using enzyme immunoassays using monoclonal antibodies directed against CD42b (GP Ib) and CD61 (GP IIb/IIIa). Platelet activation was assessed by measuring plasma guanosine monophosphate 140 levels. The amount and composition of the adsorbed proteins on the surface were analyzed by using a bicinchoninic acid protein assay and by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting technique. The heparin coating of the fibers significantly reduced platelet adhesion on the surface. However, platelet activation was reduced by heparin coating only with small-dose heparinization. The adsorption of platelet adhesive proteins such as fibrinogen and von Willebrand factor was not altered, whereas that of fibronectin was increased by heparin coating. We conclude that heparin coating of the oxygenator fibers can decrease platelet adhesion without affecting adsorption of major adhesive proteins. Surface heparin coating is associated with an increased fibronectin adsorption on the fibers.
Heparin coating can reduce platelet adhesion and activation in the presence of small-dose heparinization, potentially reducing the inflammatory response and activation of thrombosis and fibrinolysis.
心肺旁路氧合器膜上的血小板黏附与止血功能受损有关。我们研究了氧合器膜的肝素涂层对表面蛋白吸附和血小板黏附的影响。将未涂层和肝素涂层的聚丙烯膜在全血中，分别以小剂量（1 U/mL）或大剂量（5 U/mL）肝素作为抗凝剂，于37℃孵育3小时。使用针对CD42b（糖蛋白Ib）和CD61（糖蛋白IIb/IIIa）的单克隆抗体，通过酶免疫测定法评估每条纤维上黏附的血小板数量。通过测量血浆鸟苷单磷酸140水平评估血小板活化情况。使用二辛可宁酸蛋白质测定法、十二烷基硫酸钠 - 聚丙烯酰胺凝胶电泳和蛋白质印迹技术分析表面吸附蛋白的数量和组成。纤维的肝素涂层显著减少了表面的血小板黏附。然而，仅在小剂量肝素化时，肝素涂层才会降低血小板活化。纤维蛋白原和血管性血友病因子等血小板黏附蛋白的吸附未改变，而肝素涂层使纤连蛋白的吸附增加。我们得出结论，氧合器纤维的肝素涂层可减少血小板黏附，而不影响主要黏附蛋白的吸附。表面肝素涂层与纤维上纤连蛋白吸附增加有关。
在小剂量肝素化情况下，肝素涂层可减少血小板黏附和活化，可能减少炎症反应以及血栓形成和纤溶的激活。
