Costantini V, Deveglia R, Stabile A, Nenci G G
Istituto di Medicina Interna e di Medicina Vascolare, Università degli Studi di Perugia, Italy.
Blood Coagul Fibrinolysis. 2000 Jan;11(1):7-13.
In the search for a more acceptable route of heparin administration that can also be used for long-term treatment, we evaluated the bioavailability and antithrombotic activity of intraduodenal administration of unfractioned heparin (UFH) in rats. A radioiodinate derivative of UFH was administered intraduodenally in rats in conjunction with unlabeled UFH. We found that radioactivity increases very rapidly in plasma, as well as on the surface of aortic and caval segments, so that peak radioactivity was already achieved within 5 min of drug administration. Subsequently, plasma radioactivity declined rapidly, although 1.5-2.5% of the total radioactivity administered was still circulating 3 h after drug administration. The plasma anti-Xa activity was much lower and longer lasting than expected from the radioactivity counts in both peripheral and portal blood, and its level was very similar in the two circulatory districts, never exceeding 023 U/ml. This suggests that extensive degradation of the drug already occurs during its gastrointestinal absorption. Nevertheless, in a stasis-induced venous thrombosis model, intraduodenal UFH prevented thrombus formation in a dose-dependent way (ED50, 2000 IU/kg). The maximum antithrombotic effect was observed when the drug was administered 30-60 min before ligature of the vena cava, and a 40% reduction of thrombus weight was still present at 180 min. Since antithrombotic kinetics does not match the kinetics of either the plasma or vessel-bound radioactivity but approaches what is found in anti-Xa activity, the antithrombotic activity of oral heparin may be dependent on the release of unlabeled endogenous glycosaminoglycans deposited in the vessels.
在寻找一种更可接受的肝素给药途径以用于长期治疗的过程中,我们评估了大鼠十二指肠内给予普通肝素(UFH)的生物利用度和抗血栓活性。将UFH的放射性碘标记衍生物与未标记的UFH一起经十二指肠给予大鼠。我们发现,血浆以及主动脉和腔静脉段表面的放射性迅速增加,以至于在给药后5分钟内就已达到放射性峰值。随后,血浆放射性迅速下降,尽管给药后3小时仍有1.5 - 2.5%的总给药放射性在循环。血浆抗Xa活性比外周血和门静脉血中的放射性计数预期的要低得多且持续时间更长,并且其水平在两个循环区域非常相似,从未超过0.23 U/ml。这表明该药物在胃肠道吸收过程中已经发生了广泛降解。然而,在淤滞诱导的静脉血栓形成模型中,十二指肠内给予UFH以剂量依赖的方式预防血栓形成(半数有效剂量,2000 IU/kg)。当在腔静脉结扎前30 - 60分钟给药时观察到最大抗血栓作用,并且在180分钟时血栓重量仍减少40%。由于抗血栓动力学与血浆或血管结合放射性的动力学均不匹配,但接近抗Xa活性中所发现的情况,口服肝素的抗血栓活性可能依赖于沉积在血管中的未标记内源性糖胺聚糖的释放。