Stief T W, Kurz J, Doss M O, Fareed J
Institute of Clinical Chemistry, Philipps-University, D-35033, Marburg, Germany.
Thromb Res. 2000 Mar 15;97(6):473-80. doi: 10.1016/s0049-3848(99)00211-x.
Activated polymorphonuclear leukocytes participate in hemostasis. These phagocytes generate up to 5 mmol/l of oxidants of the HOCl- and chloramine-type. The present study shows, for the first time, that physiological concentrations of NaOCl or chloramines act as anticoagulants in human plasma. Prothrombin time, activated partial thromboplastin time, and thrombin time at chloramine concentrations greater than 1 mmol/l are prolonged proportional to the oxidant concentration. Plasmatic coagulation factors sensible to oxidation are fibrinogen, factor V, factor VIII, and factor X with a 50% effective dose of 2-3 mmol/l NaOCl or taurine-chloramine. Chloramines or chloramine-like agents (e.g., chloramine T(R) or vancomycin) also inactivate platelet aggregation (in whole blood or platelet-rich plasma) at an 50% effective dose of about 1.0 mmol. This irreversible oxidation of the hemostasis components is inhibited by addition of methionine, cysteine, ascorbic acid, or azide in 10-fold molar excess prior to oxidation. The oxy-radical inhibitors mannitol, superoxide dismutase, or catalase do not antagonize the action of NaOCl or chloramines. Therefore, the oxidant here involved has reaction characteristics of singlet oxygen (1O(2)), a nonradical, excited (i.e., light-emitting) oxidant. The hemostasis factors sensible to oxidation might dispose of oxidizable, for their function critical, methionine or cysteine residues. In conclusion, blood coagulation factors I, V, VIII, X and thrombocytes are sensible to nonradical oxidants of activated phagocytes. Via 1O(2) generation, polymorphonuclear leukocytes can generate a local pericellular zone of anticoagulation. The data suggest that the cell signal 1O(2) in physiological amounts is an antithrombotic agent.
活化的多形核白细胞参与止血过程。这些吞噬细胞可产生高达5 mmol/L的次氯酸(HOCl)和氯胺类氧化剂。本研究首次表明,生理浓度的次氯酸钠(NaOCl)或氯胺在人血浆中起抗凝作用。当氯胺浓度大于1 mmol/L时,凝血酶原时间、活化部分凝血活酶时间和凝血酶时间会随着氧化剂浓度的增加而成比例延长。对氧化敏感的血浆凝血因子包括纤维蛋白原、因子V、因子VIII和因子X,其50%有效剂量的次氯酸钠或牛磺酸氯胺为2 - 3 mmol/L。氯胺或类似氯胺的试剂(如氯胺T(R)或万古霉素)在约1.0 mmol的50%有效剂量下也会抑制血小板聚集(在全血或富含血小板的血浆中)。在氧化之前加入10倍摩尔过量的蛋氨酸、半胱氨酸、抗坏血酸或叠氮化物可抑制止血成分的这种不可逆氧化。氧自由基抑制剂甘露醇、超氧化物歧化酶或过氧化氢酶不能拮抗次氯酸钠或氯胺的作用。因此,这里涉及的氧化剂具有单线态氧(1O(2))的反应特性,单线态氧是一种非自由基、激发态(即发光)的氧化剂。对氧化敏感的止血因子可能具有可氧化的、对其功能至关重要的蛋氨酸或半胱氨酸残基。总之,凝血因子I、V、VIII、X和血小板对活化吞噬细胞产生的非自由基氧化剂敏感。通过产生1O(2),多形核白细胞可在细胞周围局部区域产生抗凝作用。数据表明,生理量的细胞信号1O(2)是一种抗血栓形成剂。