非人灵长类动物中与抗CD154单克隆抗体治疗相关的血栓形成倾向及其预防
Thrombophilia associated with anti-CD154 monoclonal antibody treatment and its prophylaxis in nonhuman primates.
作者信息
Koyama Ichiro, Kawai Tatsuo, Andrews David, Boskovic Svetlan, Nadazdin Ognjenka, Wee Siew Lin, Sogawa Hiroshi, Wu Dong-Li, Smith R Neal, Colvin Robert B, Sachs David H, Cosimi A Benedict
机构信息
Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
Transplantation. 2004 Feb 15;77(3):460-2. doi: 10.1097/01.TP.0000110291.29370.C0.
BACKGROUND
The authors previously reported thromboembolic complications associated with anti-CD154 monoclonal antibody (mAb) treatment in nonhuman primates. The underlying mechanisms of this complication and its management have not been established.
METHODS
Eighty cynomolgus monkey renal allograft recipients treated with anti-CD154 mAb were studied for the incidence of thrombosis and its prophylaxis.
RESULTS
Without anticoagulation prophylaxis, thromboembolic complications were seen in 5 of 11 recipients. With addition of perioperative heparin, the incidence was decreased to 2 of 10. No further improvement was observed by adding intraoperative prostaglandin (PG) E1. However, addition of ketorolac tromethamine to PGE1 and heparin decreased the incidence of thrombosis (one of eight). Most recently, the authors have found that ketorolac administration alone resulted in no thrombosis in 25 consecutive recipients.
CONCLUSIONS
Ketorolac is remarkably effective in preventing thromboembolism associated with anti-CD154 mAb treatment, suggesting the mechanism underlying this complication may be related to platelet activation leading to enhanced aggregation.
背景
作者之前报道了非人类灵长类动物中与抗CD154单克隆抗体（mAb）治疗相关的血栓栓塞并发症。这种并发症的潜在机制及其处理方法尚未明确。
方法
对80只接受抗CD154 mAb治疗的食蟹猴肾移植受者进行血栓形成发生率及其预防的研究。
结果
在未进行抗凝预防的情况下，11名受者中有5名出现血栓栓塞并发症。加用围手术期肝素后，发生率降至10名受者中的2名。加用术中前列腺素（PG）E1未观察到进一步改善。然而，在PGE1和肝素基础上加用酮咯酸氨丁三醇可降低血栓形成发生率（8名受者中的1名）。最近，作者发现连续25名受者单独使用酮咯酸未发生血栓形成。
结论
酮咯酸在预防与抗CD154 mAb治疗相关的血栓栓塞方面非常有效，提示这种并发症的潜在机制可能与导致血小板聚集增强的血小板活化有关。
Zotero 插件