Marchetti Marina, Vignoli Alfonso, Russo Laura, Balducci Donatella, Pagnoncelli Marcella, Barbui Tiziano, Falanga Anna
Department of Hematology, Ospedali Riuniti di Bergamo, Largo Barozzi, 1-24128 Bergamo, Italy.
Thromb Res. 2008;121(5):637-45. doi: 10.1016/j.thromres.2007.06.015. Epub 2007 Aug 10.
Clinical studies suggest a survival advantage in cancer patients receiving low molecular weight heparin (LMWH). A suggested mechanism for this beneficial effect may reside in the antiangiogenic activity of heparins.
In this study we investigated whether two different LMWHs, i.e. enoxaparin and dalteparin, and unfractionated heparin (UFH), affect the angiogenic potential of human microvascular endothelial cells (HMEC-1) promoted by tumor cells.
HMEC-1 cells were incubated with tumor cell conditioned media (TCM) derived from human breast cancer and leukemic cells (i.e. MCF-7, MDA.MB.231, and NB4 cell lines) or recombinant cytokines (i.e. VEGF, FGF-2, TNF-alpha) +/-heparins. Capillary-like tube formation in Matrigel and cell proliferation were evaluated.
All three TCM induced a significant (p<0.05) increase in total length of tubes formed by HMEC-1 in Matrigel. These increases were significantly counteracted (62 to 100% mean inhibition) by enoxaparin and dalteparin, but were significantly less affected by UFH. Similarly, the tube formation induced by standard VEGF, FGF-2, or TNF-alpha was 100% inhibited by enoxaparin, and 70-90% by dalteparin, whereas minor or no inhibition was observed with UFH. VEGF was the most active cytokine in TCM of both breast cancer and leukemic cells. EC proliferation was significantly increased by standard angiogenic factors, and slightly affected by breast cancer TCM (p=ns). The addition of heparins significantly counteracted the proliferative stimuli.
These results support a major role for LMWH compared to UFH in inhibiting the proangiogenic effect exerted by tumor cells or purified angiogenic factors on microvascular endothelium.
临床研究表明,接受低分子量肝素(LMWH)治疗的癌症患者具有生存优势。这种有益作用的一种可能机制可能在于肝素的抗血管生成活性。
在本研究中,我们调查了两种不同的低分子量肝素,即依诺肝素和达肝素,以及普通肝素(UFH)是否会影响肿瘤细胞促进的人微血管内皮细胞(HMEC-1)的血管生成潜能。
将HMEC-1细胞与源自人乳腺癌和白血病细胞(即MCF-7、MDA.MB.231和NB4细胞系)或重组细胞因子(即VEGF、FGF-2、TNF-α)的肿瘤细胞条件培养基(TCM)一起培养,同时添加或不添加肝素。评估基质胶中毛细血管样管的形成以及细胞增殖情况。
所有三种TCM均显著(p < 0.05)增加了HMEC-1在基质胶中形成的管的总长度。依诺肝素和达肝素显著抵消了这些增加(平均抑制率为62%至100%),但普通肝素对其影响显著较小。同样,标准VEGF、FGF-2或TNF-α诱导的管形成被依诺肝素100%抑制,被达肝素70%至90%抑制,而普通肝素的抑制作用较小或未观察到抑制作用。VEGF是乳腺癌和白血病细胞TCM中最活跃的细胞因子。标准血管生成因子显著增加内皮细胞增殖,而乳腺癌TCM对其影响较小(p = 无统计学意义)。添加肝素显著抵消了增殖刺激。
这些结果支持与普通肝素相比,低分子量肝素在抑制肿瘤细胞或纯化的血管生成因子对微血管内皮的促血管生成作用中起主要作用。