Ludwig Ralf J
Department of Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.
Curr Drug Discov Technol. 2009 Dec;6(4):281-9. doi: 10.2174/157016309789869001.
Heparin has been used as an anticoagulant for decades. Recently, attention has been drawn to the non-anticoagulant activities of heparin. Experimentally and clinically those non-anticoagulant properties of heparin inhibit inflammation and metastatic spread of tumor cells. On the molecular level, heparin inhibits the function, expression and/or synthesis of adhesion molecules, cytokines, angiogenic factors and complement. However, despite a similar anticoagulant activity, those non-anticoagulant effects of heparin differ greatly among the different heparin preparations. The same holds true for the most common adverse events of heparin treatment. The incidence of immune mediated heparin-induced thrombocytopenia and cutaneous hypersensitivity responses is greatly, but not exclusively, influenced by the heparin preparation used. As the structure-function relationship of the anti-inflammatory and anti-metastatic effects of heparins are understood in more detail, and as the risk profile of different heparin preparations regarding the induction of adverse events have been identified, we propose to use the different heparin preparations according to the individual needs of each patient.
肝素作为一种抗凝剂已使用了数十年。最近，肝素的非抗凝活性受到了关注。在实验和临床中，肝素的那些非抗凝特性可抑制肿瘤细胞的炎症和转移扩散。在分子水平上，肝素抑制黏附分子、细胞因子、血管生成因子和补体的功能、表达及/或合成。然而，尽管具有相似的抗凝活性，但肝素的那些非抗凝作用在不同的肝素制剂之间差异很大。肝素治疗最常见的不良事件也是如此。免疫介导的肝素诱导的血小板减少症和皮肤过敏反应的发生率在很大程度上（但并非唯一地）受所用肝素制剂的影响。随着对肝素抗炎和抗转移作用的结构 - 功能关系有了更详细的了解，并且随着已确定不同肝素制剂在诱导不良事件方面的风险概况，我们建议根据每位患者的个体需求使用不同的肝素制剂。
