Cardeza Foundation for Hematological Research, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Blood. 2011 Feb 17;117(7):2241-6. doi: 10.1182/blood-2010-03-274969. Epub 2010 Nov 18.
Heparin-induced thrombocytopenia (HIT) is a major cause of morbidity and mortality resulting from the associated thrombosis. Extensive studies using our transgenic mouse model of HIT have shown that antibodies reactive with heparin-platelet factor 4 complexes lead to FcγRIIA-mediated platelet activation in vitro as well as thrombocytopenia and thrombosis in vivo. We tested PRT-060318 (PRT318), a novel selective inhibitor of the tyrosine kinase Syk, as an approach to HIT treatment. PRT318 completely inhibited HIT immune complex-induced aggregation of both human and transgenic HIT mouse platelets. Transgenic HIT model mice were treated with KKO, a mouse monoclonal HIT-like antibody, and heparin. The experimental group received orally dosed PRT318, whereas the control group received vehicle. Nadir platelet counts of PRT318-treated mice were significantly higher than those of control mice. When examined with a novel thrombosis visualization technique, mice treated with PRT318 had significantly reduced thrombosis. The Syk inhibitor PRT318 thus prevented both HIT immune complex-induced thrombocytopenia and thrombosis in vivo, demonstrating its activity in HIT.
肝素诱导的血小板减少症 (HIT) 是由相关血栓引起的发病率和死亡率的主要原因。使用我们的 HIT 转基因小鼠模型进行的广泛研究表明,与肝素-血小板因子 4 复合物反应的抗体导致体外 FcγRIIA 介导的血小板活化以及体内血小板减少症和血栓形成。我们测试了 PRT-060318(PRT318),一种新型选择性 Syk 酪氨酸激酶抑制剂,作为治疗 HIT 的一种方法。PRT318 完全抑制了人类和转基因 HIT 小鼠血小板的 HIT 免疫复合物诱导的聚集。将 KKO(一种类似 HIT 的小鼠单克隆抗体和肝素)用于转基因 HIT 模型小鼠。实验组接受 PRT318 的口服剂量,而对照组接受载体。PRT318 治疗的小鼠的血小板计数明显高于对照组。当使用新的血栓形成可视化技术检查时,接受 PRT318 治疗的小鼠的血栓形成明显减少。因此,Syk 抑制剂 PRT318 可预防体内 HIT 免疫复合物诱导的血小板减少症和血栓形成,证明其在 HIT 中的活性。