Spriggs D, Gold H K, Hashimoto Y, Van Houtte E, Vermylen J, Collen D
Center for Thrombosis and Vascular Research, University of Leuven, Belgium.
Thromb Haemost. 1989 Feb 28;61(1):93-6.
F(ab')2 fragments of a murine monoclonal anti-platelet GPIIb/IIIa antibody (7E3) are a potent platelet aggregation inhibitor, which in a canine coronary artery thrombosis model accelerate lysis with recombinant tissue-type plasminogen activator (rt-PA) and prevent reocclusion (7). In the present study, we have investigated the potential value of platelet aggregation inhibition as adjunctive therapy to lysis of venous thrombi, by measuring the thrombolytic potency of 7E3-F(ab')2 and rt-PA used alone or in combination, in dogs with a 125I-fibrin labeled femoral vein thrombus. The dose-response of thrombolysis with rt-PA infused over 4 hours was linear: doses of 0.075 mg/kg, 0.15 mg/kg and 0.3 mg/kg produced 37 +/- 3, 57 +/- 11 and 83 +/- 4% lysis respectively, against a background value of 20 +/- 2%. With F(ab')2 fragments of 7E3 given as a bolus of 1.2 mg/kg, which saturated 70% of the platelet GPIIb/IIIa receptors and prolonged the bleeding to more than 30 min, lysis was not significantly increased over background. Combination of 0.3 or 0.6 mg/kg of 7E3-F(ab')2 with either 0.03 or 0.06 mg/kg of rt-PA did not produce more lysis than obtained with a comparable dose of rt-PA alone. No significant changes in plasma fibrinogen or alpha 2-antiplasmin were observed with either agent alone or with the combination. It is concluded that extensive inhibition of platelet aggregation does not potentiate the thrombolytic effect of rt-PA in this venous thrombosis model.
鼠单克隆抗血小板糖蛋白IIb/IIIa抗体(7E3)的F(ab')2片段是一种有效的血小板聚集抑制剂,在犬冠状动脉血栓形成模型中,它能与重组组织型纤溶酶原激活剂(rt-PA)协同加速血栓溶解并防止再闭塞(7)。在本研究中,我们通过测量单独或联合使用7E3-F(ab')2和rt-PA对患有125I-纤维蛋白标记的股静脉血栓的犬的溶栓效力,研究了血小板聚集抑制作为静脉血栓溶解辅助治疗的潜在价值。rt-PA在4小时内输注的溶栓剂量反应呈线性:0.075mg/kg、0.15mg/kg和0.3mg/kg的剂量分别产生37±3%、57±11%和83±4%的溶解,背景值为20±2%。给予1.2mg/kg推注的7E3的F(ab')2片段,可饱和70%的血小板糖蛋白IIb/IIIa受体并使出血时间延长至30分钟以上,与背景相比,溶解并未显著增加。0.3或0.6mg/kg的7E3-F(ab')2与0.03或0.06mg/kg的rt-PA联合使用,其溶解效果并不比单独使用相当剂量的rt-PA更好。单独使用任何一种药物或联合使用时,血浆纤维蛋白原或α2-抗纤溶酶均未观察到显著变化。结论是,在该静脉血栓形成模型中,广泛抑制血小板聚集并不能增强rt-PA的溶栓作用。