Stokol Tracy, Serpa Priscila B S, Brooks Marjory B, Divers Thomas, Ness Sally
Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.
Front Vet Sci. 2018 May 28;5:106. doi: 10.3389/fvets.2018.00106. eCollection 2018.
Equine herpesvirus type 1 (EHV-1) is a major cause of infectious respiratory disease, abortion and neurologic disease. Thrombosis in placental and spinal vessels and subsequent ischemic injury in EHV-1-infected horses manifests clinically as abortion and myeloencephalopathy. We have previously shown that addition of heparin anticoagulants to equine platelet-rich plasma (PRP) can abolish EHV-1-induced platelet activation. The goal of this study was to test whether platelets isolated from horses treated with unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) were resistant to EHV-1-induced activation. In a masked, block-randomized placebo-controlled cross-over trial, 9 healthy adult horses received 4 subcutaneous injections at q. 12 h intervals of one of the following treatments: UFH (100 U/kg loading dose, 3 maintenance doses of 80 U/kg), 2 doses of LMWH (enoxaparin) 80 U/kg 24 h apart with saline at the intervening 12 h intervals, or 4 doses of saline. Blood samples were collected before treatment and after 36 h, 40 h (4 h after the last injection) and 60 h (24 h after the last injection). Two strains of EHV-1, Ab4 and RacL11, were added to PRP and platelet membrane expression of P selectin was measured as a marker of platelet activation. Drug concentrations were monitored in a Factor Xa inhibition (anti-Xa) bioassay. We found that LMWH, but not UFH, inhibited platelet activation induced by low concentrations (1 × 10 plaque forming units/mL) of both EHV-1 strains at 40 h. At this time point, all horses had anti-Xa activities above 0.1 U/ml (range 0.15-0.48 U/ml) with LMWH, but not UFH. By 60 h, a platelet inhibitory effect was no longer detected and anti-Xa activity had decreased (range 0.03 to 0.07 U/ml) in LMWH-treated horses. Neither heparin inhibited platelet activation induced by high concentrations (5 × 10 plaque forming units/mL) of the RacL11 strain. We found substantial between horse variability in EHV-1-induced platelet activation at baseline and after treatment. Minor injection site reactions developed in horses given either heparin. These results suggest that LMWH therapy may prevent thrombotic sequelae of EHV-1, however further evaluation of dosage regimens is required.
1型马疱疹病毒(EHV-1)是传染性呼吸道疾病、流产和神经疾病的主要病因。EHV-1感染马的胎盘和脊髓血管血栓形成及随后的缺血性损伤在临床上表现为流产和脑脊髓病。我们之前已经表明,向马富血小板血浆(PRP)中添加肝素抗凝剂可以消除EHV-1诱导的血小板活化。本研究的目的是测试从接受普通肝素(UFH)或低分子肝素(LMWH)治疗的马中分离的血小板是否对EHV-1诱导的活化具有抗性。在一项双盲、区组随机、安慰剂对照的交叉试验中,9匹健康成年马每隔12小时接受以下治疗之一的4次皮下注射:UFH(100 U/kg负荷剂量,3次80 U/kg维持剂量)、间隔12小时用生理盐水、相隔24小时分2次注射80 U/kg的LMWH(依诺肝素),或4次生理盐水。在治疗前以及36小时、40小时(最后一次注射后4小时)和60小时(最后一次注射后24小时)采集血样。将两种EHV-1毒株Ab4和RacL11添加到PRP中,并测量血小板膜上P选择素的表达作为血小板活化的标志物。通过因子Xa抑制(抗Xa)生物测定法监测药物浓度。我们发现,在40小时时,LMWH而非UFH抑制了低浓度(1×10空斑形成单位/毫升)的两种EHV-1毒株诱导的血小板活化。在这个时间点上,所有接受LMWH治疗的马的抗Xa活性均高于0.1 U/ml(范围为0.15 - 0.48 U/ml),而接受UFH治疗的马则没有。到60小时时,不再检测到血小板抑制作用,且接受LMWH治疗的马的抗Xa活性已下降(范围为0.03至0.07 U/ml)。两种肝素均未抑制高浓度(5×10空斑形成单位/毫升)的RacL11毒株诱导的血小板活化。我们发现,在基线和治疗后,马之间在EHV-1诱导的血小板活化方面存在很大差异。接受肝素治疗的马出现了轻微的注射部位反应。这些结果表明,LMWH治疗可能预防EHV-1的血栓形成后遗症,然而需要进一步评估给药方案。
PLoS One. 2015-4-23
Dtsch Tierarztl Wochenschr. 1999-10
Tierarztl Prax Ausg G Grosstiere Nutztiere. 2016-10-12
Vet Rec. 2016-7-30
J Vet Emerg Crit Care (San Antonio). 2016
PLoS One. 2015-4-23
Vet Clin North Am Equine Pract. 2014-8