Jakimczuk Aleksandra, Kalaska Bartlomiej, Kamiński Kamil, Miklosz Joanna, Yusa Shin-Ichi, Pawlak Dariusz, Szczubiałka Krzysztof, Mogielnicki Andrzej
Department of Pharmacodynamics, Medical University of Bialystok, 15-089 Bialystok, Poland.
Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Krakow, Poland.
J Clin Med. 2022 Apr 16;11(8):2236. doi: 10.3390/jcm11082236.
The routine monitoring of direct oral anticoagulants (DOACs) may be considered in patients with renal impairment, patients who are heavily obese, or patients requiring elective surgery. Using the heparin-binding copolymer (HBC) and polybrene, we aimed to develop a solution for monitoring the anticoagulant activity of DOACs in human plasma in the interfering presence of unfractionated heparin (UFH) and enoxaparin. The thrombin time (TT) and anti-factor Xa activity were monitored in pooled plasma from healthy volunteers. In these tests, plasma with dabigatran or rivaroxaban was mixed with UFH or enoxaparin and then incubated with HBC or polybrene, respectively. HBC and polybrene neutralized heparins and enabled monitoring of anticoagulant activity of dabigatran in the TT test. Both agents allowed for accurate measurement of anti-factor Xa activity in the plasma containing rivaroxaban and heparins in the concentration range reached in patients' blood. Here, we present diagnostic tools that may improve the control of anticoagulation by eliminating the contamination of blood samples with heparins and enabling the monitoring of DOACs' activity.
对于肾功能不全患者、重度肥胖患者或需要择期手术的患者，可考虑对直接口服抗凝剂（DOACs）进行常规监测。我们旨在利用肝素结合共聚物（HBC）和鱼精蛋白开发一种解决方案，以在存在未分级肝素（UFH）和依诺肝素的干扰情况下监测人血浆中DOACs的抗凝活性。对健康志愿者的混合血浆监测凝血酶时间（TT）和抗Xa因子活性。在这些测试中，将含有达比加群或利伐沙班的血浆分别与UFH或依诺肝素混合，然后分别与HBC或鱼精蛋白孵育。HBC和鱼精蛋白中和了肝素，并能够在TT试验中监测达比加群的抗凝活性。两种试剂都能在患者血液中达到的浓度范围内准确测量含利伐沙班和肝素的血浆中的抗Xa因子活性。在此，我们展示了一些诊断工具，这些工具可通过消除肝素对血样的污染并能够监测DOACs的活性来改善抗凝控制。
