Fareed J, Kumar A, Rock A, Walenga J M, Davis P
Semin Thromb Hemost. 1985 Apr;11(2):138-54. doi: 10.1055/s-2007-1004371.
We have extensively studied the hemostatic parameters and the responses to the anticoagulant action of heparin and its fractions in the primate model (M. mulatta) and found these to be identical to those obtained in humans. The functional properties of antithrombin III, alpha 2-antiplasmin, and platelet factor 4 were also identical to humans in amidolytic and coagulant assays. Human antibodies against FPA, B beta 15-42 peptide, platelet factor 4, and thromboxane B2 reacted with the primate antigen, and assays were developed to measure these parameters in primates. Infusion of activated prothrombin complex concentrates (more than 100 U/kg/day) on a continual basis up to 3 days resulted in a hypercoagulable state manifested by an elevation of FPA, thromboxane B2, and changes in the thrombelastographic patterns. Similarly, infusion of homologous primate serum also resulted in a hypercoagulable state, as was evident by a sharp increase in the FPA levels. The antithrombotic effects of intravenous and subcutaneous administration of heparin, its low molecular fraction, and their constituents were studied after intravenous and subcutaneous injections. The low molecular weight fractions showed the most effective antithrombotic effects, whereas somewhat milder protection was observed with the starting material and highly anionic fraction. The prolongation of global tests, such as the APTT, TT, and changes in the thromboelastogram did not correlate with the reduction in the blood markers of hypercoagulable state. A modified simplate bleeding time method was used to study the effect of heparin and its fractions on the bleeding profile of heparin fractions. The components of fibrinolytic systems were also measurable in both the clot-based and amidolytic methods to predict the profibrinolytic actions of heparin fractions in its mode. These studies suggest that plasma markers, such as the platelet release proteins, products of thrombin activation, and prostaglandin metabolites, may provide better indices in the monitoring of the antithrombotic actions of newer heparins and antithrombotic drugs. Studies suggest that the pathophysiologic responses after a thrombogenic trigger in the primate model are close to humans, and drug modulation of these may provide relevant clinical information. This model provides the most similar preclinical model to study the actions of heparin fractions.
我们在灵长类动物模型(猕猴)中广泛研究了止血参数以及对肝素及其组分抗凝作用的反应,发现这些与在人类中获得的结果相同。在酰胺分解和凝血测定中,抗凝血酶III、α2 - 抗纤溶酶和血小板因子4的功能特性也与人类相同。针对FPA、Bβ15 - 42肽、血小板因子4和血栓素B2的人抗体与灵长类动物抗原发生反应,并开发了在灵长类动物中测量这些参数的检测方法。连续3天持续输注活化凝血酶原复合物浓缩物(超过100 U/kg/天)会导致高凝状态,表现为FPA、血栓素B2升高以及血栓弹力图模式改变。同样,输注同源灵长类动物血清也会导致高凝状态,这从FPA水平的急剧升高可以明显看出。在静脉内和皮下注射后,研究了肝素及其低分子组分及其成分的抗血栓形成作用。低分子量组分显示出最有效的抗血栓形成作用,而起始材料和高阴离子组分的保护作用则稍弱。诸如APTT、TT等整体检测的延长以及血栓弹力图的变化与高凝状态血液标志物的降低并不相关。使用改良的简易出血时间方法研究肝素及其组分对肝素组分出血情况的影响。在基于凝块和酰胺分解方法中也可测量纤溶系统的成分,以预测肝素组分在其作用方式中的促纤溶作用。这些研究表明,血浆标志物,如血小板释放蛋白、凝血酶激活产物和前列腺素代谢物,可能为监测新型肝素和抗血栓药物的抗血栓形成作用提供更好的指标。研究表明,灵长类动物模型中血栓形成触发后的病理生理反应与人类接近,对这些反应的药物调节可能提供相关临床信息。该模型为研究肝素组分的作用提供了最相似的临床前模型。