Amirkhosravi M, Francis J L
University Department of Haematology, General Hospital, Southampton.
Br J Haematol. 1993 Dec;85(4):736-44. doi: 10.1111/j.1365-2141.1993.tb03217.x.
Experimental evidence suggests that many tumours can activate blood coagulation and that such interaction is part of the pathology of metastatic tumour growth. This study aimed to study the procoagulant activity of the methylcholanthrene-induced (MC28) fibrosarcoma to determine whether coagulation activation by these cells could explain the previously reported effects of oral anticoagulants on lung seeding in this model. MC28 cells shortened the recalcification times of normal and factor VII-deficient plasma and directly activated factor X in a chromogenic assay, but did not aggregate platelets in vitro in either whole blood or platelet-rich plasma. Cellular coagulant activity was calcium-dependent, blocked by DFP and concanavalin A but not inhibited by iodoacetamide, E-64 or antibodies to human tissue factor or factor VII. Injection of viable MC28 cells into hooded Lister rats induced a decrease in platelet count (P < 0.001), plasma factor X (P < 0.001) and fibrinogen (P < 0.05) and a marked increase in plasma haemoglobin (P < 0.001). These effects were either not observed or were considerably less marked in heparinized or warfarinized animals. Injection of MC28 cells treated with concanavalin A in vitro completely abolished the clotting changes observed with untreated cells. In conclusion, MC28 cells possessed a potent factor X-activating serine proteinase procoagulant in vitro, which had some of the characteristics of a tissue factor/factor VIIa complex. In vivo, MC28 cells caused clotting activation and intravascular fibrin generation. Since thrombocytopenia was abolished by heparin and the cells lacked platelet aggregating activity in vitro, thrombocytopenia was probably secondary to intravascular coagulation and thrombin generation. The trigger for intravascular clotting activation appeared to be the cellular procoagulant activity since it was abolished by prior in vitro blockade of the latter with concanavalin A.
实验证据表明,许多肿瘤能够激活血液凝固,且这种相互作用是转移性肿瘤生长病理过程的一部分。本研究旨在研究甲基胆蒽诱导的(MC28)纤维肉瘤的促凝活性,以确定这些细胞的凝血激活是否可以解释先前报道的口服抗凝剂对该模型中肺转移的影响。MC28细胞缩短了正常血浆和缺乏因子VII的血浆的再钙化时间,并在发色底物法中直接激活因子X,但在体外全血或富含血小板的血浆中均未使血小板聚集。细胞促凝活性依赖于钙,被二异丙基氟磷酸(DFP)和伴刀豆球蛋白A阻断,但不受碘乙酰胺、E-64或针对人组织因子或因子VII的抗体抑制。将活的MC28细胞注射到带帽利斯特大鼠体内会导致血小板计数降低(P<0.001)、血浆因子X降低(P<0.001)和纤维蛋白原降低(P<0.05),以及血浆血红蛋白显著升高(P<0.001)。在肝素化或华法林化的动物中,这些效应要么未观察到,要么明显不那么显著。注射经体外伴刀豆球蛋白A处理的MC28细胞完全消除了未处理细胞所观察到的凝血变化。总之,MC28细胞在体外具有一种强大的激活因子X的丝氨酸蛋白酶促凝剂,其具有组织因子/因子VIIa复合物的一些特征。在体内,MC28细胞引起凝血激活和血管内纤维蛋白生成。由于肝素消除了血小板减少症,且细胞在体外缺乏血小板聚集活性,血小板减少症可能继发于血管内凝血和凝血酶生成。血管内凝血激活的触发因素似乎是细胞促凝活性,因为用伴刀豆球蛋白A预先体外阻断后者可消除该活性。