Badimon J J, Weng D, Chesebro J H, Fuster V, Badimon L
Cardiovascular Biology Research, Massachusetts General Hospital, Harvard Medical School Boston 02114.
Thromb Haemost. 1994 Apr;71(4):511-6.
Thrombin plays a key role in platelet activation and thrombosis. Specific inhibition of thrombin appears to be one of the best approaches to prevent thrombus formation. We have studied the effects of a synthetic alpha-aminoboronic acid derivative- [Ac, (D) Phe-Pro-Boro-Arg-Hydrochloric acid] - on platelet deposition on severely damaged arterial wall. Platelet deposition was evaluated under well characterized rheological conditions in an original perfusion chamber and detected by autologous 111In-labeled platelets. The study was performed "in vivo" in a porcine model of arterial thrombosis triggered by severely damaged vessel wall at blood flow conditions mimicking mild stenosis (1690 s-1) and patent (212 s-1) vessels. In addition, ex-vivo platelet aggregation activity was evaluated by whole blood impedance aggregometry using collagen, ADP and thrombin as agonists. The synthetic alpha-aminoboronic peptide was intravenously administered as a bolus followed by continuous infusion. Ex vivo thrombin-induced whole blood platelet aggregation was totally abolished, while ADP- and Collagen-induced whole blood platelet aggregation was not modified. The effects of the synthetic antithrombin on platelet deposition were evaluated in native blood (non-anticoagulated) conditions and in combination with heparin. Under both experimental conditions, the synthetic peptide significantly inhibited platelet deposition at local flow conditions of both high (1690 s-1) and low (212s-1) shear rates. Our results suggest that specific inhibition of locally generated thrombin might be a good strategy to prevent platelet dependent arterial thrombus formation independently of the local flow shear rate of the area at risk.
凝血酶在血小板活化和血栓形成中起关键作用。特异性抑制凝血酶似乎是预防血栓形成的最佳方法之一。我们研究了一种合成的α-氨基硼酸衍生物-[乙酰基,(D)苯丙氨酸-脯氨酸-硼-精氨酸盐酸盐]-对严重受损动脉壁上血小板沉积的影响。在一个原始灌注室中,在特征明确的流变学条件下评估血小板沉积,并通过自体111铟标记的血小板进行检测。该研究在猪动脉血栓形成模型中“体内”进行,该模型由严重受损的血管壁在模拟轻度狭窄(1690秒-1)和通畅(212秒-1)血管的血流条件下引发。此外,使用胶原、ADP和凝血酶作为激动剂,通过全血阻抗聚集法评估体外血小板聚集活性。合成的α-氨基硼酸肽静脉推注给药,随后持续输注。体外凝血酶诱导的全血血小板聚集完全被消除,而ADP和胶原诱导的全血血小板聚集未改变。在天然血液(未抗凝)条件下以及与肝素联合使用时,评估了合成抗凝血酶对血小板沉积的影响。在这两种实验条件下,合成肽在高(1690秒-1)和低(212秒-1)剪切率的局部血流条件下均显著抑制血小板沉积。我们的结果表明,特异性抑制局部产生的凝血酶可能是一种很好的策略,可独立于危险区域的局部血流剪切率来预防血小板依赖性动脉血栓形成。