Raut S, Gaffney P J
Division of Haematology, National Institute for Biological Standards and Control, Hertfordshire, UK.
Thromb Res. 1996 Feb 15;81(4):503-9. doi: 10.1016/0049-3848(96)00024-2.
Heparin is widely used as an antithrombotic drug, having excellent anticoagulant properties. However in certain clinical situations heparin's efficacy seems to be somewhat limited. Despite the administration of heparin there is a high incidence of reocclusion of coronary arteries following thrombolytic therapy, and it has been observed that a significant number of patients receiving heparin treatment still exhibit thrombus extension. Although it is well established that the in vitro and in vivo anticoagulant activities of heparin is mediated via the potentiation of the major coagulation inhibitor, antithrombin III (ATIII), some in vivo antithrombotic mechanisms are not fully understood. There is poor correlation between the anticoagulant activity of heparin as measured by in vitro assays and their in vivo antithrombotic efficacy. This may be due to heparin being targeted to many blood constituents whose resultant activities on the coagulation system have not been measured as yet. The antithrombotic activity of heparin as well as the pathogenesis of bleeding complications during heparin treatment cannot be completely explained by the inhibition of blood coagulation factors. Platelet dysfunction and acceleration of fibrinolytic process have been implicated as additional factors involved. Recently a number of reports have suggested that the inhibition of the antithrombotic activity of heparin in these clinical situations may be due to the interaction of heparin with other plasma proteins specifically with fibrin(ogen) present in the thrombus. Despite the possible pathophysiological significance of heparin-fibrin(ogen) interaction, little is known about the physicochemical aspects of this reaction. In this study an attempt was made to locate where heparin binds to fibrin(ogen), using various isolated structural domains from the plasmin-mediated digests of fibrinogen and the individual chains of fibrinogen. The BIALITE system (Pharmacia Biosensor AB, Uppsala, Sweden) was employed for such a study. This utilises the Surface Plasmon Resonance (SPR) phenomenon and allows a direct quantitative analysis of the label-free molecular interaction, in real-time, from which association and dissociation rate constants can readily be obtained.
肝素作为一种抗血栓药物被广泛使用,具有出色的抗凝特性。然而,在某些临床情况下,肝素的疗效似乎有些有限。尽管使用了肝素,但溶栓治疗后冠状动脉再闭塞的发生率仍然很高,并且已经观察到大量接受肝素治疗的患者仍表现出血栓扩展。虽然肝素在体外和体内的抗凝活性是通过增强主要凝血抑制剂抗凝血酶III(ATIII)来介导的这一点已得到充分证实,但一些体内抗血栓机制尚未完全明了。通过体外测定法测得的肝素抗凝活性与其体内抗血栓疗效之间的相关性较差。这可能是由于肝素作用于许多血液成分,而这些成分对凝血系统产生的活性尚未得到测定。肝素的抗血栓活性以及肝素治疗期间出血并发症的发病机制不能完全通过抑制血液凝固因子来解释。血小板功能障碍和纤溶过程加速被认为是另外涉及的因素。最近有许多报告表明,在这些临床情况下肝素抗血栓活性的抑制可能是由于肝素与其他血浆蛋白,特别是血栓中存在的纤维蛋白(原)相互作用所致。尽管肝素 - 纤维蛋白(原)相互作用可能具有病理生理学意义,但对该反应的物理化学方面了解甚少。在本研究中,尝试使用纤维蛋白原经纤溶酶介导消化得到的各种分离结构域以及纤维蛋白原的各个链来确定肝素与纤维蛋白(原)结合的位置。为此研究采用了BIALITE系统(瑞典乌普萨拉的Pharmacia Biosensor AB公司)。该系统利用表面等离子体共振(SPR)现象,能够实时对无标记分子相互作用进行直接定量分析,从中可以很容易地获得缔合和解离速率常数。