Semin Thromb Hemost 2014; 40(08): 837-844
DOI: 10.1055/s-0034-1395157
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Mast Cell–Derived Heparin Proteoglycans As a Model for a Local Antithrombotic

Riitta Lassila
1   Aplagon Ltd, Helsinki, Finland
2   Coagulation Disorders Unit, Hematology and Cancer Center, Helsinki University Central Hospital, Helsinki, Finland
3   Medical faculty, University of Helsinki, Helsinki, Finland
,
Annukka Jouppila
4   Coagulation Disorders Unit, Helsinki University Central Hospital Research Institute, Helsinki, Finland
› Author Affiliations
Further Information

Publication History

Publication Date:
13 November 2014 (online)

Abstract

Mast cell–derived heparin proteoglycans (HEP-PG) reside in vascular tissue and serve as a local antithrombotic. Heparin, as used clinically, is isolated from its protein backbone from porcine and bovine gut mucosa. The isolated heparin is an anticoagulant; however, when bound to a protein carrier the heparin conjugates will become antiplatelet agents by inhibiting collagen-induced platelet aggregation and procoagulant activity, as distinct from soluble heparin. HEP-PG, whether soluble or immobilized to a surface, inhibit platelet deposition on the collagen surface in flowing blood. Mimics of HEP-PG, can be tailored to molecules carrying both antiplatelet and anticoagulant (APAC) properties. These molecules can target the vascular injury site and take residence there. Inhibition of thrombus growth using these APACs under these conditions has been demonstrated in several animal models. Although efficacious for antiplatelet and anticoagulant effects, the bleeding time is shorter with APACs than with unfractionated heparin, suggestive of beneficial efficacy/safety ratio. These strategies may be utilized in drug development, where many vascular injury-related problems can be tackled locally.

 
  • References

  • 1 Wardrop D, Keeling D. The story of the discovery of heparin and warfarin. Br J Haematol 2008; 141 (6) 757-763
  • 2 Jorpes E. Heparin in the treatment of thrombosis. An account of its chemistry, physiology and application in medicine. 2nd ed. New York, NY: Oxford University Press; 1946
  • 3 Bäckman R. Erik Jorpes, Kökar-Moskva-Stockholm. 2nd ed. Helsinki, Finland: Söderström; 1985
  • 4 Gallus AS, Hirsch J, Cade JF, Turpie AG, Walker IR, Gent M. Thrombolysis with a combination of small doses of streptokinase and full doses of heparin. Semin Thromb Hemost 1975; 2 (1) 14-32
  • 5 Tchougounova E, Pejler G. Regulation of extravascular coagulation and fibrinolysis by heparin-dependent mast cell chymase. FASEB J 2001; 15 (14) 2763-2765
  • 6 Bode W. The structure of thrombin: a janus-headed proteinase. Semin Thromb Hemost 2006; 32 (Suppl. 01) 16-31
  • 7 Valent P, Baghestanian M, Bankl HC , et al. New aspects in thrombosis research: possible role of mast cells as profibrinolytic and antithrombotic cells. Thromb Haemost 2002; 87 (5) 786-790
  • 8 Lassila R, Lindstedt K, Kovanen PT. Native macromolecular heparin proteoglycans exocytosed from stimulated rat serosal mast cells strongly inhibit platelet-collagen interactions. Arterioscler Thromb Vasc Biol 1997; 17 (12) 3578-3587
  • 9 Kauhanen P, Kovanen PT, Lassila R. Coimmobilized native macromolecular heparin proteoglycans strongly inhibit platelet-collagen interactions in flowing blood. Arterioscler Thromb Vasc Biol 2000; 20 (11) E113-E119
  • 10 Olsson E, Asko-Seljavaara S, Lassila R. Topically administered macromolecular heparin proteoglycans inhibit thrombus growth in microvascular anastomoses. Thromb Haemost 2002; 87 (2) 245-251
  • 11 Kauhanen P, Kovanen PT, Reunala T, Lassila R. Effects of skin mast cells on bleeding time and coagulation activation at the site of platelet plug formation. Thromb Haemost 1998; 79 (4) 843-847
  • 12 Wang Y, Kovanen PT. Heparin proteoglycans released from rat serosal mast cells inhibit proliferation of rat aortic smooth muscle cells in culture. Circ Res 1999; 84 (1) 74-83
  • 13 Gao C, Boylan B, Fang J, Wilcox DA, Newman DK, Newman PJ. Heparin promotes platelet responsiveness by potentiating αIIbβ3-mediated outside-in signaling. Blood 2011; 117 (18) 4946-4952
  • 14 Warkentin TE, Greinacher A, Gruel Y, Aster RH, Chong BH ; scientific and standardization committee of the international society on thrombosis and haemostasis. Laboratory testing for heparin-induced thrombocytopenia: a conceptual framework and implications for diagnosis. J Thromb Haemost 2011; 9 (12) 2498-2500
  • 15 Lassila R, Antovic JP, Armstrong E , et al. Practical viewpoints on the diagnosis and management of heparin-induced thrombocytopenia. Semin Thromb Hemost 2011; 37 (3) 328-336
  • 16 Lippi G, Favaloro EJ. Activated partial thromboplastin time: new tricks for an old dogma. Semin Thromb Hemost 2008; 34 (7) 604-611
  • 17 Al Dieri R, de Laat B, Hemker HC. Thrombin generation: what have we learned?. Blood Rev 2012; 26 (5) 197-203
  • 18 Adams M. Assessment of thrombin generation: useful or hype?. Semin Thromb Hemost 2009; 35 (1) 104-110
  • 19 Dejana E, Callioni A, Quintana A, de Gaetano G. Bleeding time in laboratory animals. II - A comparison of different assay conditions in rats. Thromb Res 1979; 15 (1-2) 191-197
  • 20 Dejana E, Callioni A, Quintana A. de Gaetano G. Bleeding time in laboratory animals. III – Do tail bleeding times in rats only measure a platelet defect? (the aspirin puzzle). Thromb Res 1979; 15: 199-207
  • 21 Folts J. An in vivo model of experimental arterial stenosis, intimal damage, and periodic thrombosis. Circulation 1991; 83 (6, Suppl): IV3-IV14
  • 22 Fontayne A, Meiring M, Lamprecht S , et al. The humanized anti-glycoprotein Ib monoclonal antibody h6B4-Fab is a potent and safe antithrombotic in a high shear arterial thrombosis model in baboons. Thromb Haemost 2008; 100 (4) 670-677
  • 23 Hanson SR, Kotze HF, Savage B, Harker LA. Platelet interactions with Dacron vascular grafts. A model of acute thrombosis in baboons. Arteriosclerosis 1985; 5 (6) 595-603
  • 24 Bonar RA, Favaloro EJ, Marsden K. External quality assurance for heparin monitoring. Semin Thromb Hemost 2012; 38 (6) 632-639
  • 25 Morishima Y, Honda Y, Kamisato C, Shibano T. Comparison of antithrombotic and hemorrhagic effects of edoxaban, a novel factor Xa inhibitor, with unfractionated heparin, dalteparin, lepirudin and warfarin in rats. Thromb Res 2013; 132 (2) 234-239
  • 26 Takahashi S, Hirai N, Shirai M, Ito K, Asai F. Comparison of the blood coagulation profiles of ferrets and rats. J Vet Med Sci 2011; 73 (7) 953-956
  • 27 Lassila R, Badimon JJ, Vallabhajosula S, Badimon L. Dynamic monitoring of platelet deposition on severely damaged vessel wall in flowing blood. Effects of different stenoses on thrombus growth. Arteriosclerosis 1990; 10 (2) 306-315
  • 28 Badimon L, Badimon JJ, Lassila R, Heras M, Chesebro JH, Fuster V. Thrombin regulation of platelet interaction with damaged vessel wall and isolated collagen type I at arterial flow conditions: effects of hirudins, heparin and calcium chelation. Blood 1991; 78: 423-434