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DOI: 10.1055/s-0038-1651070
Effects of an Enzymatically Depolymerized Heparin as Compared with Conventional Heparin in Healthy Volunteers
Publication History
Received 11 September 1986
Accepted after revision 27 November 1986
Publication Date:
06 July 2018 (online)
Summary
A low molecular weight heparin (LMW-heparin) with a mean molecular weight of 4900 dalton was prepared by controlled enzymatic depolymerization of conventional porcine mucosal heparin. The effects of 2,500, 5,000 and 10,000 U (Xal; 29,58 and 116 mg) on factor Xa inhibition (Xal), factor Ila inhibition (Hal), APTT, AT III and platelet count were compared to those of 5,000 U (Xal; 26 mg) of conventional heparin given s. c. to 6 healthy volunteers. 5,000 U (Xal; 58 mg) of LMW-heparin was given i. v. A dose related response with regard to the Xal and the Ila-inhibitory activities with peak values at 4 hours after the s. c. injections was obtained. An increase of the Xal/IIal ratio over the time after injection was seen only after i. v. administration of the LMW-heparin. The APTT was only slightly prolonged and remained within normal range after s. c. injection. AT III and platelet counts were unaffected. The biological half life of the LMW-heparin was 111 minutes if assayed by Xa inhibition, 76 minutes if assayed by Ila inhibition and 40 minutes if assayed by APTT. A strong correlation between the Xal activities obtained and body weight was seen, indicating that LMW-heparin should be administered individually according to body weight.
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References
- 1 Johnson EA, Mulloy B. The molecular weight range of mucosal heparin preparations. Carbohydrate Res 1966; 51: 119-127
- 2 Laurent TC. Studies on fractionated heparin. Arch Biochem Biophys 1961; 92: 224-231
- 3 Lasker SE, Stivala SS. Physicochemical studies of fractionated bovine heparin I. Arch Biochem Biophys 1966; 115: 360-372
- 4 Cifonelli JA. The relationship of molecular weight, and sulphate content and distribution to anticoagulant activity of heparin preparations. Carbohydrate Res 1974; 37: 145-154
- 5 Andersson L-O, Barrowcliffe TW, Holmer E, Johnson EA, Sims G EC. Anticoagulant properties of heparin fractionated by affinity chromatography on matrix-bound antithrombin-III and by gel filtration. Thromb Res 1976; 9: 575-583
- 6 Andersson L-O, Barrowcliffe TW, Holmer E, Johnson EA, Soderstrom G. Molecular weight dependency of the heparin potentiated inhibition of thrombin and activated factor X effect of heparin neutralization in plasma. Thromb Res 1979; 15: 531-541
- 7 Holmer E, Kurachi K, Soderstrom G. The molecular weight dependence of the rate enhancing effect of heparin on the inhibition of thrombin, FXa, FIXa, FXIa, FXIIa and kallikrein by antithrombin. Biochem J 1981; 193: 395-400
- 8 Ockelford PA, Carter CJ, Hirsh J. The lack of relationship between anti-Xa activity and antithrombotic activity of low molecular weight heparin. Thromb Haemostas 1981; 46: 116 (Abstr)
- 9 Thomas DP, Merton RE, Barrowcliffe TW, Thunberg L, Lindahl U. Effects of heparin oligosaccharides with high. affinity for antithrombin III in experimental thrombosis. Thromb Haemostas 1982; 47: 244-248
- 10 Buchanan MR, Boneu B, Ofosu F, Hirsh J. The relative importance of thrombin inhibition and factor Xa inhibition to the antithrombotic effects of heparin. Blood 1985; 65: 198-201
- 11 Ofosu FA, Blajchman MA, Modi GJ, Smith LM, Buchanan MR, Hirsh J. The importance of thrombin inhibition for the expression of the anticoagulant activities of heparin, dermatan sulphate, low molecular weight heparin and pentosan polysulphate. Br J Haemat 1985; 60: 695-704
- 12 Bergqvist D, Burmark US, Frisell J, Hallbook T, Lindblad B, Risberg B, Torngren S, Wallin G. Low molecular weight heparin once daily compared with conventional low dose heparin twice daily. A prospective double-blind multicenter trial on prevention of postoperative thrombosis. Br J Surg 1986; 73: 204-208
- 13 Kakkar VV, Murray W JG. Efficacy and safety of low molecular weight heparin (CY 216) in preventing postoperative venous thromboembolism: a co-operative study. Br J Surg 1985; 72: 786-791
- 14 Kakkar VV, Djazaeri B, Fok J, Fletcher M, Scully MF, Westwick J. Low molecular weight heparin and prevention of postoperative deep vein thrombosis. Br Med J 1982; 284: 375-379
- 15 Schmitz-Huebner U, Biinte H, Freise G, Reers B, Riischemeyer C, Scherer R, Schulte H, van der Loo J. Clinical efficacy of low molecular weight heparin in postoperative thrombosis prophylaxis. Klin Wochenschr 1984; 62: 349-353
- 16 Massonet-Castel S, Pelissier E, Dreyfus G, Deloche G, Abry B, Guiburt P, Terrier E, Passelecq JM, Jaulmes B, Carpentier A. Low molecular weight heparin in extra corporeal circulation. Lancet 1984; 1: 1182
- 17 Barrowcliffe TW, Curtis AD, Tomlinson TP, Hubbard AR, Johnson EA, Thomas DP. Standardization of low molecular weight heparins: A collaborative study. Thromb Haemostas 1985; 54: 675-679
- 18 Beermann B, Lahnborg G. Pharmacokinetics of heparin in healthy and obese subjects and in combination with dihydroergotamine. Thromb Haemostas 1981; 45: 24-26
- 19 Cipolle RJ, Seifert RD, Neilan BA, Zaske DE, Haus E. Heparin kinetics: Variable related to disposition and dosage. Clin Pharmacol Ther 1981; 29: 387-393
- 20 Brozovic M, Sterling Y, Abbosh J. Plasma heparin levels after low dose subcutaneous heparin in patients undergoing hip replacement. Br J Haematol 1975; 31: 461-466
- 21 Cochetto DM, Bjornsson TD. Progress toward and understanding of the anticoagulant effect and pharmacokinetics of heparin. Pharm International 1984; jan: 7-11
- 22 Thomas DP, Barrowcliffe TW, Merton RE, Stocks J, Dawes J, Pepper DS. In vivo release of anti-Xa clotting activity by a heparin analogue. Thromb Res 1980; 17: 831-840
- 23 Nilsson B, Bergqvist D, Hedner U, Pedersen PC, Ostergaard PB. Effects of low molecular weight heparins (LMWH) prepared by three different methods on experimental thrombosis and haemostasis in rabbits. Thromb Haemostas 1985; 54: 31 (Abstr)
- 24 Nilsson IM. Haemorrhagic and thrombotic diseases. Wiley & Sons Ltd; London: 1974
- 25 Teien AN, Lie M, Abildgaard U. Assay of heparins in plasma using a chromogenic substrate for activated factor X. Thromb Res 1976; 8: 549-553
- 26 Odegaard OR, Lie M, Abildgaard U. Heparin co-factor activity measured with an amidolytic method. Thromb Res 1975; 6: 287-294
- 27 Jacques LB. Heparins-anionic polyelectrolyte drugs. Pharmacological Reviews 1979; 31: 99-166
- 28 Levy SW, Jacques LB. Appearance of heparin antithrombin active chains in vivo after injection of commercial heparin and in anaphylaxis. Thromb Res 1978; 13: 429-441
- 29 Bergqvist D, Hedner U, Sjorin E, Holmer E. Anticoagulant effects of two types of low molecular weight heparin administered subcutaneously. Thromb Res 1983; 32: 381-391
- 30 Fareed J, Kumar A, Walenga JM, Emanuele RM, Williamson K, Hoppensteadt D. Antithrombotic actions and pharmacokinetics of heparin fractions and fragments. Nouv Rev Fr Hematol 1984; 26: 267-275
- 31 Bara L, Billaud E, Gramond G, Kher A, Samama M. Comparative pharmacokinetics of a low molecular weight heparin (PK 10169) and unfractionated heparin after intravenous and subcutaneous administration. Thromb Res 1985; 39: 631-636
- 32 Ly B, Arnesen KE, Holm HA, Handeland GE, Abildgaard U. Subcutaneous LMW or unfractionated heparin in deep vein thrombosis: A randomized double-blind study with dose adjustments according to heparin concentrations in plasma. Thromb Haemostas 1985; 54: 91 (Abstr)