Thromb Haemost 1994; 72(05): 659-662
DOI: 10.1055/s-0038-1648937
Original Article
Schattauer GmbH Stuttgart

Ex Vivo Inhibition of Platelet Aggregation in Patients with Severe Limb Arteriopathy Treated with BAY U3405, a Specific IX A2 Receptor Antagonist

S Bellucci
1   The Laboratory of Hematology, Hôpital Lariboisière, Paris, France
,
W Kedra
2   Department of Physiology and Functional Explorations, Hôpital Lariboisière, Paris, France
,
H Groussin
1   The Laboratory of Hematology, Hôpital Lariboisière, Paris, France
,
N Jaillet
1   The Laboratory of Hematology, Hôpital Lariboisière, Paris, France
,
P Molho-Sabatier
3   Department of Angiohematology, Hôpital Lariboisière, Paris, France
,
B Andreassian
4   Department of Vascular Surgery, Hôpital Beaujon, Clichy, France
,
G Tobelem
3   Department of Angiohematology, Hôpital Lariboisière, Paris, France
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 27. Oktober 1993

Accepted after resubmission 12. Juli 1994

Publikationsdatum:
06. Juli 2018 (online)

Summary

A double-blind, placebo-controlled randomized study with BAY U3405, a specific thromboxane A2 (TX A2) receptor blocker, was performed in patients suffering from severe stade II limb arteriopathy. BAY U3405 or placebo was administered in 16 patients at 20 mg four times a day (from day 1 to day 3). Hemostatic studies were done before therapy, and on day 2 and day 3 under therapy. On day 3, BAY U3405 was shown to induce a highly statistically significant decrease of the velocity and the intensity of the aggregations mediated by arachidonic acid (56 ± 37% for the velocity, 58 ± 26% for the intensity) or by U46619 endoperoxide analogue (36 ± 35% for the velocity, 37 ± 27% for the intensity). Similar results were already observed on day 2. By contrast, such a decrease was not noticed with ADP mediated platelet aggregation. Furthermore, plasma levels of betathrombo-globulin and platelet factor 4 remained unchanged. Peripheral hemodynamic parameters were also studied. The peripheral blood flow was measured using a Doppler ultrasound; the pain free walking distance and the total walking ability distance were determined under standardized conditions on a treadmill. These last two parameters show a trend to improvement which nevertheless was not statistically significant. All together these results encourage further in vivo studies using BAY U3405 or related compounds on a long-term administration.

 
  • References

  • 1 Hamberg M, Svensson J, Samuelsson B. Thromboxanes: a new group of biologically active compounds derived from prostaglandin endoperoxides. Proc Natl Acad Sci USA 1975; 72: 2994-2998
  • 2 Granstrom E, Diczfalusy U, Hamberg M, Hansson G, Malmsten C, Samuelsson B. Thromboxane A2: biosynthesis and effects on platelets. Prostaglandins and the cardiovascular system Samuelsson B, Paoletti R, Ramwell P. eds. In: Advances in Prostaglandin, Thromboxane and Leu-kotriene Research. Raven Press; New York: 1982. 10 15-18
  • 3 Moncada S, Vane JR. Arachidonic acid metabolites and the interactions between platelets and blood-vessel walls. N Engl J Med 1979; 300: 1142-1147
  • 4 Kennedy I, Coleman RA, Humphrey PPA, Levy GP, Lumley P. Studies on the characterization of prostanoid receptors: a proposed classification. Prostaglandins 1982; 24: 667-689
  • 5 Halushka PV, Mais DE, Saussy Jr DL. Platelet and vascular smooth muscle thromboxane A2/Prostaglandin H2 receptors. Fed Proc 1987; 46: 149-153
  • 6 Brass LF, Shaller CC, Belmonte EJ. Inositol triphosphate induced granule secretion from platelets. Evidence that the activation of phospholipase C mediated by platelet thromboxane receptors involves a guanine nucleotide binding protein dependent mechanism distinct from that of thrombin. J Clin Invest 1987; 79: 1269-1275
  • 7 Kroll MH, Schafer AI. Biochemical mechanisms of platelet activation. Blood 1989; 74: 1181-1195
  • 8 Seuter F, Perzbom E, Fiedler VB, Rosentreter U, Boshagen H. Inhibition of platelet aggregation by a novel thromboxane antagonist BAY U3405. XIIth Congress of the International Society on Thrombosis and Haemostasis. Thromb Haemost 1989; 62: 345A
  • 9 Perzbom E, Fiedler VB, Seuter F, Stasch JP, Weber H, Sander E, Boshagen H, Rosentreter U. Characterization of BAY U3405, a novel thromboxane A2/endoperoxide receptor antagonist. Stroke 1990; 21 (Suppl IV) 143-145
  • 10 Fiedler VB, Seuter F, Perzbom E. Effect of the novel thromboxane antagonist BAY U3405 on experimental coronary artery disease. Stroke 1990; 21 (Suppl IV) 149-151
  • 11 Seuter F, Perzbom E, Fiedler VB. Effect of BAY U3405, a new thromboxane antagonist, on collagen-induced thrombo-embolism in rabbits. Stroke 1990; 21 (Suppl IV) 146-148
  • 12 Francis HP, Greenham SJ, Patel UP, Thompson AM, Gardiner PJ. BAY U3405, an antagonist of thromboxane A2 and prostaglandin D2 induced bronchoconstriction in the guinea-pig. Brit J Pharmacol 1991; 104: 596-602
  • 13 Drouet L, Bal C, Pignaud G, Thiam-Cisse M. Comparative antithrombotic effects of aspirin and a thromboxane A2 antagonist in vivo in the guinea-pig. XIIth Congress of the International Society on Thrombosis and Haemostasis. Thromb Haemost 1991; 65: 1357-2408A
  • 14 Fiedler VB, Perzbom E, Seuter F. Protective effect of a novel thromboxane antagonist BAY U3405, on canine myocardial damage after coronary artery occlusion and reperfusion. Pharmacotherapy 1991; 11: 77-84
  • 15 Weber H, Ritter W, Perzbom E, Horstmann R, Kuhlmann J. Tolerability and pharmacodynamic effects of the thromboxane A2 antagonist BAY U3405 in healthy volunteers. J Clin Pharmacol 1990; 30: 849-875 Abstr
  • 16 Kaplan KL, Owen J. Plasma levels of beta thromboglobulin and Platelet Factor 4 as indices of platelet activation in vivo. Blood 1981; 57: 199-202
  • 17 Mielke CH, Kaneshiro MM. The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 34: 204-209
  • 18 Dimitriadou C, Sultan Y, Levy-Toledano S, Bemal-Hoyos E, Caen JP. Etude du temps de saignement quantitatif et des fonctions plaquettaires au cours des purpuras thrombopeniques. Nouv Press Med 1974; 3 (22) 1425-1428
  • 19 Ross R, Glomset JA. The pathogenesis of atherosclerosis. N Engl J Med 1976; 295: 420-425
  • 20 Fitzgerald GA, Pedersen AK, Patrono C. Analysis of prostacyclin and thromboxane A2 biosynthesis in cardiovascular disease. Circulation 1983; 67: 1174-1177
  • 21 Fitzgerald GA, Smith B, Pedersen AK, Brash AR. Increased prostacyclin biosynthesis in patients with severe atherosclerosis and platelet activation. N Engl J Med 1984; 310: 1065-1068
  • 22 Fitzgerald DJ, Roy L, Catella F, Fitzgerald GA. Platelet activation in unstable coronary disease. N Engl J Med 1986; 315: 983-989
  • 23 Kroll MH, Zavoico GB, Schafer AI. Second messenger function of phosphatidic acid in platelet activation. J Cell Physiol 1989; 139: 558-564
  • 24 Kinlough-Rathbone RL, Packham MA, Mustard JF. Synergism between platelet aggregating agents: the role of the arachidonate pathway. Thromb Res 1977; 11: 567-580
  • 25 Ludlam CA, Cash JD. Studies on the liberation of beta-thromboglobulin from human platelets in vitro. Brit J Hematol 1976; 247: 239-247
  • 26 Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nature (New Biol) 1971; 231: 232-235
  • 27 Preston FE, Whipps S, Jackson CA, French AJ, Wyld PJ, Stoddard CJ. Inhibition of prostacyclin and thromboxane A2 after low-dose aspirin. N Engl J Med 1981; 304: 76-79
  • 28 Fitzgerald GA, Oates JA, Hawiger J, Maas RL, Roberts LJ, Lawson JA, Brash AR. Endogenous biosynthesis of prostacyclin and thromboxane and platelet function during chronic administration of aspirin in man. J Clin Invest 1983; 71: 676-688
  • 29 Gresele P, Amout J, Deckmyn H, Huybrechts E, Pieters G, Vermylen J. Role of proaggregatory and antiaggregatory prostaglandins in hemostasis Studies with combined thromboxane synthetase inhibition and thromboxane receptor antagonism. J Clin Invest 1987; 80: 1435-1415
  • 30 Defreyn G, Deckmyn H, Vermylen J. A thromboxane synthetase inhibitor reorients endoperoxide metabolism in whole blood towards prostacyclin and prostaglandin E2. Thromb Res 1982; 26: 389-400
  • 31 Defreyn G, Machin SJ, Carreras LO, Dauden MV, Chamone DAF, Vermylen J. Familial bleeding tendency with partial platelet thromboxane synthetase deficiency: reorientation of cyclic endoperoxide metabolism. BrJ Haematol 1981; 49: 29-41
  • 32 Foster MR, Hornby EJ, Stratton LE. Effect of GR 32191 and other thromboxane receptor blocking drugs on human platelet deposition onto de-endothelialized arteries. Thromb Res 1992; 65: 769-784
  • 33 Hornby EJ, Foster MR, McCabe PJ, Stratton LE. The inhibitory effect of GR 32191, a thromboxane receptor blocking drug, on human platelet aggregation adhesion and secretion. Thromb Haemost 1989; 61: 429-436