Thromb Haemost 1996; 76(04): 615-620
DOI: 10.1055/s-0038-1650631
Original Article
Schattauer GmbH Stuttgart

Recombinant Full-length Tissue Factor Pathway Inhibitor (TFPI) Prevents Thrombus Formation and Rethrombosis after Lysis in a Rabbit Model of Jugular Vein Thrombosis

Brigitte Kaiser
The Friedrich Schiller University Jena, Medical Faculty, Center for Vascular Biology and Medicine Erfurt, Erfurt, Germany
,
Jawed Fareed
1   Loyola University Medical Center, Department of Pathology, Maywood, IL, USA
› Author Affiliations
Further Information

Publication History

Received 18 March 1996

Accepted after resubmission 12 June 1996

Publication Date:
10 July 2018 (online)

Summary

In the jugular vein of rabbits thrombus formation was induced by vessel wall damage using a balloon catheter and following reduction of blood flow by 80-90% for 60 min (partial stasis). The blood flow in the vein was measured continuously and the incidence of primary thrombus formation, the time until lysis with recombinant tissue-type plasminogen activator (rt-PA) as well as the incidence of rethrombosis after lysis were determined. At the end of the experiment the wet weight of the thrombus formed inside the vessel was measured. For the determination of haemostaseological parameters blood was drawn from the cannulated femoral artery.

Recombinant full-length tissue factor pathway inhibitor (TFPI) was studied with regard to its effect both on primary thrombus formation and on rethrombosis after lysis. In control animals damage of the vessel wall combined with partial stasis led to the formation of occlusive venous thrombi. In vitro bolus injection of TFPI (5,10,20 Μg/kg) at the time of thrombus induction prevented the formation of venous thrombi during the 1 h period of partial stasis. In the subsequent observation period a dose-dependent inhibition of later occurring partial or complete thrombotic occlusion was found. At the dose of 20 Μg/kg i.v. in all animals TFPI prevented a complete thrombotic occlusion of the vein up to 3 h after stasis. To study the effectiveness of TFPI on rethrombosis after lysis TFPI was injected i.v. after lysis of the thrombus with rt-PA (600 Μg/kg i.v. bolus + 600 Μg/kg i.v. infusion over 60 min). In saline treated control rabbits a reocclusion of the vessel was seen in 8 of 10 animals. TFPI (10, 20, 40 Μg/kg i.v.) injected at the end of rt-PA administration caused a dose-dependent inhibition of thrombotic reocclusion after lysis. At 40 Μg/kg i.v. the formation of occlusive thrombi was prevented up to 3 h after lysis. TFPI at the doses used caused modest anticoagulant effects in global clotting assays; activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) were only slightly prolonged. A clear and dose-dependent prolongation of clotting times was only seen in the Heptest® assay.

The results show that the physiologic coagulation inhibitor TFPI acts as a strong antithrombotic agent in an experimental model of venous thrombus formation and thrombotic reocclusion after lysis in rabbits.

 
  • References

  • 1 Davie EW, Fujikawa K, Kisiel W. The coagulation cascade: initiation, maintenance and regulation. Biochemistry 1991; 30: 10363-10370
  • 2 Petersen LC, Valentin S, Hedner U. Regulation of the extrinsic pathway system in health and disease: the role of factor Vila and tissue factor pathway inhibitor. Thromb Res 1995; 79: 1-47
  • 3 Rapaport SI, Rao LVM. The tissue factor pathway: how it has become a prima ballerina. Thromb Haemost 1995; 74: 7-17
  • 4 Nemerson Y. The tissue factor pathway of blood coagulation. Semin Hematol 1992; 29: 170-176
  • 5 Carson SD, Brozna JP. The role of tissue factor in the production of thrombin. Blood Coag Fibrinol 1993; 4: 281-292
  • 6 Girard TJ, Warren LA, Novotny WF, Likert KM, Brown SG, Miletich JP, Broze Jr GJ. Functional significance of the Kunitz-type inhibitory domains of lipoprotein-associated coagulation inhibitor. Nature 1989; 338: 518-520
  • 7 Pedersen AH, Nordfang O, Norris F, Wiberg FC, Christensen M, Bach Moellers K, Meidahl-Pedersen J, Beck TC, Norris K, Hedner U, Kisiel W. Recombinant human extrinsic pathway inhibitor: production, isolation, and characterization of its inhibitory activity on tissue factor-initiated coagulation reactions. J Biol Chem 1990; 265: 16786-16793
  • 8 Broze Jr GJ, Girard TJ, Novotny WF. Regulation of coagulation by a multivalent Kunitz-type inhibitor. Biochemistry 1990; 29: 7539-7546
  • 9 Broze >Jr GJ. Tissue factor pathway inhibitor. Thromb Haemost 1995; 74: 90-93
  • 10 Broze Jr GJ. Tissue factor pathway inhibitor and the current concept of blood coagulation. Blood Coag Fibrinol 1995; (Suppl. 01) 6: S1-13
  • 11 Sandset PM, Abildgaard U. Extrinsic pathway inhibitor - the key to feedback control of blood coagulation initiated by tissue thromboplastin. Haemostasis 1991; 21: 219-239
  • 12 Rapaport SI. The extrinsic pathway inhibitor: a regulator of tissue-factor dependent blood coagulation. Thromb Haemost 1991; 66: 6-15
  • 13 Lindahl AK. Tissue factor pathway inhibitor in health and disease. Trends Cardiovasc Med 1995; 5: 167-171
  • 14 Lindahl AK, Sandset PM, Abildgaard U. The present status of tissue factor pathway inhibitor. Blood Coag Fibrinol 1992; 3: 439-449
  • 15 Wada H, Wakita Y, Shiku H. Tissue factor expression in endothelial cells in health and disease. Blood Coag Fibrinol 1995; (Suppl. 01) 6: S26-31
  • 16 Abildgaard U. Relative roles of tissue factor pathway inhibitor and antithrombin in the control of thrombogenesis. Blood Coag Fibrinol 1995; (Suppl. 01) 6: S45-49
  • 17 Hoppensteadt DA, Jeske W, Fareed J, Bermes Jr EW. The role of tissue factor pathway inhibitor in the mediation of the antithrombotic actions of heparin and low-molecular-weight heparin. Blood Coag Fibrinol 1995; (Suppl. 01) 6: S57-64
  • 18 Abildgaard U. Heparin/low molecular weight heparin and tissue factor pathway inhibitor. Haemostasis 1993; (Suppl. 01) 23: 103-106
  • 19 Hufnagel CA. Deep vein thrombosis: an overview. Angiology 1990; 41: 337-351
  • 20 Diquelou A, Dupouy D, Gaspin D, Constans J, Sie P, Boneu B, Sakariassen KS, Cadroy Y. Relationship between endothelial tissue factor and thrombogenesis under blood flow conditions. Thromb Haemost 1995; 74: 778-783
  • 21 Kaiser B, Hoppensteadt DA, Jeske W, Wun TC, Fareed J. Inhibitory effects of TFPI on thrombin and factor Xa generation in vitro - modulatory action of glycosaminoglycans. Thromb Res 1994; 75: 609-616
  • 22 Kaiser B, Jeske W, Hoppensteadt D, Fareed J. Inhibitory effects of TFPI variants on thrombin and factor Xa generation in fibrinogen-deficient human plasma. Thromb Res 1994; 76: 561-568
  • 23 Holst J, Lindblad B, Bergqvist D, Nordfang O, Ostergaard PB, Petersen JGL, Nielsen G, Hedner U. Antithrombotic effect of recombinant truncated tissue factor pathway inhibitor (TFPIM61) in experimental venous thrombosis - a comparison with low molecular weight heparin. Thromb Haemost 1994; 71: 214-219
  • 24 Day KC, Hoffmann LC, Palmier MO, Kretzmer KK, Huang MD, Pyla EY, Spokas E, Broze Jr GJ, Warren TG, Wun TC. Recombinant lipoprotein-associated coagulation inhibitor inhibits tissue thromboplastin-induced intravascular coagulation in the rabbit. Blood 1990; 76: 1538-1545
  • 25 Bregengard C, Nordfang O, Wildgoose P, Svendsen O, Hedner U, Diness V. The effect of two-domain tissue factor pathway inhibitor on endotoxin-induced disseminated intravascular coagulation in rabbits. Blood Coag Fibrinol 1993; 4: 699-706
  • 26 Carr C, Bild GS, Chang ACK, Peer GT, Palmier MO, Frazier RB, Gustafson ME, Wun TC, Creasey AA, Hinshaw LB, Taylor Jr FB, Galluppi GR. Recombinant E. coli-derived tissue factor pathway inhibitor reduces coagulopathic and lethal effects in the baboon gram-negative model of septic shock. Circulatory Shock 1995; 44: 126-137
  • 27 Abendschein DR, Meng YY, Torr-Brown S, Sobel BE. Maintenance of coronary patency after fibrinolysis with tissue factor pathway inhibitor. Circulation 1995; 92: 944-949
  • 28 Haskel EJ, Torr SR, Day KC, Palmier MO, Wun TC, Sobel BE, Abendschein DR. Prevention of arterial reocclusion after thrombolysis with recombinant lipoprotein-associated coagulation inhibitor. Circulation 1991; 84: 821-827
  • 29 Lindahl AK, Sandset PM, Thune-Wiiger M, Nordfang O, Sakariassen KS. Tissue factor pathway inhibitor prevents thrombus formation on procoagulant subendothelial matrix. Blood Coag Fibrinol 1994; 5: 755-760
  • 30 Eisenberg PR, Siegel JE, Abendschein DR, Miletich JP. Importance of factor Xa in determining the procoagulant activity of whole-blood clots. J Clin Invest 1993; 91: 1877-1883
  • 31 Prager NA, Abendschein DR, McKenzie CR, Eisenberg PR. Role of thrombin compared with factor Xa in the procoagulant activity of whole blood clots. Circulation 1995; 92: 962-967