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Cvirn, G; Gallistl, S; Koestenberger, M; Baier, K; Fritsch, P; Greilberger, J; Jürgens, G; Muntean, W.
The anticoagulant action of recombinant human activated protein C (rhAPC, Drotrecogin alpha activated): comparison between cord and adult plasma.
THROMB HAEMOST. 2004; 91(5): 912-918. Doi: 10.1267/THRO04050912
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Führende Autor*innen der Med Uni Graz
Cvirn Gerhard
Co-Autor*innen der Med Uni Graz
Fritsch Peter
Gallistl Siegfried
Greilberger Joachim
Jürgens Günther
Koestenberger Martin
Muntean Eugen
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Abstract:
The present study was performed to compare the anti-coagulant efficiency of recombinant human activated protein C (rhAPC) in cord with that in adult plasma. RhAPC is a promising candidate to improve the outcome of severe sepsis. However, different anticoagulant efficiency of rhAPC in cord compared with adult plasma has to be expected due to physiological low plasma levels of tissue factor pathway inhibitor (TFPI) and antithrombin (AT) present in neonates, two inhibitors known to markedly influence the anticoagulant action of APC. Clot formation was induced in our experiments by addition of high (30 micro M) or low (20 pM) amounts of lipidated tissue factor (TF). High amounts of TF are conventionally applied in standard clotting assays, whereas plasma activation with low amounts of TF probably better matches the conditions in vivo. We demonstrate that under low coagulant challenge increasing amounts of rhAPC (0.1-0.5 micro g/ml final plasma concentration) dose-dependently prolonged clotting time and suppressed thrombin potential and prothrombin fragment 1+2 generation in both cord and adult plasma. The same was true for experiments performed under high coagulant challenge when 4-16 micro g/ml of rhAPC were added. Whereby, cord plasma was significantly more susceptible to addition of rhAPC in the presence of high amounts of TF and adult plasma was significantly more susceptible to addition of rhAPC in the presence of low amounts of TF. We demonstrate that increased anticoagulant efficiency of rhAPC in adult plasma under low coagulant challenge is attributable to the physiological high levels of TFPI and AT present in adults.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Anticoagulants - pharmacology
Antithrombin III - analysis
Blood Coagulation - drug effects
Blood Coagulation Tests - drug effects
Dose-Response Relationship, Drug - drug effects
Fetal Blood - drug effects
Humans - drug effects
Infant, Newborn - drug effects
Lipoproteins - blood
Protein C - pharmacology
Recombinant Proteins - pharmacology
Thromboplastin - pharmacology

Find related publications in this database (Keywords)
recombinant human activated protein C
tissue factor pathway inhibitor
antithrombin
tissue factor
thrombin potential
cord and adult plasma
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