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J M Walenga

Publications and source records attributed to J M Walenga.

At least 163 records · Page 9Linked to original sources
PubMed1987

Antithrombotic activity of a synthetic heparin pentasaccharide in a rabbit stasis thrombosis model using different thrombogenic challenges.

A synthetic pentasaccharide, representing the critical sequence required in heparin for binding to antithrombin III (AT III), produces strong anti-factor Xa activity in vitro in the presence of AT III and is devoid of any activity directed towards thrombin. This pentasaccharide provides a unique tool to study the question of whether an agent capable of inhibiting factor Xa but devoid of anti-factor IIa activity in vitro, has the capacity to produce an antithrombotic effect in vivo. We have previously demonstrated in a rabbit stasis thrombosis model using a human serum challenge, a significant antithrombotic effect of the pentasaccharide. This finding and discrepancies with some earlier reports on the antithrombotic actions of other oligosaccharide fragments, led us to extend these studies. Four modifications of the stasis thrombosis model were developed using the following thrombogenic challenges selected for their specified induction sites of thrombosis, thromboplastin, an activated prothrombin complex concentrate, a non-activated prothrombin complex concentrate administered simultaneously with Russell's viper venom, and factor Xa. Dose-dependent antithrombotic responses were obtained in all four systems with ED50 values between 25-43 ug/kg for pentasaccharide as compared to 16-47 ug/kg for heparin. Complete inhibition of induced thrombosis was obtained in all four systems for pentasaccharide. Ex vivo analysis revealed expected anti-factor Xa levels but no anti-factor IIa activity. It is concluded that an oligosaccharide with high anti-factor Xa activity and devoid of anti-factor IIa activity is capable of inhibiting thrombosis induced in rabbit stasis models, but that higher dosages than heparin are required for this effect.

Animals↗
PubMed1986

Molecular markers of hemostatic activation in atherosclerosis: a new concept in diagnostic profiling of endogenous pathophysiologic transition.

Molecular markers of hemostatic activation provide a reliable measure of the endogenous pathophysiologic state in atherosclerosis. Measurement of these markers before and after exercise provides a diagnostic probe for cellular-vascular interactions in patients with atherosclerosis. Molecular markers may possibly identify very early stages of atherosclerosis due to their inherent sensitivity. A high-risk cardiovascular population can be easily recognized by profiling molecular markers of hemostatic activation. Newly developed immunoassays can be used to quantitate these markers in routine laboratories. Additional clinical studies are needed to establish the diagnostic role of these molecular markers in patients with atherosclerosis and related disorders.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Coagulant versus amidolytic properties of human and bovine thrombins: implications in standardization and diagnostic usage.

Since the introduction of synthetic peptide substrates for thrombin, many amidolytic methods for the determination of AT III, heparin cofactor II, prothrombin, thrombin, platelet factor 4, and absolute levels of heparin have been proposed. All of these methods utilize thrombin that has been standardized in coagulant assays using either fibrinogen (human or bovine) or citrated plasma substrates. These thrombin preparations may contain noncoagulant forms of thrombin, prothrombin fragments, and other serine protease enzymes. Impurities other than variant forms of thrombin in commercial preparations may interact with antithrombin and other reagents altering the results of an assay. Similarly, the noncoagulant forms of thrombin contribute to amidolytic but not coagulant activity. If these parameters are not properly controlled, the assays based on amidolysis are seriously affected. Our studies on the amidolytic and coagulant properties of commercial thrombins suggest that, although these preparations are assigned their potency in NIH units, they vary greatly and do not truly exhibit the same potency as designated in the coagulant assays. In addition, these thrombin preparations show wide variations in their amidolytic actions toward synthetic chromogenic and fluorogenic peptide substrates. We propose that thrombin preparations for chromogenic and fluorogenic peptide assays should be standardized in terms of their amidolytic activity under defined conditions. In addition, further studies should be conducted to prove their efficacy in providing reliable diagnostic information in clinical laboratory assays.

Amidohydrolases↗
PubMed1986

Laboratory studies on the intravenous and subcutaneous administration of PK 10169 in man.

Intravenous and subcutaneous administration of PK 10169 in healthy human volunteers were studied utilizing numerous old and new laboratory methods for the monitoring of the effects of this agent. In the intravenous studies, individual groups of 10 healthy volunteers were administered with 2,500-12,500 anti-Xa units (25-125 mg) PK 10169 as a single bolus, and blood samples were drawn at 30 min, 1, 4 and 24 h after the administration of the drug. In the subcutaneous studies, 4,000 anti-Xa units (40 mg) b.i.d. of PK 10169 were administered to a group of 10 healthy individuals for 7 consecutive days, and blood samples were drawn 6 h after each dose. Citrated blood samples collected from both studies were centrifuged, plasma was frozen at -70 degrees C in aliquots, and various laboratory parameters were determined in batches. In the intravenous studies, the global clotting assays (activated partial thromboplastin time and thrombin time) were only prolonged at initial stages of treatment, whereas a marked increase in the antiprotease and antifibrinopeptide A generation activity titer was observed for periods of up to 24 h. In the subcutaneous studies, no significant prolongation of the global clotting assays was noted; however, the anti-Xa levels were significantly increased throughout the study period (7 days). Only a trace of anti-IIa activity was observed. In contrast, a strong antifibrinopeptide A generation activity was observed in all samples which persisted after the discontinuation of PK 10169. These studies suggest that PK 10169 may exert its clinical effects by multiple mechanisms which are only partially assessable by routine laboratory methods.

Blood Coagulation↗
PubMed1986

In vitro evaluation of heparin fractions: old vs. new methods.

Conventionally, heparin has been evaluated for its anticoagulant effect by various nonspecific, poorly standardized coagulant methods such as the U.S. Pharmacopeial and other global (APTT) tests. However, these assays are relatively insensitive to heparin fractions and fragments, and give varying with the newer modes of heparin administration. It has become necessary, therefore, to develop other methods able to detect a proper therapeutic/prophylactic level and to evaluate a standard potency for these agents. Newer amidolytic assays utilizing synthetic substrates provide for specific anti-factor Xa or anti-factor IIa evaluation. Although these factors are believed to reflect the antithrombotic effect of heparin and its fractions/fragments, conclusive clinical studies are not available at this time. Interactions with non-AT-III-mediated pathways, the contact, kallikrein-kinin, and fibrinolytic system, other coagulant factors, endothelium, and eicosanoid system all can contribute to the overall antithrombotic response of heparin. Some of these actions are not measurable by current in vitro test methods. Amidolytic, immunochemical, and physical assays using various activators to generate endogenous factor Xa, as well as assays for the detection of metabolic or release products of each of these systems, may be more relevant to in vivo conditions. Specific low molecular weight markers such as fibrinopeptide A, which provide the earliest detection of hemostatic activation, can be measured directly, or an in vitro system can be developed to quantitate the relative generation of these markers. These methods can then be modified to assay the in vitro potency of heparin preparations. With proper consideration of reagent specificity and concentration, molecular interactions, reaction time and temperature, ionic type and concentration, reliable accurate methods for a true in vitro representation of in vivo events may be developed. Clinical assays must measure an endogenous response to therapy and not merely an absolute circulating level of drug. However, a standardized pure enzyme system may be ideal to evaluate the potency of these agents. The development of heparin derivatives necessitates a reassessment of currently practiced laboratory technology. Furthermore, well-defined biochemical methods are required for a standardized evaluation of potency and clinical monitoring of these agents.

Blood Coagulation↗
PubMed1985

In vitro coagulant and amidolytic methods for evaluating the activity of heparin and a low molecular weight derivative (PK 10169).

In summary, the following points have been presented. PK 10169 produced somewhat weaker effects on the coagulant tests in comparison to heparin in various whole blood and citrated plasma assays. In the synthetic substrate assays, PK 10169 produced a pronounced inhibition of various serine proteases in the AT III supplemented system. No significant inhibition was noted in the non-AT III systems. Preliminary data show that PK 10169-AT III complex is capable of producing direct inhibition of the generation of factors Xa and XIIa. In all platelet function tests studied, this agent failed to produce any modulating effects. PK 10169 did not produce an effect on the fibrinolytic system in vitro. However, analysis of blood samples obtained from animals treated in vivo with this agent suggests activation of fibrinolysis. Thus, the mechanism of action must involve certain cellular components or endogenous modulation of the heparin fraction. The newly developed FPA generation test can be modified by various activators or blood systems to mimic closely in vivo physiology. PK 10169 produces a dose response that is more sensitive and more global by this method than the amidolytic anti-Xa or anti-IIa. In contrast to heparin, larger amounts of platelet factor 4 and protamine sulfate are needed to neutralize the anti-Xa and anti-IIa actions of this agent. Additionally, the anti-IIa component is more susceptible to neutralization than the anti-Xa component. Our studies also suggest that PK 10169 is resistant to the action of certain heparin digestive systems, such as heparinase.

Antithrombin III↗
PubMed1985

Studies on the antithrombotic effects and pharmacokinetics of heparin fractions and fragments.

The pharmacokinetics of heparin differ markedly from those of its fractions both in man and in experimental animal models. The route of administration determines the relative availability of different molecular species that exert the anti-Xa, anti-IIa, fibrinopeptide A generation inhibiting actions and the release of tissue plasminogen activator-like activity from the endothelial cell lining. The bioavailability of heparin fractions has proved to be much greater than heparin after subcutaneous or intraperitoneal administration. Most of the low molecular weight heparin fractions exhibit sustained antiprotease and antithrombotic actions. The pharmacokinetics of the specific anti-IIa and anti-Xa actions of heparin and its fractions is dependent on the molecular composition of these agents. Even if the fractions are standardized for identical potencies by the in vitro assays, the elimination rate of anti-Xa and anti-IIa actions are significantly different for each fraction. The antithrombotic actions of heparin and its fractions also vary widely in the rabbit stasis thrombosis model. Different fractions show variable antithrombotic actions against defined thrombogenic challenges. Moreover, selection and potency of a thrombogenic agent is of crucial importance in these studies. The primate (Macaca mulatta) model offers a useful preclinical model for the pharmacologic evaluation of the low molecular heparin fractions. Since the coagulation system and heparinizability index of this model approximate a human response, the data may be used to reflect therapeutic and prophylactic responses, as well as to assess toxic effects, such as bleeding.

Animals↗
PubMed1985

Validity of serine protease inhibition tests in the evaluation and monitoring of the effect of heparin and its fractions.

The advent of heparin fractions for clinical use has prompted a reevaluation of the available methods for the assaying of heparin activity in blood. Newly developed heparin fractions are routinely evaluated in terms of their anti-Xa and anti-IIa amidolytic USP, APTT, and anti-Xa coagulant actions. A wide variation between these assays exists due to the use of nonstandard reagents and varying assay conditions. Amidolytic assays, although more biochemically defined than coagulant assays, do not use a natural substrate and work in a diluted plasma system. This may account for discrepancies and differing sensitivities between results in the amidolytic and coagulant assays. The APTT, PTT, and TT may not be effected by the LMFs, and these are the tests currently used to monitor patients on heparin therapy. A poor correlation is observed between the global tests with the newly developed anti-Xa and anti-IIa assays. Furthermore, marked differences in the inhibitory responses are observed with heparin and its fractions. The anti-Xa and anti-IIa assays may provide a more sensitive assay than the APTT, but the poor correlation between assays suggests a multiple effect of heparin and its fractions. Which assay or assays are the best measure of the antithrombotic efficacy of this drug remains to be determined. However, a random selection of an assay is surely not a proper means to monitor these drugs, and a battery of current methodology should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Amides↗
PubMed1985

Usefulness of fibrinopeptide A generation tests in experimental and clinical studies with low molecular weight heparin fractions.

FPA generation test provides a sensitive tool to study the events leading to the production of fibrin from fibrinogen. Drug modulation of pathways resulting in thrombin generation can be readily assessed utilizing the FPA generation test. In circumstances in which conventional clotting and amidolytic methods fail to detect any antiprotease effects, the FPA generation test provides the sensitivity to study these actions. The FPA generation test demonstrates the collective action of antithrombotic agents on inhibition of activation of the pathways leading to the generation of thrombin. The generation systems are easily modified by activators to provide identification of sites, components, and modulating interaction of various heparin derivatives on the hemostatic system. The FPA generation test assesses the overall inhibitory effects of heparin and thus provides insight into the pharmacokinetics of the biologically active components of these agents. Currently, the FPA generation test may be utilized to demonstrate pharmacokinetics and pharmacodynamics but has limited quantitative capacity in this regard. The FPA generation test performed on native plasma may provide insight into the great variation in individual hemostatic parameters important to dosage determinations.

Blood Coagulation Tests↗
PubMed1985

A primate model (Macaca mulatta) to study the pharmacokinetics of heparin and its fractions.

We have extensively studied the hemostatic parameters and the responses to the anticoagulant action of heparin and its fractions in the primate model (M. mulatta) and found these to be identical to those obtained in humans. The functional properties of antithrombin III, alpha 2-antiplasmin, and platelet factor 4 were also identical to humans in amidolytic and coagulant assays. Human antibodies against FPA, B beta 15-42 peptide, platelet factor 4, and thromboxane B2 reacted with the primate antigen, and assays were developed to measure these parameters in primates. Infusion of activated prothrombin complex concentrates (more than 100 U/kg/day) on a continual basis up to 3 days resulted in a hypercoagulable state manifested by an elevation of FPA, thromboxane B2, and changes in the thrombelastographic patterns. Similarly, infusion of homologous primate serum also resulted in a hypercoagulable state, as was evident by a sharp increase in the FPA levels. The antithrombotic effects of intravenous and subcutaneous administration of heparin, its low molecular fraction, and their constituents were studied after intravenous and subcutaneous injections. The low molecular weight fractions showed the most effective antithrombotic effects, whereas somewhat milder protection was observed with the starting material and highly anionic fraction. The prolongation of global tests, such as the APTT, TT, and changes in the thromboelastogram did not correlate with the reduction in the blood markers of hypercoagulable state. A modified simplate bleeding time method was used to study the effect of heparin and its fractions on the bleeding profile of heparin fractions. The components of fibrinolytic systems were also measurable in both the clot-based and amidolytic methods to predict the profibrinolytic actions of heparin fractions in its mode. These studies suggest that plasma markers, such as the platelet release proteins, products of thrombin activation, and prostaglandin metabolites, may provide better indices in the monitoring of the antithrombotic actions of newer heparins and antithrombotic drugs. Studies suggest that the pathophysiologic responses after a thrombogenic trigger in the primate model are close to humans, and drug modulation of these may provide relevant clinical information. This model provides the most similar preclinical model to study the actions of heparin fractions.

Animals↗
PubMed1985

A modified stasis thrombosis model to study the antithrombotic actions of heparin and its fractions.

The original stasis thrombosis model of Wessler has been modified. Numerous thrombogenic agents were evaluated for their pathophysiologic effects and were classified in terms of stasis clot in the jugular vein. Alterations produced in coagulation parameters, such as the PT, APTT, thrombin time, activated recalcification time (Hemachron), and thrombelastographic pattern were recorded. Since the pathophysiologic activation of the hemostatic system varies considerably in different diseases, a proper animal model along with a proper type of thrombogenic trigger should be carefully selected to produce pathogenesis and to study the therapeutic responses of heparin and its derivatives. In the modified stasis thrombosis model, besides monitoring the formation of the jugular vein stasis clot, it is proposed that the following tests may be useful to establish hypercoagulable states: Functional levels of various coagulation factors, platelet counts, fibrinogen levels, and whole blood activated clotting times. The nature of activation processes in each thrombogenic challenge should be carefully analyzed in terms of pathways involved; for example, the administration of heterologous serum (such as human, monkey) to rabbits produces anaphylactoid reactions, including hemolysis, thrombocytopenia, clinical chemistry abnormalities (enzymes), and many problems that may involve the complement and immune systems. All previous data obtained using heterologous sera as a thrombogenic trigger are of questionable value as to the efficacy of some of the antithrombotic agents tested against it. In addition to the species and the thrombogenic challenge, the following factors may contribute significantly to the pathophysiologic response and its alteration by various agents: (1) Composition of the thrombogenic agent; (2) effect of preparatory drugs, such as anesthetics, on the hemostatic parameters; (3) alterations on injection time, volume, osmolarity, and temperature; (4) variations in the circulation time of the thrombogenic agent and stasis time of the ligated jugular vein stasis segment; and (5) blood sample collection and handling. Since the kallikrein-kinin cascade is closely associated with the coagulation and the fibrinolytic network, a systemic monitoring of blood pressure may provide information on the effect of thrombogenic agents on hemodynamics.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1985

Studies on the profibrinolytic actions of heparin and its fractions.

Utilizing modified immunochemical methods (ELISA and radioimmunoassay) tissue plasminogen activator, B beta 15-42 RPs and protein C antigen levels were measured in man and a subhuman primate model after subcutaneous and intravenous administration of various low molecular weight heparin fractions. A wide scatter in the data was observed in the t-PA and B beta 15-42 RP levels; however, statistical analysis of the data revealed that certain low molecular weight heparin fractions increased the levels of these endogenous markers of fibrinolysis. No significant alteration in the protein C levels was noted at any time; however, a wide scatter in these data was also evident. The profibrinolytic actions of low molecular weight heparin fractions may be related to the release of t-PA, which is easily measured in plasma. Since it has strong affinity for endogenous sites (thrombus, surface), wide scatter in the data may occur. Physical exercise may also increase the levels. Most of the results reported in our studies represent data on blood samples that were obtained using the simple venipuncture method. We also find that the intravenous administration of the low molecular weight heparin fractions also caused a shortening of the ELT. Since the low molecular weight heparin fractions are heterogeneous in nature, the profibrinolytic actions may be related to one or more of these constituent fragments. Thus, the molecular identity of the profibrinolytic component of low molecular weight fractions remains unknown at this time. Also unknown is if there is a relationship between this effect and anticoagulant activity.

Animals↗