Why the study?
Do APACs reduce thrombus formation and platelet aggregation with a better safety profile compared to unfractionated heparin in preclinical models?
Do APACs reduce thrombus formation and platelet aggregation with a better safety profile compared to unfractionated heparin in preclinical models?
APACs, which mimic mast cell-derived heparin proteoglycans, demonstrate dual antiplatelet and anticoagulant properties with a potentially better safety profile (shorter bleeding time) than unfractionated heparin in preclinical models.
APAC merits human trials to assess antithrombotic potential; leaves open whether preclinical advantages over UFH will improve outcomes.
Mast cell-derived heparin proteoglycans (HEP-PG) reside in vascular tissue and serve as a local antithrombotic. Heparin, as used clinically, is isolated from its protein backbone from porcine and bovine gut mucosa. The isolated heparin is an anticoagulant; however, when bound to a protein carrier the heparin conjugates will become antiplatelet agents by inhibiting collagen-induced platelet aggregation and procoagulant activity, as distinct from soluble heparin. HEP-PG, whether soluble or immobilized to a surface, inhibit platelet deposition on the collagen surface in flowing blood. Mimics of HEP-PG, can be tailored to molecules carrying both antiplatelet and anticoagulant (APAC) properties. These molecules can target the vascular injury site and take residence there. Inhibition of thrombus growth using these APACs under these conditions has been demonstrated in several animal models. Although efficacious for antiplatelet and anticoagulant effects, the bleeding time is shorter with APACs than with unfractionated heparin, suggestive of beneficial efficacy/safety ratio. These strategies may be utilized in drug development, where many vascular injury-related problems can be tackled locally.
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Jouppila et al. (2014) studied this question.
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