Why the study?
Because bleeding was suggested as a side effect of berberine, the authors evaluated whether various isoquinoline alkaloids influence hemocoagulation through platelet aggregation or blood coagulation inhibition.
Do isoquinoline alkaloids inhibit platelet aggregation or blood coagulation in whole human blood?
Do isoquinoline alkaloids inhibit platelet aggregation or blood coagulation in whole human blood?
Bulbocapnine and papaverine demonstrate antiplatelet effects in whole human blood, with bulbocapnine acting at the level of thromboxane receptors, though the clinical impact for most isoquinoline alkaloids is likely low due to the high concentrations required.
Weak antiplatelet effects at high concentrations unlikely to cause bleeding; leaves open clinical relevance of isoquinoline alkaloids on hemocoagulation.
Isoquinoline alkaloids have multiple biological activities, which might be associated with positive pharmacological effects as well as negative adverse reactions. As bleeding was suggested to be a side effect of the isoquinoline alkaloid berberine, we decided to ascertain if different isoquinoline alkaloids could influence hemocoagulation through the inhibition of either platelet aggregation or blood coagulation. Initially, a total of 14 compounds were screened for antiplatelet activity in whole human blood by impedance aggregometry. Eight of them demonstrated an antiplatelet effect against arachidonic acid-induced aggregation. Papaverine and bulbocapnine were the most potent compounds with biologically relevant IC50 values of 26.9 ± 12.2 μM and 30.7 ± 5.4 μM, respectively. Further testing with the same approach confirmed their antiplatelet effects by employing the most physiologically relevant inducer of platelet aggregation, collagen, and demonstrated that bulbocapnine acted at the level of thromboxane receptors. None of the alkaloids tested had an effect on blood coagulation measured by a mechanical coagulometer. In conclusion, the observed antiplatelet effects of isoquinoline alkaloids were found mostly at quite high concentrations, which means that their clinical impact is most likely low. Bulbocapnine was an exception. It proved to be a promising antiplatelet molecule, which may have biologically relevant effects.
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Parvin et al. (2022) studied this question.
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