Procoagulant and prothrombotic responses of human endothelium to indomethacin and endotoxin in vitro. Relevance to non-steroidal anti-inflammatory drug enteropathy.
BACKGROUND
In view of the association between non-steroidal anti-inflammatory drugs (NSAIDs) and microvascular injury in the intestine, this study investigated the procoagulant changes in cultured human umbilical vein endothelial cells (HUVEC) when exposed to indomethacin either alone or in the presence of bacterial lipopolysaccharide (LPS).


METHODS
Confluent HUVEC cultures were cultured for 1, 6, 12, and 24 h in the presence of LPS (10 micrograms/ml) with or without indomethacin (1-100 microM). After incubation, supernatants were analysed for 6-keto-prostaglandin (PG) F1 alpha and PGE2 content, whereas cells were freeze-fractured and assayed in a one-stage clotting assay for the expression of procoagulant activity (PCA).


RESULTS
LPS induced a significant expression of PCA at 6, 12, and 24 h, with a significantly increased production of 6-keto-PGF1 alpha, whereas the increased PGE2 production was much less pronounced. Indomethacin alone induced a time-dependent PCA response; when coincubated with LPS the PCA response was greater than that produced by either indomethacin or LPS alone. Indomethacin totally abolished the synthesis of antithrombotic eicosanoids.


CONCLUSIONS
Indomethacin induces PCA in HUVEC and augments LPS-induced PCA, while it abolishes the antithrombotic prostanoid response in these cells. These observations may be relevant to the microvascular injury and thrombosis observed in NSAID enteropathy.
Nygård
G
G
University Dept. of Medicine, Royal Free Hospital School of Medicine, London, UK.
Hudson
M
M
Mazure
G
G
Anthony
A
A
Dhillon
A P
AP
Pounder
R E
RE
Wakefield
A J
AJ
D015121:6-Ketoprostaglandin F1 alpha / Q000096:biosynthesis; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001779:Blood Coagulation Factors / Q000096:biosynthesis*; D002478:Cells, Cultured; D015232:Dinoprostone / Q000096:biosynthesis; D015777:Eicosanoids / Q000096:biosynthesis; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000378:metabolism*; D004731:Endotoxins / Q000494:pharmacology*; D006801:Humans; D007213:Indomethacin / Q000494:pharmacology*; D007410:Intestinal Diseases / Q000139:chemically induced; D008070:Lipopolysaccharides / Q000494:pharmacology; D013927:Thrombosis / Q000139:chemically induced
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001779:Blood Coagulation Factors; D015777:Eicosanoids; D004731:Endotoxins; D008070:Lipopolysaccharides; D015121:6-Ketoprostaglandin F1 alpha; D015232:Dinoprostone; D007213:Indomethacin