title: Fibrinogen-coated albumin microcapsules reduce bleeding in severely thrombocytopenic rabbits.
abstract: Severe thrombocytopenia frequently occurs in patients receiving chemotherapy and in patients with autoimmune disorders. Thrombocytopenia is associated with bleeding, which may be serious and life threatening. Current treatment strategies for thrombocytopenia may require transfusion of allogeneic platelets, which is associated with serious drawbacks. These include the occurrence of anti-platelet antibodies, which may result in refractoriness to further platelet transfusions, and the potential risk of transfer of blood-borne diseases. Therefore, we have recently developed a platelet substitute product (Synthocytes), which is composed of human albumin microcapsules with fibrinogen immobilized on their surface. Here we show that the intravenous administration of these microcapsules not only corrects the prolonged bleeding time in rabbits rendered thrombocytopenic either by anti-platelet antibodies or by chemotherapy, but also reduces bleeding from surgical wounds inflicted in the abdominal skin and musculature. No potential systemic prothrombotic effect of the microcapsules was observed in a model of rabbit venous thrombosis. As for the mechanism of action, experiments with normal and thrombocytopenic human blood in an endothelial cell matrix-coated perfusion chamber demonstrated an interaction between the fibrinogen-coated albumin microcapsules and native platelets. It was shown that the fibrinogen-coated albumin microcapsules could facilitate platelet adhesion to endothelial cell matrix and correct the impaired formation of platelet aggregates in relatively platelet-poor blood. This study indicates that fibrinogen-coated albumin microcapsules can act to improve primary hemostasis under thrombocytopenic conditions and may eventually be a promising agent for prophylaxis and treatment of bleeding in patients with severe thrombocytopenia.
authors.affiliation: Center for Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Academic Medical Center, University of Amsterdam, The Netherlands. m.m.levi@amc.uva.nl
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.forename: P W
authors.initials: PW
authors.lastname: Friederich
authors.forename: S
authors.initials: S
authors.lastname: Middleton
authors.forename: P G
authors.initials: PG
authors.lastname: de Groot
authors.forename: Y P
authors.initials: YP
authors.lastname: Wu
authors.forename: R
authors.initials: R
authors.lastname: Harris
authors.forename: B J
authors.initials: BJ
authors.lastname: Biemond
authors.forename: H F
authors.initials: HF
authors.lastname: Heijnen
authors.forename: J
authors.initials: J
authors.lastname: Levin
authors.forename: J W
authors.initials: JW
authors.lastname: ten Cate
mesh_terms: D000418:Albumins / Q000009:adverse effects; D000818:Animals; D001792:Blood Platelets; D001802:Blood Substitutes; D002214:Capsules; D004195:Disease Models, Animal; D005340:Fibrinogen / Q000009:adverse effects; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D011817:Rabbits; D013921:Thrombocytopenia / Q000628:therapy*; D013927:Thrombosis; D013997:Time Factors
chemical_list: D000418:Albumins; D001802:Blood Substitutes; D002214:Capsules; D005340:Fibrinogen