title: Ecarin clotting time is sensitive to heparinoids: comparison of two different techniques.
abstract: Ecarin clotting time (ECT) is currently developed for the specific monitoring of antithrombin drugs, such as hirudin, argatroban, and hirulog. Aqueous reagent and dry chemistry technology have become available for ECT monitoring of antithrombin agents. Currently, many heparinoids and heparinomimetic drugs are being developed. These agents activate heparin cofactor II (HCII) and primarily mediate their effects by inhibiting thrombin. Although the test is specific for antithrombin agents, heparin cofactor II-mediated thrombin inhibitors are capable of prolonging the ECT. In order to study the relative effects of some of these agents, ECT was measured in human plasma supplemented with Pl-88 (a sulfated pentomanose; Progen Industries Limited, Sydney, Australia), aprosulate, pentosan polysulfate, dermatan sulfate, unfractionated heparin (UFH), and recombinant hirudin (r-hirudin). All agents were supplemented to the citrated-pooled plasma prepared from 10 healthy volunteers at a graded dosage of 0 to 100 microg/ml. These techniques gave comparable results for all of the agents used (PI-88, r2 = 0.99; r-hirudin, r2 = 0.98; UFH, r2 = 0.98; dermatan sulfate, r2 = 0.95; aprosulate, r2 = 0.95; pentosan polysulfate, r2 = 0.94). The relative anticoagulant effects of various agents used on ECT varied widely, exhibiting their potency in the following order: r-hirudin = pentosan polysulfate > dermatan sulfate > PI-88 > aprosulate > UFH. The sensitivity of ECT was adjusted by varying the concentration of the ecarin reagent. The results suggest that HCII-mediated inhibition of thrombin can be detected by using ECT reagents.
authors.affiliation: Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: M
authors.initials: M
authors.lastname: Demir
authors.forename: O
authors.initials: O
authors.lastname: Iqbal
authors.forename: B
authors.initials: B
authors.lastname: Untch
authors.forename: D A
authors.initials: DA
authors.lastname: Hoppensteadt
authors.forename: B S
authors.initials: BS
authors.lastname: Gaikwad
authors.forename: J
authors.initials: J
authors.lastname: Fareed
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology; D000925:Anticoagulants / Q000494:pharmacology; D000970:Antineoplastic Agents / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects; D001780:Blood Coagulation Tests / Q000379:methods* / Q000592:standards; D003871:Dermatan Sulfate / Q000494:pharmacology; D004187:Disaccharides / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring / Q000379:methods / Q000592:standards; D010450:Endopeptidases / Q000494:pharmacology*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005343:Fibrinolytic Agents / Q000494:pharmacology; D006496:Heparinoids / Q000494:pharmacology*; D006629:Hirudins / Q000494:pharmacology; D006801:Humans; D009844:Oligosaccharides / Q000494:pharmacology; D010426:Pentosan Sulfuric Polyester / Q000494:pharmacology; D012680:Sensitivity and Specificity; D013917:Thrombin / Q000037:antagonists & inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D000970:Antineoplastic Agents; D004187:Disaccharides; D004791:Enzyme Inhibitors; D005343:Fibrinolytic Agents; D006496:Heparinoids; D006629:Hirudins; D009844:Oligosaccharides; C120158:phosphomannopentaose sulfate; D003871:Dermatan Sulfate; D010426:Pentosan Sulfuric Polyester; D010450:Endopeptidases; D013917:Thrombin; C020097:ecarin; C069690:aprosulate