title: Anti-metastatic effect of a non-anticoagulant low-molecular-weight heparin versus the standard low-molecular-weight heparin, enoxaparin.
abstract: Low-molecular-weight heparins (LMWH) exhibit potent anticoagulant efficacy via their plasmatic effects on thrombin and factor Xa. These agents are also effective in releasing endothelial tissue factor pathway inhibitor (TFPI), the natural inhibitor of tissue factor, and exhibit significant anti-metastatic effects in experimental animal models. However, the potential for bleeding complications has slowed down the more widespread adoption of LMWH therapy in cancer patients. In this study, the effect of a non-anticoagulant form of LMWH (NA-LMWH) on experimental lung metastasis and tumor cell-induced platelet aggregation in vivo was compared to the LMWH enoxaparin. Using the B16 melanoma mouse model of metastasis, subcutaneous (s.c.) injection of NA-LMWH or enoxaparin (10 mg/kg), three hours before intravenous (i.v.) injection of metastatic melanoma cells, followed by daily doses for 14 days, reduced lung tumor formation by 70% (P < 0.001). I.v. injection of tumor cells resulted in a significant (50-62%, P < 0.01) fall in platelet counts. Pre-injection (i.v.) of enoxaparin completely abolished the tumor cell-induced thrombocytopenia, whereas NA-LMWH had no effect. Four hours after a single s.c. dose, enoxaparin but not NA-LMWH prolonged the clotting time three-fold and delayed the time to clot initiation more than 10-fold as measured by a Sonoclot analyzer and by thromboelastography, respectively. Enoxaparin but not NA-LMWH demonstrated a significant anticoagulant effect in mice. Both NA-LMWH and enoxaparin caused similar TFPI release from endothelial cells in vitro. These data provide evidence to support the potential of NA-LMWH as an anti-metastatic agent without any significant impact on coagulation.
authors.affiliation: Pharmaceutical Research Institute at Albany College of Pharmacy, 106 New Scotland Avenue, Albany, NY 12208, USA. mousas@acp.edu
authors.forename: Shaker A
authors.initials: SA
authors.lastname: Mousa
authors.forename: Robert
authors.initials: R
authors.lastname: Linhardt
authors.forename: John L
authors.initials: JL
authors.lastname: Francis
authors.forename: Ali
authors.initials: A
authors.lastname: Amirkhosravi
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects; D045744:Cell Line, Tumor; D004305:Dose-Response Relationship, Drug; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism; D017984:Enoxaparin / Q000494:pharmacology* / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D008074:Lipoproteins / Q000378:metabolism; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology / Q000517:prevention & control* / Q000556:secondary; D008546:Melanoma, Experimental / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D051379:Mice; D010314:Partial Thromboplastin Time; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count; D011516:Prothrombin / Q000037:antagonists & inhibitors; D013916:Thrombelastography; D013921:Thrombocytopenia / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D000970:Antineoplastic Agents; D017984:Enoxaparin; D065427:Factor Xa Inhibitors; D006495:Heparin, Low-Molecular-Weight; D008074:Lipoproteins; C517149:NA-LMWH; C051928:lipoprotein-associated coagulation inhibitor; D011516:Prothrombin; C025337:Factor IIa