Comparative anticoagulant and platelet modulatory effects of enoxaparin and sulodexide.
Sulodexide represents a novel antithrombotic agent with multiple sites of action on blood coagulation and vascular processes. The purpose of this study was to compare sulodexide and enoxaparin on anticoagulant effects, tissue factor (TF)-induced activation of platelets, inhibition of microparticle generation and to investigate their effect on heparin-induced platelet aggregation (HIPA). Sulodexide was compared with enoxaparin at equigravimetric concentrations. When compared to enoxaparin, sulodexide produced a stronger anticoagulant effect in the prothrombin time (PT), activated partial thromboplastin time (APTT), Heptest, and thrombin time (TT) assays. In addition, sulodexide had a stronger inhibitory effect on TF-mediated microparticle generation (IC(50) = 2.8 microg/ mL), P-selectin expression (IC(50) = 4.8 microg/ml), and platelet aggregate formation (IC(50) = 8.5 microg/mL) compared to higher IC(50) values with enoxaparin. Sulodexide and enoxaparin exhibited a similar effect on heparin-induced thrombocytopenia (HIT) antibody-mediated platelet activation HIPA assays. These results suggest that sulodexide is a relatively stronger anticoagulant agent than enoxaparin. Sulodexide is subcutaneously absorbed. Its ability to inhibit TF-mediated platelet activation may contribute to the observed therapeutic effects of sulodexide in microvascular vasculopathy such as diabetic nephropathy. These results also suggest that inhibition of TF activation of platelets by sulodexide may be independent of its anticoagulant effects. These results warrant further investigation of sulodexide in additional preclinical and clinical studies.
Adiguzel
Cafer
C
Department of Pathology, Loyola University Medical Center, Maywood, IL 60153, USA.
Iqbal
Omer
O
Hoppensteadt
Debra
D
Jeske
Walter
W
Cunanan
Josephine
J
Litinas
Evangelos
E
He Zhu
Walenga
Jeanine M
JM
Fareed
Jawed
J
D000925:Anticoagulants / Q000494:pharmacology* / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects*; D001792:Blood Platelets / Q000187:drug effects*; D017984:Enoxaparin / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D005434:Flow Cytometry; D006025:Glycosaminoglycans / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects; D010974:Platelet Aggregation / Q000187:drug effects; D011517:Prothrombin Time; D013918:Thrombin Time
D000925:Anticoagulants; D017984:Enoxaparin; D006025:Glycosaminoglycans; C007858:glucuronyl glucosamine glycan sulfate