title: The tainted heparin story: an update.
abstract: Recently, certain batches of heparin have been associated with an acute, rapid onset of serious side-effects indicative of allergic-type reactions. These reports generated significant concern regarding the possible presence of a dangerous contaminant within heparin and highlighted the need to re-assess the purity criteria of heparin preparations for clinical use. Given the nature of the array of all possible contaminants, traditional screening tests cannot safely differentiate between contaminated and uncontaminated heparin preparations. Mono- and bi-dimensional NMR spectroscopy are powerful techniques that are able to detect and quantify a wide variety of potential sulfated polysaccharide contaminants. As such, these techniques are powerful tools for the analysis and assessment of heparin preparations.
authors.affiliation: Institute for Chemical and Biochemical Research, NMR centre, Milan 20133, Italy. guerrini@ronzoni.it
authors.forename: Marco
authors.initials: M
authors.lastname: Guerrini
authors.forename: Zachary
authors.initials: Z
authors.lastname: Shriver
authors.forename: Antonella
authors.initials: A
authors.lastname: Bisio
authors.forename: Annamaria
authors.initials: A
authors.lastname: Naggi
authors.forename: Benito
authors.initials: B
authors.lastname: Casu
authors.forename: Ram
authors.initials: R
authors.lastname: Sasisekharan
authors.forename: Giangiacomo
authors.initials: G
authors.lastname: Torri
mesh_terms: D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects* / Q000032:analysis / Q000737:chemistry / Q000592:standards; D002648:Child; D002809:Chondroitin Sulfates / Q000009:adverse effects / Q000032:analysis* / Q000138:chemical synthesis / Q000737:chemistry / Q000494:pharmacology; D003167:Complement Activation / Q000187:drug effects; D004196:Disease Outbreaks / Q000662:veterinary; D004340:Drug Contamination; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D006493:Heparin / Q000009:adverse effects* / Q000032:analysis / Q000737:chemistry / Q000592:standards; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D015394:Molecular Structure; D019906:Nuclear Magnetic Resonance, Biomolecular / Q000379:methods*; D019318:Porcine Reproductive and Respiratory Syndrome / Q000453:epidemiology; D013431:Sulfates / Q000032:analysis; D013552:Swine; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000925:Anticoagulants; D013431:Sulfates; D006493:Heparin; D002809:Chondroitin Sulfates; D007610:Kallikreins