title: Differential inhibitory effect of fondaparinux on the procoagulant potential of intact monocytes and monocyte-derived microparticles.
abstract: Monocytes and monocyte-derived microparticles (MMPs) play a major role in acute coronary syndrome (ASC). Activated monocytes (ac-M) and MMPs support thrombin generation via tissue factor (TF). The aim of this study was to evaluate the inhibitory effect of fondaparinux, a selective Xa inhibitor, on thrombin generation supported by activated monocytes and MMPs. Monocytes were purified by elutriation. They were activated by LPS, allowing to obtain both ac-M and MMPs. Thrombin generation was performed using Fluoroscan(®) in these two cell models, in comparison with a cell-free model (TF 5 pM final). Two concentrations of ac-M (0.2 × 10⁶ and 1 × 10⁶/well) and four concentrations of MMPs (40,000; 80,000; 120,000 and 160,000/well) were tested. TGT was evaluated for increasing fondaparinux concentrations (0, 0.1, 0.4, 0.7 and 1.2 μg/ml). Without fondaparinux, 0.2 × 10⁶ ac-M and 160,000 MMPs induced comparable results. Fondaparinux inhibited thrombin generation in the three models. Inhibition was fondaparinux concentration dependent. Rate index was the most sensitive parameter, compared to lag-time, peak and endogenous thrombin potential. The rate index IC(50) were 0.69 ± 0.03 μg/ml for ac-M, 0.20 ± 0.03 μg/ml for MMPs, and 0.22 ± 0.02 μg/ml for cell-free model. Fondaparinux exerted an inhibitory effect at all concentrations, including the lowest (0.1 μg/ml). The extend of inhibition was similar between MMPs and cell-free models, and stronger than ac-M model. We assume that the efficacy of fondaparinux 2.5 mg once daily in ACS patients may be in part attributed to its inhibitory effect on MMPs.
authors.affiliation: Laboratoire d'Hématologie, CHU Robert Debré, 51092 Reims Cedex, France.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ben-Hadj-Khalifa-Kechiche
authors.forename: Nathalie
authors.initials: N
authors.lastname: Hezard
authors.forename: Stephane
authors.initials: S
authors.lastname: Poitevin
authors.forename: Marie-Geneviève
authors.initials: MG
authors.lastname: Remy
authors.forename: Bernadette
authors.initials: B
authors.lastname: Florent
authors.forename: Touhami
authors.initials: T
authors.lastname: Mahjoub
authors.forename: Philippe
authors.initials: P
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects* / Q000502:physiology; D055252:Cell-Derived Microparticles / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D008297:Male; D009000:Monocytes; D011134:Polysaccharides / Q000097:blood / Q000494:pharmacology*; D013917:Thrombin / Q000037:antagonists & inhibitors / Q000502:physiology; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D011134:Polysaccharides; D013917:Thrombin; D000077425:Fondaparinux