title: Poly-N-acetyl glucosamine fibers accelerate hemostasis in patients treated with antiplatelet drugs.
abstract: BACKGROUND
  Nanofibers consisting of poly-N-acetyl glucosamine (pGlcNAc), as the functional component of products for surface hemostasis, have been shown to activate platelets and thereby the clotting mechanism. The nanofiber-activated platelets provide a catalytic surface for acceleration of the intrinsic coagulation cascade, thrombin generation, and fibrin polymerization.
  
  
  METHODS
  Thromboelastographic analysis was undertaken to study the role of the pGlcNAc nanofibers in platelet activation and acceleration of fibrin polymerization. Thromboelastographic studies were performed without added activators of coagulation.
  
  
  RESULTS
  The pGlcNAc nanofibers were found to accelerate fibrin polymerization in whole blood and platelet-rich plasma. Treatment with eptifibatide (an inhibitor of the platelet GPIIbIIIa receptor) and corn trypsin inhibitor inhibited clotting of whole blood and platelet-rich plasma. The inhibition was reversed by treatment with pGlcNAc nanofibers. Inhibition was not observed after treatment with aspirin alone, MRS2359 (platelet ADP receptor inhibitor), or by a combination of aspirin and MRS2359. The pGlcNAc nanofibers accelerate clotting in normal blood treated with aspirin and MRS2359. Clopidogrel (Plavix) and aspirin did not affect the kinetics of pGlcNAc-mediated fibrin polymerization in blood from patients treated with antiplatelet drugs compared with nontreated blood.
  
  
  CONCLUSIONS
  These results provide evidence that pGlcNAc nanofibers activate platelets and accelerate the clotting of blood, and on how best to achieve surface hemostasis when patients are coagulopathic because of shock and/or to treatment with antiplatelet drugs.
authors.affiliation: Francis Owen Blood Research Laboratory, Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27516, USA. tfischer@med.inc.edu
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Fischer
authors.forename: William E
authors.initials: WE
authors.lastname: Hays
authors.forename: C Robert
authors.initials: CR
authors.lastname: Valeri
mesh_terms: D000117:Acetylglucosamine / Q000494:pharmacology*; D015906:Angioplasty, Balloon, Coronary; D001777:Blood Coagulation / Q000187:drug effects*; D005337:Fibrin / Q000187:drug effects; D006801:Humans; D057139:Nanofibers; D015539:Platelet Activation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D053657:Platelet-Rich Plasma; D013916:Thrombelastography
chemical_list: D010975:Platelet Aggregation Inhibitors; C113831:poly-N-acetyl glucosamine; D005337:Fibrin; D000117:Acetylglucosamine