Français
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)
Journal of Thoracic and Cardiovascular Surgery 2008-Dec

Formation of anti-platelet factor 4/heparin antibodies after cardiac surgery: influence of perioperative platelet activation, the inflammatory response, and histocompatibility leukocyte antigen status.

Seuls les utilisateurs enregistrés peuvent traduire des articles
Se connecter S'inscrire
Le lien est enregistré dans le presse-papiers
Domenico Paparella
Giuseppe Scrascia
Antonella Galeone
Maria Coviello
Giangiuseppe Cappabianca
Maria Teresa Venneri
Biagio Favoino
Michele Quaranta
Luigi de Luca Tupputi Schinosa
Theodore E Warkentin

Mots clés

Abstrait

BACKGROUND

Anticoagulation therapy with heparin induces antibodies that recognize multimolecular complexes of platelet factor 4 bound to heparin (anti-platelet factor 4/heparin antibodies). Considering that cardiac surgery induces an intense platelet activation and proinflammatory response, we examined the relationship between formation of anti-platelet factor 4/heparin antibodies and plasma levels of platelet factor 4 and interleukin 6. We also examined the relationship between anti-platelet factor 4/heparin seroconversion and the histocompatibility leukocyte antigen system.

METHODS

In 71 patients undergoing cardiac surgery, anti-platelet factor 4/heparin antibody levels were evaluated by means of enzyme-linked immunosorbent assay preoperatively and 14 days postoperatively. Platelet serotonin release assays were performed to assess the platelet-activating potential of the antibodies. Plasma levels of platelet factor 4 and interleukin 6 were assayed at prespecified time points. Histocompatibility leukocyte antigen status was assessed preoperatively in all patients and was compared with that of 6156 healthy subjects.

RESULTS

Thirty-seven (52%) patients had anti-platelet factor 4/heparin antibodies with an OD value of 0.45 or greater in 1 or more of the assays. Applying strict seroconversion criteria (>2-fold increase in Optical Density), only 16 (22.5%) patients had evidence of anti-platelet factor 4/heparin antibody seroconversion after the operation. Neither the presence of anti-platelet factor 4/heparin antibodies nor seroconversion influenced postoperative outcomes. The CW4 allele was significantly more frequent among seroconverted patients (46.9% vs 19.1%, P = .002). Platelet factor 4 levels did not influence seroconversion. Patients with anti-platelet factor 4/heparin levels of 0.45 OD units or greater 14 days after the operation had significantly higher interleukin 6 levels measured 1 hour after protamine administration.

CONCLUSIONS

Patients with a greater amount of perioperative inflammation could be more likely to have anti-platelet factor 4/heparin antibodies 1 to 2 weeks later. We provide additional evidence that the histocompatibility leukocyte antigen CW4 confers genetic susceptibility in an acquired inflammatory disorder that includes the anti-platelet factor 4/heparin immune response.

Rejoignez notre
page facebook

La base de données d'herbes médicinales la plus complète soutenue par la science

  • Fonctionne en 55 langues
  • Cures à base de plantes soutenues par la science
  • Reconnaissance des herbes par image
  • Carte GPS interactive - étiquetez les herbes sur place (à venir)
  • Lisez les publications scientifiques liées à votre recherche
  • Rechercher les herbes médicinales par leurs effets
  • Organisez vos intérêts et restez à jour avec les nouvelles recherches, essais cliniques et brevets

Tapez un symptôme ou une maladie et lisez des informations sur les herbes qui pourraient aider, tapez une herbe et voyez les maladies et symptômes contre lesquels elle est utilisée.
* Toutes les informations sont basées sur des recherches scientifiques publiées

Google Play badgeApp Store badge