Thromb Haemost 1993; 70(05): 817-821
DOI: 10.1055/s-0038-1649676
Platelets
Schattauer GmbH Stuttgart

Ro 44-9883, a New Non-Peptidic GPIIb-GPIIIa Antagonist Prevents Platelet Loss in a Guinea Pig Model of Extracorporeal Circulation

Jean-P Carteaux
The Pharma Division, Preclinical Research, Hoffmann-La Roche Ltd, Basel, Switzerland
,
Beat Steiner
The Pharma Division, Preclinical Research, Hoffmann-La Roche Ltd, Basel, Switzerland
,
Sébastien Roux
The Pharma Division, Preclinical Research, Hoffmann-La Roche Ltd, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Received 10 November 1992

Accepted after revision 02 June 1993

Publication Date:
05 July 2018 (online)

Summary

Extensive contact between blood and artificial surfaces causes platelet activation and depletion. The aim of the present study was to test the efficacy of Ro 44-9883, a potent and selective peptidomimetic GPIIb-IIIa antagonist, in preventing platelet loss in guinea pigs undergoing extracorporeal circulation (ECC) with bubble oxygenation. In 15 guinea pigs, an arterio-arterial shunt was created and perfused for 1 h from the aortic arch to the descending aorta. The guinea pigs were divided into three groups: A control group receiving only heparin as an i.v. bolus, a low dose-treated group and a high dose-treated group receiving in addition to heparin and before starting ECC, 1 or 7 mg/kg Ro 449883 as an i.v. bolus, respectively. In the control group, the platelet count at 30 and 60 min of ECC was dramatically decreased (35 ± 4% and 25 ± 3% of initial value). In the low dose-treated group, Ro 44-9883 partially prevented the drop in platelet count (69 ± 8% and 54 ± 9%; p <0.05) whereas in the high dose-treated group, the platelet count was normal at 30 min (97 ± 8%) and only slightly decreased at 60 min (80 ± 7%). Mean arterial pressure and hematocrit were not significantly different between groups during the experiment. We conclude that i) ECC in guinea pigs provides an interesting in-vivo model for studying platelet loss by contact activation and ii) Ro 44-9883 prevents platelet loss during ECC in a dose dependent manner.

 
  • References

  • 1 Harker LA, Malpass TW, Branson HE, Hessel II EA, Slichter SJ. Mechanism of abnormal bleeding in patients and undergoing cardiopulmonary bypass: Acquired transient platelet dysfunction associated with selective α-granule release. Blood 1980; 56: 824-834
  • 2 Chenoweth DE, Cooper SW, Hugli TE, Stewart RW, Blackstone EH, Kirklin JW. Complement activation during cardiopulmonary bypass. N Engl J Med 1981; 304: 497-503
  • 3 Holloway DS, Summaria L, Sandesara J, Vagher JP, Alexander JC, Caprini JA. Decreased platelet number and function and increased fibrinolysis contribute to postoperative bleeding in cardiopulmonary bypass patients. Thromb Haemostas 1988; 55: 62-67
  • 4 Addonizio VP, Colman RW. Platelets and extracorporeal circulation. Biomaterials 1982; 3: 9-15
  • 5 McKenna R, Bachman F, Whittaker B, Gilson JR, Weinberg MJ. The hemostatic mechanism after open heart surgery. II Frequency of abnormal platelet function during and after extracorporeal circulation. J Thorac Cardiovasc Surg 1975; 70: 298-308
  • 6 Woodman RC, Harker LA. Bleeding complication associated with cardiopulmonary bypass. Blood 1990; 76: 1680-1697
  • 7 Ashmore PG, Svitek V, Ambrose P. The incidence and effects of particulate aggregation and micro embolism in pump oxygenatorsystems. J Thorac Cardiovasc Surg 1968; 55: 691-697
  • 8 Wakefield TW, Bouffard JA, Spaulding SA, Petry NA, Gross MD, Lindblad B, Stanley JC. Sequestration of platelets in the pulmonary circulation as a consequence of protamine reversal of the anticoagulant effect of heparin. J Vase Surg 1987; 5: 187-193
  • 9 Toeh KH, Christakis GT, Weisel RD, Mullen JC, Madonik MM, Ivanov J, Henderson MJ, Warbickcerone A, Johnston LG, Mee AV, Wong PY, Reilly PA, Glynn MFX. Prevention of myocardial platelets deposition and thromboxane release with dipyridamole. Circulation 1986; 74 (03) 0145-0152
  • 10 Hennessy VL, Hicks RE, Niewiarowski S, Edmunds LH, Colman RW. Effects of surface area and composition on the function of human platelets during extracorporeal circulation. Am J Physiol 1977; 232: H622-H628
  • 11 George JN, Pickett EB, Saucerman S, Mcever RP, Kunicki TJ, Kieffer N, Newman PJ. Platelet surface glycoproteins. Studies on resting and activated platelets and platelet microparticles in normal subjects, and observations in patients during adult respiratory distress syndrome and cardiac surgery. J Clin Invest 1986; 78: 340-346
  • 12 Wenger RK, Lukiasiewics H, Mikuta BS, Niewiarowski S, Edmunds LH. Loss of platelet fibrinogen receptors during clinical cardiopulmonary bypass. J Thorac Cardiovasc Surg 1989; 97: 235-239
  • 13 Musial J, Niewiarowski S, Rucinski B, Stewart GJ, Cook JJ, Williams JA, Edmunds LH. Inhibition of platelet adhesion to surfaces of extracorporeal circuits by desintegrins. RGD containing peptides from viper venoms. Circulation 1990; 82: 261-273
  • 14 Phillips DR, Charo IF, Parise LV, Fitzgerald LA. The platelet membrane glycoprotein IIb-IIIa complex. Blood 1988; 71: 831-43
  • 15 Gluszko P, Rucinski B, Musial J, Wenger RK, Schmaier AH, Colman RW, Edmunds LH, Niewiarowski S. Fibrinogen receptors in platelet adhesion to surfaces of extracorporeal circuit. Am J Physiol 1987; 252: H615-H621
  • 16 Jen CJ, Lin JS. Direct observation of platelet adhesion to fibrinogen and fibrin coates surfaces. Am J Physiol 1991; 261: H1457-H1463
  • 17 Gould RJ, Polokoff MA, Friedman PA, Huang T, Holt JC, Cook JJ, Niewiarowski S. Disintegrins: A family of integrin inhibitory proteins from viper venoms. Proc Soc Exp Biol Chem 1990; 195: 168-171
  • 18 Kouns C, Kirchhofer D, Hadvary P, Edenhofer A, Weller T, Pfenninger G, Baumgartner HR, Jennings LK, Steiner B. Reversible conformational changes induced in glycoprotein IIb-IIIa by a potent and selective peptidomimetic inhibitor. Blood 1992; 80: 2539-2547
  • 19 Addonizio VP, Fisher CA, Jenkin BK, Strauss III JF, Musial JF, Edmunds LH. Iloprost (ZK 36374) a stable analogue of prostacyclin, preserves platelets during simulated extracorporeal circulation. J Thorac Cardiovasc Surg 1985; 89: 926-933
  • 20 Zilla P, Fasol R, Groscurth P, Klepetko W, Reichenspurner H, Wolner E. Blood platelets in cardiopulmonary bypass operations. Recovery occurs after initial stimulation, rather than continual activation. J Thorac Cardiovasc Surg 1989; 97: 379-385
  • 21 Harker LA. Bleeding after cardiopulmonary bypass. N Engl J Med 1986; 314: 1446-1448
  • 22 Van OeverenW, Kazatchkine MD, Descamps-Latscha B, Maillet F, Fischer E, Carpentier A, Wildevuur CRH. Deleterious effects of cardiopulmonary bypass. A prospective study of bubble versus membrane oxygenation. J Thorac Cardiovasc Surg 1985; 89: 888-899
  • 23 Cottrell ED, Kappa JR, Stenach N, Fisher CA, Tuszynski GP, Switalska HI, Addonizio VP. Temporary inhibition of platelet function with iloprost (ZK 36374) preserves canine platelets during extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg 1988; 96: 535-541
  • 24 Walenga JM, Bakhos M, Messmore HL, Koza M, Wallock M, Orfei E, Fareed J, Pifarre R. Comparison of recombinant hirudin and heparin as an anticoagulant in a cardiopulmonary bypass model. Blood Coag Fibrinolysis 1991; 2: 105-111
  • 25 Juhàsz-Nagy S, Kekesi V, Sotonyi P, Moravcsik G, Kovàcs G. Prevention by a stable prostacyclin analogue, τ-oxoprostaglandin I2, of the platelet loss during experimental cardiopulmonary bypass. Acta Chirurgica Hungaria 1988; 29 (03) 0251-0261
  • 26 Thelin S, Hultman J, Ronquist G. Effects of adenosine on the pig heart during normothermic ischemia and reperfusion. Scand J Thorac Cardiovasc Surg 1991; 25: 207-213
  • 27 Thelin S, Bagge L, Hultman J, Borowiec J, Nilsson L, Thorelius J. Heparin-coated cardiopulmonary bypass circuits reduce blood cell trauma. Experiments in the pig. Eur J Cardiothorac Surg 1991; 5: 486-91
  • 28 Palatianos GM, Dewangee MK, Smith W, Novak S, Hsu LC, Kapadvanjwala M, Sfakianakis GN, Kaiser GA. Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo II heparin coated surfaces. ASAIO Trans 1991; 37: 620-622
  • 29 Marcolin R, Cugno M, Pesenti A, Uziel L, Giuffrida A, Vitale G, Keim R, Meda F, Fabrizi I, Gattinoni L. Extracorporeal circulation in sheep with normal bleeding time using a surface heparinized circuit. ASAIO Trans 1991; 37: 584-587
  • 30 Shigeta O, Gluszko P, Downing SW, Lu W, Niewiarowski S, Edmunds LH. Protection of platelets during long term extracorporeal membrane oxygenation in sheep with a single dose of a disintegrin. Circulation 1992; 86 (02) 398-404
  • 31 Fujitani B, Wakitani K. Studies on antiplatelet effect of OP-41483, a prostaglandin I2 analog, in experimental animals. 1 Effect on platelet function and thrombosis Jpn J Pharmacol 1990; 52: 123-130
  • 32 Brody MJ, Shaffer RA, Dixon RL. A method for the study of peripheral vascular responses in the rat. J Appl Physiol 1963; 18: 645-647
  • 33 Durussel JJ, Claperon N, Dufaux J, Quemada D, Rossignol P. Extracorporeal cephalic blood autoperfusion method in the rat. Hemorrheological evaluation and proposed pharmacological uses. J Pharmacol Methods 1986; 15: 201-211
  • 34 Nagel K, Ghussen F, Kruger I, Isselhard W. Miniature equipment for the perfusion of rat limbs. Res Exp Med 1987; 187: 1-8
  • 35 Kouns WC, Weller T, Hadvary P, Lennings LK, Steiner B. Identification of a peptidomimetic inhibitor with minimal effects on the conformation of GP IIb-IIIa. Blood 1992; 80: 165a
  • 36 Carteaux JP, Roux S, Kuhn H, Tschopp T, Colombo V, Hadvary P. Ro 44-9883, a new non-peptidic GPIIb-IIIa antagonist prevents platelet loss during experimental cardiopulmonary bypass. J Thoracic Cardiovasc Surg, in press.