PMID- 19295478
OWN - NLM
STAT- MEDLINE
DCOM- 20100222
LR  - 20171116
IS  - 1540-0514 (Electronic)
IS  - 1073-2322 (Linking)
VI  - 32
IP  - 5
DP  - 2009 Nov
TI  - Enoxaparin attenuates endothelial damage with less bleeding compared with 
      unfractionated heparin in endotoxemic rats.
PG  - 530-4
LID - 10.1097/SHK.0b013e3181a2e279 [doi]
AB  - Prophylactic use of anticoagulants during sepsis is strongly recommended for the 
      prevention of venous thrombosis. Moreover, recent studies suggested the positive 
      effects of anticoagulants to the inflammation. In this study, we planned to 
      confirm the effects of heparins on protecting against endothelial damage in 
      endotoxemia. In addition, we also examined the differences between unfractionated 
      heparin (UFH) and enoxaparin. Wistar rats received 8.5 mg/kg (i.v.) LPS, followed 
      by a bolus infusion of either 350 U/kg of UFH, 2.0 mg/kg of enoxaparin, or 
      placebo. Microscopic observation of the mesenteric microcirculation and the 
      measurement of the bleeding area after puncture with a microneedle were performed 
      3 h later (n = 6 in each group). In another series, blood samples were taken 3 h 
      after the LPS injection, and blood cell counts, coagulation markers, and organ 
      damage markers were measured (n = 6 in each). As a result, the leukocyte 
      adherence to the endothelium was significantly reduced in both the UFH and 
      enoxaparin groups, and thus, endothelial damage was attenuated in these groups. 
      The bleeding area was markedly expanded in the UFH group compared with the other 
      groups (P < 0.01 each). The decrease in white blood cells and platelet count was 
      significantly suppressed in the enoxaparin group compared with the UFH group (P < 
      0.05 each). The fibrinogen level was maintained at significantly better levels, 
      and the elevation of alanine aminotransferase was significantly suppressed in 
      enoxaparin group (P < 0.05 each). In conclusion, both UFH and enoxaparin protect 
      against endothelial damage by preventing leukocyte adhesion. However, UFH 
      significantly increases the bleeding area, whereas enoxaparin does not increase 
      bleeding, and thus, it can reduce organ damages in the endotoxemic rat.
FAU - Iba, Toshiaki
AU  - Iba T
AD  - Department of Emergency and Disaster Medicine, Juntendo University School of 
      Medicine, Bunkyo-ku, Tokyo, Japan. toshiiba@cf6.so-net.ne.jp
FAU - Takayama, Toshio
AU  - Takayama T
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Shock
JT  - Shock (Augusta, Ga.)
JID - 9421564
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Lipopolysaccharides)
RN  - 9001-32-5 (Fibrinogen)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.11.2 (CD13 Antigens)
SB  - IM
MH  - Animals
MH  - Anticoagulants/*pharmacology
MH  - CD13 Antigens/metabolism
MH  - Endothelium/*drug effects
MH  - *Endotoxemia/chemically induced/pathology
MH  - Enoxaparin/*pharmacology
MH  - Fibrinogen/metabolism
MH  - Hemorrhage/drug therapy
MH  - Heparin/pharmacology
MH  - Lipopolysaccharides/toxicity
MH  - Male
MH  - Rats
MH  - Rats, Wistar
EDAT- 2009/03/20 09:00
MHDA- 2010/02/23 06:00
CRDT- 2009/03/20 09:00
PHST- 2009/03/20 09:00 [entrez]
PHST- 2009/03/20 09:00 [pubmed]
PHST- 2010/02/23 06:00 [medline]
AID - 10.1097/SHK.0b013e3181a2e279 [doi]
PST - ppublish
SO  - Shock. 2009 Nov;32(5):530-4. doi: 10.1097/SHK.0b013e3181a2e279.