Determination of "in vitro" degradation of protamine in plasma by three different methods

Insulin Release from NPH Insulin-Loaded Pluronic® F127 Hydrogel in the Presence of Simulated Tissue Enzyme Activity

Background: Despite the widespread use of newer basal insulins, Natural Protamine Hagedorn (NPH) insulin still represents a well-established basal formulation with its long history of use, featuring the native form of human insulin. However, NPH insulin exhibits an undesirable peak within hours after a single subcutaneous (s.c.) injection, which may lead to hypoglycemia followed by insufficient basal insulin delivery. This may be attributed to the s.c. enzyme activities degrading the protamine in NPH microcrystals. Methods: A thermogelling block copolymer Pluronic® F127 (PF127) was utilized as a protective carrier for NPH microcrystals and as a modulator for insulin release from NPH. NPH insulin-loaded PF127 gel was prepared with varying concentrations of the polymer (15–25%) under mild conditions. The formulations were characterized for their gelling temperature, morphology, gel erosion, and in vitro insulin release, with trypsin concentrations up to 5 U/mL. Results: Scanning electron microscopy (SEM) showed that the integrity of NPH microcrystals was maintained after preparation. The burst release of insulin from NPH was significantly attenuated over the course of ~16h in the presence of PF127 with or without enzyme activity. Conclusion: NPH-PF127 successfully resisted the acceleration of NPH crystal dissolution and insulin release in vitro in the presence of protamine-degrading enzyme activity, warranting further testing.

Blood-interaction performance of differently sulphated hyaluronic acids

Seven differently sulphated hyaluronic acid derivatives, having a general formula HyalSx where x can be 1, 2, 2.5, 3, 3.5, 3.8, 4, were synthetized. Coagulation tests i.e. whole blood clotting time and thrombin time were performed on these compounds and significant prolongations were observed from HyalS2.5 up to HyalS4. All that means the heparin like activity increases by increasing the sulphation degree of hyaluronic acid. The interaction of each of them with thrombin and FXa was studied in order to understand the mechanism of coagulation inactivation and the role of the sulphate position in the disaccharide unit to favour the protease inhibiting reaction. The bioactivity of HyalSx in terms of FXa and thrombin inactivation increases increasing with sulphation degree but the FXa inactivation seems to be mediated by ATIII, while the aspecific electrostatic interaction seems to play an important role in the inactivation of thrombin. Also the interaction with human serum albumin was studied by ATR/FT-IR technique and no changes of protein conformation was observed, as occurs in the case of heparin.

Heparin rebound: a comparative study of protamine chloride and protamine sulfate in patients undergoing coronary artery bypass surgery

Heparin rebound has been suggested to occur when protamine sulfate, but not protamine chloride, is used to neutralize heparin. This study was undertaken to compare these two protamine salts in 32 patients undergoing coronary artery bypass surgery. Initial heparin and subsequent protamine doses were determined by constructing a heparin-activated coagulation time response curve. Heparin was neutralized either with protamine sulfate or protamine chloride. The total protamine/heparin dose ratio was 0.71 +/- 0.05 for protamine sulfate and 0.77 +/- 0.07 (mg/100 U) for protamine chloride. The initial neutralization effect, the subsequent behavior of the plasma heparin level, and the various coagulation parameters did not differ significantly between the groups. Two hours after neutralization, a small and temporary increase of plasma heparin level was observed in both groups. The postoperative blood losses were comparable in both groups. Thus, protamine chloride was not a clinically superior antidote to heparin than protamine sulfate. The observed heparin rebound levels were low and clinically insignificant in terms of blood loss, but they were associated with slight changes in coagulation monitoring.