Studies in patients with bleeding disorders show that platelet-vessel interaction is important for thromboxane formation in bleeding time wounds

von Willebrand's disease and hemophilia are associated with diminished thromboxane A2 (TXA2) formation in clotting whole blood

Von Willebrand's disease (vWd) and hemophilia are associated with hemorrhagic diathesis and disturbances in platelet aggregation to vessel wall. We compared the time course of thromboxane A2 (TXA2) formation by platelets during spontaneous clotting of blood of patients with von Willebrand syndrome and from patients with hemophilia A or B with that of healthy controls which were matched for sex, age and serum lipid status. In clotting blood of healthy females the TXA2 production rose at 37 degrees C in 60 min up to 228.2 +/- 32.3 ng/ml. In patients with vWd the TXA2 production at 60 min was significantly lower (129.1 +/- 26.7 ng/ml, p < 0/05). In hemophilia type A and B the TXA2 formation after 5-30 min was significantly diminished in comparison to healthy male controls (p < 0.05). From the diminished amount of TXA2 formed during spontaneous clotting of whole blood we conclude that the activation of platelets of patients with von Willebrand syndrome or hemophilia type A and B is diminished as compared to healthy controls possibly caused by reduced formation of thrombin in the blood coagulation process.

Intravascular cysteinyl-leukotriene formation by clotting whole human blood. Evidence from clamped umbilical vein segments and thrombus specimens

We have recently demonstrated that contact activation of the intrinsic coagulation cascade in vitro is accompanied not only by thromboxane (TX) B2 generation but also by the formation of 5-lipoxygenase-derived cysteinyl-leukotrienes (LT). In our present study we have investigated the effects of the vascular wall on the eicosanoid formation by whole human blood. Incubation of whole human blood in clamped segments of autologous umbilical veins incubated in oxygenated Tyrode solution led to a time-dependent generation of cysteinyl-LT and TXB2 in the blood samples. A clear dissociation in the time-dependent production profiles was observed with cysteinyl-LT practically reaching a plateau phase at 60 min while TXB2 levels increased up to 90 min. In blood samples incubated in glass tubes for 60 min TXB2 production was about 13 times higher and cysteinyl-LT formation only about half as much as in the umbilical vein segments indicating a differential stimulation of both the cyclooxygenase and 5-lipoxygenase pathway of arachidonic acid metabolism in these experiments. By reverse phase HPLC the immunoreactive cysteinyl-LT were identified as a mixture of LTC4, LTD4 and LTE4. Since the data were suggestive of intravascular cysteinyl-LT formation in thrombotic vessels, thrombus specimens from patients with acute deep vein thrombosis of the lower limb were analysed for these compounds by combined reverse phase HPLC and specific radioimmunoassay.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of regular and enteric-coated aspirin on bleeding time, thromboxane, and prostacyclin

We compared the effect of different aspirin schedules, dosages, and formulations on various bleeding time parameters including bleeding time, plasma and total blood volume, and levels of the stable metabolites of thromboxane A2 (TXA2) and prostacyclin (PGI2) (respectively, TXB2 and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha)) to determine the optimal dosage and formulation of aspirin to inhibit TXA2 production while sparing PGI2. In a randomized, parallel study, 52 healthy male volunteers (62 independent observations) with no history of bleeding disorders were given 80 mg or 325 mg of regular aspirin, or 325 mg of enteric-coated aspirin to ingest daily (14 pills) or every other day (7 pills) for a continuous 14 day period. Bleeding times were performed on day 1 before aspirin, 6 h after aspirin on day 1, and before aspirin on day 14. Bleeding times, plasma volume, and total volume increased significantly from before aspirin to after 6 h and 14 days (p < 0.0001 for all parameters) for all aspirin formulations. For day 1 before aspirin ingestion to 6 h later, both TX and PGI2 (p < 0.008) decreased significantly. 6 h after ingestion of aspirin on day 1 to day 14, both TX and PGI2 levels also significantly decreased (p < 0.0001). There was a highly significant decrease in PGI2 production on every other day aspirin schedules (p = 0.0001) particularly with 80 mg of aspirin, while the decrease in PGI2 production on daily aspirin was not significant (p = 0.10). The most favourable ratio of 6-keto-PGF1 alpha to TXB2 occurred with 80 mg daily.(ABSTRACT TRUNCATED AT 250 WORDS)