In vitro assay of thrombolysis with 125I-fibrinogen

Enhancement of ultrasound-accelerated thrombolysis by echo contrast agents: dependence on microbubble structure

The combination of ultrasound (US) exposure and ultrasound contrast agent (UCA) further increases the amount of drug-mediated thrombolysis. The aim of this study was to examine the efficacy of the combination of US and UCA on tissue plasminogen activator (tPA) thrombolysis, and the dependence on the microbubble structure. A catheter-type transducer capable of US emission (10 MHz, spatial peak temporal average intensity = 1.02 W/cm2 and peak negative pressure = 0.33 MPa) in the continuous-wave mode was employed. In 28 artificial white thrombi, serial changes in acoustic properties monitored by echography and histopathology during the tPA-mediated thrombolysis were analyzed. The thrombi were assorted to 4 groups; UCA nontreated (Control), sonicated albumin (A)-, SH-U508A (SH)- and dodecafluoropentane emulsion (DDFP)-treated groups. Persistence of microbubble opacification and thrombus weight were also measured. After the sample was suspended in a beaker with tPA (8000U) and 100 mL of saline, the UCA was administered and the mixture exposed to US for 10 min. Weight reduction of the thrombus was greatest in the DDFP Group (-49 +/- 8%), and that in the A Group (-8 +/- 5%) was not significantly different from that in the Control Group (-5 +/- 1%). The persistence of the microbubbles expressed as the decay of the time-intensity curve, was longest in the DDFP Group. The echo intensity of the superficial layer of the thrombus exposed to US was high and weight loss was marked. Multiple cavity formation was observed histopathologically. The stability of the microbubbles was an important factor of the US and UCA enhancement effect on tPA-mediated thrombolysis. This combination therapy has potential for clinical application in patients with thrombotic arterial and venous occlusion and left arterial thrombus.

Histological observations and the process of ultrasound contrast agent enhancement of tissue plasminogen activator thrombolysis with ultrasound exposure

Although the enhancement of tissue plasminogen activator (tPA) induced thrombolysis by ultrasound has been reported to be augmented by ultrasound contrast agents (UCA), few data exist regarding its process. The present study evaluated the effect of a galactose based UCA on the efficacy of ultrasonic enhancement of tPA thrombolysis and observed the serial changes in the acoustic property and histopathology. A catheter-type transducer capable of ultrasound emission in both continuous (CW) and pulsed wave (PW) was used. The tPA thrombolysis was studied in 30 artificial white thrombi, which were assigned to 4 study groups based on insonation modes and with and without UCA. Each sample was suspended in 100ml saline in a beaker. Five minutes after tPA (8000U) administration, ultrasound was applied for 10min. For the UCA-treated groups, UCA (0.25g) was added 5 min after the start of ultrasound exposure. The alteration of the thrombus was monitored with echography. Weight reduction of the thrombus was -25+/-6% in PW and -30+/-7% in CW, which was significantly enhanced by UCA treatment, 40+/-3% (p<0.005) in PW+UCA and -43+/-7% (p<0.005) in CW+UCA. The area of thrombus echo image minimally decreased with ultrasound alone (-12+/-6%: PW, -23+/-11%: CW). In the UCA groups, UCA induced a remarkable reduction of size (-36+/-3%: PW+UCA, -43+/-7%: CW+UCA) with a high-echo intensity in the superficial layer of the thrombus, where multiple cavity formation was observed by light microscope. UCA markedly enhanced the effect of ultrasound on tPA thrombolysis. The altered acoustic property and corresponding histological microcavity formation in the shallow layer within the thrombus suggests that UCA augmented infiltration of tPA into the thrombus.

Identification of a low molecular weight polypeptide of pregnant bovine uterine origin (LMW-UDF): influence on coagulation system in vitro. Part I

Acidified extracts of pregnant bovine uterus were found to contain a heparin-affinity polypeptide(s). The eluted peak was assayed in the Chandler loop method for whole blood and fibrin thrombus generation. Significant differences in the mean weight and size of whole blood thrombi (243.5 +/- 50 mg and 3.5 cm +/- 0.6 cm) occurred with 1 microgram of purified polypeptide when compared to control samples containing albumin (47.87 +/- .30 g and 0.8 cm +/- 0.3 cm). This activity was detected by the Chandler loop method with 100 ng to 10 micrograms of protein when analyzed in a dose-response fashion. When tested for fibrin thrombus formation this activity persisted. Experiments with 125I fibrinogen revealed no net increase or decrease of uptake into whole blood thrombi when purified polypeptide was added. The heparin-affinity polypeptide(s) possessed a molecular weight of approximately 6-4 kDa when examined by SDS-PAGE. We have therefore designated this polypeptide as low molecular weight-uterine derived factor (LMW-UDF).

The effect of hyperlipoproteinemia on thrombolysis: in vitro studies using purified lipoproteins from normolipemic donors

To determine whether or not lipoproteins affect thrombolysis in vitro using Chandler's loop method, VLDL, LDL, and HDL fractions from healthy male donors were obtained by ultracentrifugation. The lipoproteins were used to enrich whole blood or fibrin thrombi radiolabeled with 125-I-fibrinogen. Lipoprotein-enriched or unenriched thrombi were perfused in rotating Chandler loops with lipoprotein-enriched or unenriched plasma, respectively. Lysis was initiated by adding high molecular weight urokinase or single chain pro-urokinase to the perfusion medium. In some experiments, plasminogen was also added. Variation in the amounts of these activators and plasminogen permitted study of the effect of lipoproteins over a range of thrombolysis. No consistent statistically significant difference in the degree or time course of lysis of lipoprotein-enriched vs. unenriched thrombi or perfusion media was found. These studies, using normal lipoproteins, do not preclude the possibility that lipoproteins from patients with type IIa, IIb, or IV hyperlipoproteinemia may be genetically abnormal or may function pathologically, resulting in an effect on thrombolysis.

Comparative study of thrombolysis by high and low molecular weight urokinase in an in vitro perfusion system

Two urokinase preparations of different molecular weights were standardized against the International Reference Preparation for Urokinase and compared in an in vitro whole blood perfusion system using thrombi formed with whole blood and 125I-fibrinogen. Plasminogen was added to one group and normal saline to the other. Thrombolysis, as well as plasminogen and plasmin inhibitor levels were monitored over a 60 minute period following the addition of the urokinase to the perfusion mediums. There was a high correlation as well as no significant difference found between the percents lysis caused by the high and low molecular weight urokinase. Added plasminogen resulted in a rapid decrease of plasmin inhibitors in both urokinase groups. In the saline groups this decrease was highly negatively correlated with the percent lysis. It is concluded that both high and low molecular weight urokinase behave similarly in an in vitro whole blood thrombolytic perfusion system over the time period studied.