THROMBOSIS RESEARCH Printed in the United
vol.
8, pp. 403-411, Pergamon Press,
States
1976 Inc.
THE EFFECT OF LEtJKoP&lIA VERSUSTHROMBOCYTOPENIA ON ENDOTOXININDUCEDINTRAVASCULAR COAGULATION Boguslaw Lipinski and Victor Gurewich Vascular Laboratory, Lemuel Shattuck Hospital, Tufts University School of Medicine, Boston, Massachusetts
(Received 29.10.1975; in revised form Accepted by Editor S. Nie:.:iarowski)
4.2.1976.
ABSTRACT The effect of leukopenia and thrombocytopenia on endotoxin induced thrombin elaboration and fibrin deposition in rabbits were compared. Leukopenia was induced by pretreatment with nitrogen mustard (HN2) Fibrin deposition was and thrombocytopenia with neuraminidase. determined by a previously described quantitative, radioisotope Thrombin elaboration was evaluated by two semiquantitatechnique. Leukotive measures of soluble fibrin monomer complexes in plasma. penia but not thrombocytopenia inhibited both fibrin deposition and A non-specific effect of HN2 was excluded by thrombin elaboration. It was studying HN2-treated animals with normal leukocyte counts. concluded that leukocytes are essential and that platelets have little if any role in endotoxin induced intravascular coagulation. INTRODUCTION The mechanism by which two appropriately induce
intravascular
Intravascular prevented rabbits
fibrin
coagulation
deposition
Shwartzman reaction bloreover,
peritoneal
(1,2) .
by nitrogen
(GSR) (3,4) leukocytes
been shown to have thrombogenic coagulation
and renal
cortical
doses
incompletely
has been implicated
by anticoagulants made leukopenic
is
spaced
since
Leukocytes
nor fibrin
the process
deposition from endotoxin
activity
capable
403
(6).
can be
to be required
neither
obtained
necrosis
endotoxin
understood.
appear
mustard develop
of
the generalized
in organs treated
of inducing
since
(5). rabbits
intravascular
have
ENDOl?OXIN
404
The role
of platelets
of platelets
other
is
in the reaction
in rabbits
rendered
hand,
clear.
(7,8),
CLOTl’ING
Early
in complement-6
by a previously
3 occurs
endotoxin
described
was determined
factor
study,
antibodies deficient
fibrin
technique
Thrombocytopenia
means and the results with nitrogen
(9).
On the
rabbits
deposition
(5).
by two semiquantitative
monomer (FM) complexes.
the importance
in
(10).
induced
quantitative
indirectly
stressed
and the GSR has been shown to be inhibited
the GSR can be induced of platelet
Vo1.8,No.3
studies
by antiplatelet
In the present
leukopenic
less
T.V.
thrombocytopenic
which no release
immunologic
INDUCED
Thrombin elaboration
measures
was induced
compared with
was determined
of
fibrin
in rabbits
those
found
by non-
in rabbits
made
mustard. METHODS AND MATERIALS
Animal Models:
New Zealand
Sodium phentobarbital
(Nembutal)
from a polyethylene rabbit
was given
catheter
after
which a baseline
line
blood
was followed
radioisotope
(PE 90)
this
period,
(0)
blood
blood
followed
B E. coli
a carotid through
samples
injection
artery.
Each
a marginal
Collection
of the second
were collected
the animal was killed
5 animals
0 lll:B4,
Difco
by a second
(Type V, Sigma Chemicals, using
Bovine
hourly
for
and the organs
St.
Louis,
5 animals
of
ear
of basedose of 3 hours.
removed for
on blood
0.8
units/kg
the first
taken
(lipopoly-
25 ug/kg
75 ug/kg.
were given
MO., containing mucin)
endotoxin
Michigan)
injection
48 hours before
count was performed
were given
Laboratories,
endotoxin
submaxillary
(5 ml) intravenously
A platelet
Blood was collected
sample was taken.
Group II--Neuraminidase--Endotoxin:
saline
into
kg were used.
counting.
in 24 hours
protein,
1.8-2.5
anesthesia.
(1 mg) intravenously
Group I Control--Endotoxin: saccharide
weighing
inserted
by the intravenous
Subsequently,
At the end of
rabbits
was used for
12’1-fibrinogen
vein
endotoxin.
white
0.58
Neuraminidase
units
dissolved
per milligram in 0.85%
dose of endotoxin.
from a central
ear artery
just
ENDOTOXIN INDUCED I.V.
prior
to administering
endotoxin
was administered
HN2 72 hours
Mustard
before
on blood
were performed
dose of endotoxin.
24 hours
- Nitrogen
Group III given
the first
405
The second
dose of
as in Group I. 5 rabbits
(HN2) 24 hours--Endotoxin: dose of
from a central The second
dose of endotoxin.
of the first
later
the first taken
CLOTTING
endotoxin.
Platelet
ear artery dose of
were
and WBC counts
before
administration
endotoxin
was administered
(Fraction
I,
??
24 hours
later
as in Group I.
Labelled
Rabbit
Laboratories,
Fibrinogen:
Inc.,
Kankakee,
A 1% w/v solution
Rabbit Ill.)
(0.85% saline)
was purified was labelled
(11).
The specific
Counting:
A well
method of McFarlane
fibrinogen
as previously
with
described
lz5iodine
radioactivity
Miles
according
of the final
(5). to the
material
was S-10 uCi/mg. Radioisotope scaler
(Spectrometer
in the following lungs
organs
in tap water,
and divided expressed. material
counts
fibrin
White blood
(kg)
heart=1
as a multiple
(cortex),
the organs
unit). of
liver,
were washed
were used
for
the lowest
The radioactivity
the heart
by the total
of the rabbit.
deposition”
has previously
of stabilized
(cpm/g
were multiplied
as the “fibrin
kidney
have been found to be invariably
was expressed
by the weight
heart,
weight
count.
of
been shown to have the solubility
This
The
each organ
The sum of these
each rabbit.
to a
The radioactivity
dry and 1.0 gram portions
and were used as a reference
of radioactivity
was used.
blotted
(5)
organs
connected
from the animal,
counting.
units
The heart
counter
removal
for
in the other
Baird Atomic)
was determined:
After
and spleen.
thoroughly
Model 530,
scintillation
organ
counts
radioactive
characteristics
(5).
cells
(WBC) and platelets
were counted
on a Coulter
counter
(Model Fn). Soluble methods :
fibrin
1) A slight
monomer (FM) was determined modification
of the serial
by two semiquantitative dilution
protamine
sulfate
was
$06
ENDCTOXIN INDUCED I.V.
(SDPS) method (12)
was used.
Indianapolis,
Ind.)
the following
dilutions
liter
was mixed with l:lO,
:
(Pasteur
Inc.,
N.Y.)
N.Y.,
tenths
of
of fibrin
strands
(fs)
The FM concentration
criteria:
l+=l:lOfs
or g;
described
Two milliliter
samples
collected
with
of a millitest
titrated
2+=1:20fs
the test
l-4+
or g;
tubes.
plasma.
pH 7.4
ml.
using
by this
the SDPS test
of
N.J.)
reaction
4+=1:80fs
with Sepharose-4B
or g.
was utilized(13
from blood
8 ml per hour.
collected
of
fibrinogen
chromatographic
of
to 0.5
with
The volume of
by the staphylococcal
sensitive
was
to the following
or g;
preparation
and
was considered
to the column and eluted
a commercial
Somerville,
according
The concentration
was determined
tubes
Only the presence
tubes
plasma prepared
at a rate
Two
were mixed gently
a positive
3+=l:JOfs
were applied
in
FBA PHarmaceuticals
30 minutes.
containing
was graded
was 3.5
(SCT) method (14),
correlate
for
dilution
(9:l)
in each fraction
obtained
12x75 mm glass
poor
in any of
of platelet-poor
buffer
Diagnostic,
(pH 6.5)
Two tenths
The tubes
column chromatography
3.8% sodium citrate
The results
(g)
The last
2) Previously
(Behring
dilutions.
or a gel
recorded.
phosphate-citrate
Co.,
saline
(Trasylol,
at room temperature
reaction.
titer
into
aprotinin
sulfate
a positive
material
and 1:80.
Lilly
of plasma was then added to each of the test
to stand
each fraction
1:40
buffered
were added to 1 ml of platelet
the protamine
then allowed
of
1% (Eli
M Tris
were placed
pipette)
a milliliter
containing
sulfate,
0.05
1:20,
of each of the dilutions
Three drops
into
Protamine
CLOTTING
reactive
clumping staphylococci
ug/ml
of
fibrinogen.
method have been shown to
(1s). RESULTS
Platelets 205x103
:
The baseline
(123-330))
21~x103
platelet
were not significantly
the platelet
counts
different
in the neuraminidase
(p
vol.
8, pp. 403-411, Pergamon Press,
States
1976 Inc.
THE EFFECT OF LEtJKoP&lIA VERSUSTHROMBOCYTOPENIA ON ENDOTOXININDUCEDINTRAVASCULAR COAGULATION Boguslaw Lipinski and Victor Gurewich Vascular Laboratory, Lemuel Shattuck Hospital, Tufts University School of Medicine, Boston, Massachusetts
(Received 29.10.1975; in revised form Accepted by Editor S. Nie:.:iarowski)
4.2.1976.
ABSTRACT The effect of leukopenia and thrombocytopenia on endotoxin induced thrombin elaboration and fibrin deposition in rabbits were compared. Leukopenia was induced by pretreatment with nitrogen mustard (HN2) Fibrin deposition was and thrombocytopenia with neuraminidase. determined by a previously described quantitative, radioisotope Thrombin elaboration was evaluated by two semiquantitatechnique. Leukotive measures of soluble fibrin monomer complexes in plasma. penia but not thrombocytopenia inhibited both fibrin deposition and A non-specific effect of HN2 was excluded by thrombin elaboration. It was studying HN2-treated animals with normal leukocyte counts. concluded that leukocytes are essential and that platelets have little if any role in endotoxin induced intravascular coagulation. INTRODUCTION The mechanism by which two appropriately induce
intravascular
Intravascular prevented rabbits
fibrin
coagulation
deposition
Shwartzman reaction bloreover,
peritoneal
(1,2) .
by nitrogen
(GSR) (3,4) leukocytes
been shown to have thrombogenic coagulation
and renal
cortical
doses
incompletely
has been implicated
by anticoagulants made leukopenic
is
spaced
since
Leukocytes
nor fibrin
the process
deposition from endotoxin
activity
capable
403
(6).
can be
to be required
neither
obtained
necrosis
endotoxin
understood.
appear
mustard develop
of
the generalized
in organs treated
of inducing
since
(5). rabbits
intravascular
have
ENDOl?OXIN
404
The role
of platelets
of platelets
other
is
in the reaction
in rabbits
rendered
hand,
clear.
(7,8),
CLOTl’ING
Early
in complement-6
by a previously
3 occurs
endotoxin
described
was determined
factor
study,
antibodies deficient
fibrin
technique
Thrombocytopenia
means and the results with nitrogen
(9).
On the
rabbits
deposition
(5).
by two semiquantitative
monomer (FM) complexes.
the importance
in
(10).
induced
quantitative
indirectly
stressed
and the GSR has been shown to be inhibited
the GSR can be induced of platelet
Vo1.8,No.3
studies
by antiplatelet
In the present
leukopenic
less
T.V.
thrombocytopenic
which no release
immunologic
INDUCED
Thrombin elaboration
measures
was induced
compared with
was determined
of
fibrin
in rabbits
those
found
by non-
in rabbits
made
mustard. METHODS AND MATERIALS
Animal Models:
New Zealand
Sodium phentobarbital
(Nembutal)
from a polyethylene rabbit
was given
catheter
after
which a baseline
line
blood
was followed
radioisotope
(PE 90)
this
period,
(0)
blood
blood
followed
B E. coli
a carotid through
samples
injection
artery.
Each
a marginal
Collection
of the second
were collected
the animal was killed
5 animals
0 lll:B4,
Difco
by a second
(Type V, Sigma Chemicals, using
Bovine
hourly
for
and the organs
St.
Louis,
5 animals
of
ear
of basedose of 3 hours.
removed for
on blood
0.8
units/kg
the first
taken
(lipopoly-
25 ug/kg
75 ug/kg.
were given
MO., containing mucin)
endotoxin
Michigan)
injection
48 hours before
count was performed
were given
Laboratories,
endotoxin
submaxillary
(5 ml) intravenously
A platelet
Blood was collected
sample was taken.
Group II--Neuraminidase--Endotoxin:
saline
into
kg were used.
counting.
in 24 hours
protein,
1.8-2.5
anesthesia.
(1 mg) intravenously
Group I Control--Endotoxin: saccharide
weighing
inserted
by the intravenous
Subsequently,
At the end of
rabbits
was used for
12’1-fibrinogen
vein
endotoxin.
white
0.58
Neuraminidase
units
dissolved
per milligram in 0.85%
dose of endotoxin.
from a central
ear artery
just
ENDOTOXIN INDUCED I.V.
prior
to administering
endotoxin
was administered
HN2 72 hours
Mustard
before
on blood
were performed
dose of endotoxin.
24 hours
- Nitrogen
Group III given
the first
405
The second
dose of
as in Group I. 5 rabbits
(HN2) 24 hours--Endotoxin: dose of
from a central The second
dose of endotoxin.
of the first
later
the first taken
CLOTTING
endotoxin.
Platelet
ear artery dose of
were
and WBC counts
before
administration
endotoxin
was administered
(Fraction
I,
??
24 hours
later
as in Group I.
Labelled
Rabbit
Laboratories,
Fibrinogen:
Inc.,
Kankakee,
A 1% w/v solution
Rabbit Ill.)
(0.85% saline)
was purified was labelled
(11).
The specific
Counting:
A well
method of McFarlane
fibrinogen
as previously
with
described
lz5iodine
radioactivity
Miles
according
of the final
(5). to the
material
was S-10 uCi/mg. Radioisotope scaler
(Spectrometer
in the following lungs
organs
in tap water,
and divided expressed. material
counts
fibrin
White blood
(kg)
heart=1
as a multiple
(cortex),
the organs
unit). of
liver,
were washed
were used
for
the lowest
The radioactivity
the heart
by the total
of the rabbit.
deposition”
has previously
of stabilized
(cpm/g
were multiplied
as the “fibrin
kidney
have been found to be invariably
was expressed
by the weight
heart,
weight
count.
of
been shown to have the solubility
This
The
each organ
The sum of these
each rabbit.
to a
The radioactivity
dry and 1.0 gram portions
and were used as a reference
of radioactivity
was used.
blotted
(5)
organs
connected
from the animal,
counting.
units
The heart
counter
removal
for
in the other
Baird Atomic)
was determined:
After
and spleen.
thoroughly
Model 530,
scintillation
organ
counts
radioactive
characteristics
(5).
cells
(WBC) and platelets
were counted
on a Coulter
counter
(Model Fn). Soluble methods :
fibrin
1) A slight
monomer (FM) was determined modification
of the serial
by two semiquantitative dilution
protamine
sulfate
was
$06
ENDCTOXIN INDUCED I.V.
(SDPS) method (12)
was used.
Indianapolis,
Ind.)
the following
dilutions
liter
was mixed with l:lO,
:
(Pasteur
Inc.,
N.Y.)
N.Y.,
tenths
of
of fibrin
strands
(fs)
The FM concentration
criteria:
l+=l:lOfs
or g;
described
Two milliliter
samples
collected
with
of a millitest
titrated
2+=1:20fs
the test
l-4+
or g;
tubes.
plasma.
pH 7.4
ml.
using
by this
the SDPS test
of
N.J.)
reaction
4+=1:80fs
with Sepharose-4B
or g.
was utilized(13
from blood
8 ml per hour.
collected
of
fibrinogen
chromatographic
of
to 0.5
with
The volume of
by the staphylococcal
sensitive
was
to the following
or g;
preparation
and
was considered
to the column and eluted
a commercial
Somerville,
according
The concentration
was determined
tubes
Only the presence
tubes
plasma prepared
at a rate
Two
were mixed gently
a positive
3+=l:JOfs
were applied
in
FBA PHarmaceuticals
30 minutes.
containing
was graded
was 3.5
(SCT) method (14),
correlate
for
dilution
(9:l)
in each fraction
obtained
12x75 mm glass
poor
in any of
of platelet-poor
buffer
Diagnostic,
(pH 6.5)
Two tenths
The tubes
column chromatography
3.8% sodium citrate
The results
(g)
The last
2) Previously
(Behring
dilutions.
or a gel
recorded.
phosphate-citrate
Co.,
saline
(Trasylol,
at room temperature
reaction.
titer
into
aprotinin
sulfate
a positive
material
and 1:80.
Lilly
of plasma was then added to each of the test
to stand
each fraction
1:40
buffered
were added to 1 ml of platelet
the protamine
then allowed
of
1% (Eli
M Tris
were placed
pipette)
a milliliter
containing
sulfate,
0.05
1:20,
of each of the dilutions
Three drops
into
Protamine
CLOTTING
reactive
clumping staphylococci
ug/ml
of
fibrinogen.
method have been shown to
(1s). RESULTS
Platelets 205x103
:
The baseline
(123-330))
21~x103
platelet
were not significantly
the platelet
counts
different
in the neuraminidase
(p
