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1.
Food Funct ; 15(2): 1031-1049, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38193367

RESUMO

Orange juice is an important food source of bioactive compounds, mainly the flavanones hesperidin and narirutin. This study aimed to investigate the underlying molecular mechanisms of action of orange juice's health properties by analyzing changes in the plasma proteome of healthy Brazilian volunteers after consuming juices made from 'Bahia' (BOJ-source of flavanones) and 'Cara Cara' (CCOJ-source of flavanones and carotenoids) oranges cultivated in Brazil. We used an untargeted proteomic approach, with a particular emphasis on the juices' effects on blood coagulant activity. We identified 247 differentially expressed proteins, of which 170 significantly increased or decreased after BOJ consumption and 145 after CCOJ. These proteins are involved in 105 processes that can significantly regulate cell adhesion, cell signaling, cell metabolism, inflammation, or others. Bioinformatic analysis evidenced proteins with major cellular regulatory capacity (e.g., FN1 and GAPDH) and predicted transcription factors (TFs) (e.g., SP1 and CEBPA) and miRNAs (e.g., miR-1-3p and miR-615-3p) that could be involved in the regulation of differentially expressed proteins. In-silico docking analyses between flavanone metabolites and TFs evidenced the higher binding capacity of narirutin phase II metabolites with akt1 and p38, interactions that suggest how the expression of genes of differentially expressed proteins were activated or inhibited. Moreover, the study shed light on proteins of coagulation cascade that presented expression modulated by both juices, proposing the modulation of blood coagulant activity as a potential benefit of OJ (mainly CCOJ) consumption. Taken together, this study revealed that BOJ and CCOJ consumption affected plasma proteome in healthy individuals, suggesting potential molecular targets and mechanisms of OJ bioactive compounds in humans.


Assuntos
Citrus sinensis , Coagulantes , Flavanonas , MicroRNAs , Humanos , Citrus sinensis/química , Brasil , Proteoma/análise , Proteômica , Flavanonas/metabolismo , Sucos de Frutas e Vegetais , Frutas/química , MicroRNAs/metabolismo , Coagulantes/análise , Coagulantes/metabolismo
2.
Toxins (Basel) ; 13(8)2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34437385

RESUMO

Snakebite envenomation is a serious neglected tropical disease, and its management is often complicated by the diversity of snake venoms. In Asia, pit vipers of the Ovophis species complex are medically important venomous snakes whose venom properties have not been investigated in depth. This study characterized the venom proteomes of Ovophis convictus (West Malaysia), Ovophis tonkinensis (northern Vietnam, southern China), and Ovophis okinavensis (Okinawa, Japan) by applying liquid chromatography-tandem mass spectrometry, which detected a high abundance of snake venom serine proteases (SVSP, constituting 40-60% of total venom proteins), followed by phospholipases A2, snake venom metalloproteinases of mainly P-III class, L-amino acid oxidases, and toxins from other protein families which were less abundant. The venoms exhibited different procoagulant activities in human plasma, with potency decreasing from O. tonkinensis > O. okinavensis > O. convictus. The procoagulant nature of venom confirms that consumptive coagulopathy underlies the pathophysiology of Ovophis pit viper envenomation. The hetero-specific antivenoms Gloydius brevicaudus monovalent antivenom (GbMAV) and Trimeresurus albolabris monovalent antivenom (TaMAV) were immunoreactive toward the venoms, and cross-neutralized their procoagulant activities, albeit at variably limited efficacy. In the absence of species-specific antivenom, these hetero-specific antivenoms may be useful in treating coagulotoxic envenomation caused by the different snakes in their respective regions.


Assuntos
Crotalinae , Proteoma , Proteínas de Répteis , Venenos de Víboras , Animais , Antivenenos/imunologia , Coagulantes/análise , Coagulantes/imunologia , Coagulantes/toxicidade , Humanos , L-Aminoácido Oxidase/análise , L-Aminoácido Oxidase/imunologia , L-Aminoácido Oxidase/toxicidade , Metaloproteases/análise , Metaloproteases/imunologia , Metaloproteases/toxicidade , Fosfolipases A2/análise , Fosfolipases A2/imunologia , Fosfolipases A2/toxicidade , Plasma/efeitos dos fármacos , Proteoma/análise , Proteoma/imunologia , Proteoma/toxicidade , Proteômica , Proteínas de Répteis/análise , Proteínas de Répteis/imunologia , Proteínas de Répteis/toxicidade , Serina Proteases/análise , Serina Proteases/imunologia , Serina Proteases/toxicidade , Venenos de Víboras/química , Venenos de Víboras/imunologia , Venenos de Víboras/toxicidade
3.
PLoS Negl Trop Dis ; 14(4): e0007802, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32236099

RESUMO

Snakebite is a neglected tropical disease that results in a variety of systemic and local pathologies in envenomed victims and is responsible for around 138,000 deaths every year. Many snake venoms cause severe coagulopathy that makes victims vulnerable to suffering life-threating haemorrhage. The mechanisms of action of coagulopathic snake venom toxins are diverse and can result in both anticoagulant and procoagulant effects. However, because snake venoms consist of a mixture of numerous protein and peptide components, high throughput characterizations of specific target bioactives is challenging. In this study, we applied a combination of analytical and pharmacological methods to identify snake venom toxins from a wide diversity of snake species that perturb coagulation. To do so, we used a high-throughput screening approach consisting of a miniaturised plasma coagulation assay in combination with a venom nanofractionation approach. Twenty snake venoms were first separated using reversed-phase liquid chromatography, and a post-column split allowed a small fraction to be analyzed with mass spectrometry, while the larger fraction was collected and dispensed onto 384-well plates. After fraction collection, any solvent present in the wells was removed by means of freeze-drying, after which it was possible to perform a plasma coagulation assay in order to detect coagulopathic activity. Our results demonstrate that many snake venoms simultaneously contain both procoagulant and anticoagulant bioactives that contribute to coagulopathy. In-depth identification analysis from seven medically-important venoms, via mass spectrometry and nanoLC-MS/MS, revealed that phospholipase A2 toxins are frequently identified in anticoagulant venom fractions, while serine protease and metalloproteinase toxins are often associated with procoagulant bioactivities. The nanofractionation and proteomics approach applied herein seems likely to be a valuable tool for the rational development of next-generation snakebite treatments by facilitating the rapid identification and fractionation of coagulopathic toxins, thereby enabling specific targeting of these toxins by new therapeutics such as monoclonal antibodies and small molecule inhibitors.


Assuntos
Anticoagulantes/análise , Fatores Biológicos/análise , Coagulantes/análise , Peptídeos/análise , Proteínas/análise , Venenos de Serpentes/química , Animais , Coagulação Sanguínea/efeitos dos fármacos , Fracionamento Químico , Cromatografia Líquida , Humanos , Plasma/efeitos dos fármacos , Proteômica , Espectrometria de Massas em Tandem
4.
Molecules ; 25(3)2020 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-32024220

RESUMO

Aluminium exerts undeniable human health effects, so its concentration should be controlled in water treatment plants. The article presents and discusses the results of studies on the influence of selected properties of aluminium coagulants on the concentration of aluminium remaining in the purified water. The coagulants used were classical hydrolysing aluminium salts: aluminium sulphate (VI) and sodium aluminate as well as pre-hydrolysed polyaluminium chlorides: Flokor 105B and PAX XL10 that had different the alkalinity coefficient r = [OH-]/[Al3+]. The Al species distribution in the coagulants samples were analysed by the Ferron complexation timed spectrophotometry. On the basis of their reaction rates with ferron reagent, the aluminium species were divided into three categories: monomeric (Ala), medium polymerised (Alb) and colloidal (Alc). The usefulness of the tested aluminium coagulants due to the concentration of residual aluminium and dissolved aluminium, which is easily assimilated by the human body, was increased according to the following series: sodium aluminate (Ala = 100%, Alb = 0) < aluminium sulphate (VI) (Ala = 91%, Alb = 9%) < PAX XL 10 (Ala = 6%, Alb = 28%, r = 2.10) < Flokor 105B (Ala = 3%, Alb = 54%, r = 2.55).


Assuntos
Alumínio , Purificação da Água , Qualidade da Água , Água/análise , Alumínio/análise , Alumínio/química , Coagulantes/análise , Coagulantes/química , Humanos
5.
Environ Sci Pollut Res Int ; 26(36): 36296-36307, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31713819

RESUMO

Cake formed by flocs is a crucial factor to affect membrane fouling during coagulation-ultrafiltration process. To investigate the role of floc properties on cake, cake characteristics under various coagulant dosage conditions were calculated by scanning electron microscope (SEM) imaging. Results found that one SEM image with × 5000 magnification could accurately estimate cake porosity with relative error lower than 5.00% for all conditions, whereas more SEM images with × 10,000 magnification or × 20,000 magnification should be applied to calculate cake porosity precisely. This could be explained by different pore information of SEM images with various magnifications. Compared to single SEM image with × 10,000 magnification and × 20,000 magnification, single SEM image with × 5000 magnification contained the most comprehensive pore information and slightly overestimated pore area for pore smaller than 0.4 µm2 due to lower resolution. To verify feasibility by SEM image evaluating cake characteristics, cake porosity calculated by SEM image and Carman-Kozeny equation were analyzed. The results showed that cake porosity estimated by these two methods were nearly the same, proving the feasibility of this method. Moreover, with the increase of coagulant dosage, cake porosity presented similar variation with floc average size, indicating that floc average size was likely to dominate cake porosity in this study. For pore characteristics, pore average characteristic length and pore average area were in accordance with floc fractal dimension, whereas pore fractal dimension and pore amount were consistent with floc average size. This gives specific information about the relation between floc properties and cake characteristics.


Assuntos
Floculação , Microscopia Eletrônica de Varredura , Ultrafiltração/métodos , Incrustação Biológica/prevenção & controle , Coagulantes/análise , Fractais , Membranas Artificiais , Porosidade , Ultrafiltração/instrumentação
6.
Mil Med ; 184(Suppl 1): 392-399, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30901410

RESUMO

INTRODUCTION: The development of methods that generate individualized assessments of the procoagulant potential of burn patients could improve their treatment. Beyond its role as an essential intermediate in the formation of thrombin, factor (F)Xa has systemic effects as an agonist to inflammatory processes. In this study, we use a computational model to study the FXa dynamics underlying tissue factor-initiated thrombin generation in a small cohort of burn patients. MATERIALS AND METHODS: Plasma samples were collected upon admission (Hour 0) from nine subjects (five non-survivors) with major burn injuries and then at 48 hours. Coagulation factor concentrations (II, V, VII, VIII, IX, X, TFPI, antithrombin (AT), protein C (PC)) were measured and used in a computational model to generate time course profiles for thrombin (IIa), FXa, extrinsic tenase, intrinsic tenase and prothrombinase complexes upon a 5 pM tissue factor stimulus in the presence of 1 nM thrombomodulin. Parameters were extracted from the thrombin and FXa profiles (including max rate (MaxRIIa and MaxRFXa) and peak level (MaxLIIa and MaxLFXa)). Procoagulant potential was also evaluated by determining the concentration of the complexes at select times. Parameter values were compared between survivors and non-survivors in the burn cohort and between the burn cohort and a simulation based on the mean physiological (100%) concentration for all factor levels. RESULTS: Burn patients differed at Hour 0 (p < 0.05) from 100% mean physiological levels for all coagulation factor levels except FV and FVII. The concentration of FX, FII, TFPI, AT and PC was lower; FIX and FVIII were increased. The composition differences resulted in all nine burn patients at Hour 0 displaying a procoagulant phenotype relative to 100% mean physiological simulation (MaxLIIa (306 ± 90 nM vs. 52 nM), MaxRIIa (2.9 ± 1.1 nM/s vs. 0.3 nM/s), respectively p < 0.001); MaxRFXa and MaxLFXa were also an order of magnitude greater than 100% mean physiological simulation (p < 0.001). When grouped by survival status and compared at the time of admission, non-survivors had lower PC levels (56 ± 18% vs. 82 ± 9%, p < 0.05), and faster MaxRFXa (29 ± 6 pM/s vs. 18 ± 6 pM/s, p < 0.05) than those that survived; similar trends were observed for all other procoagulant parameters. At 48 hours when comparing non-survivors to survivors, TFPI levels were higher (108 ± 18% vs. 59 ± 18%, p < 0.05), and MaxRIIa (1.5 ± 1.4 nM/s vs. 3.6 ± 0.7 nM/s, p < 0.05) and MaxRFXa (13 ± 12 pM/s vs. 35 ± 4 pM/s, p < 0.05) were lower; similar trends were observed with all other procoagulant parameters. Overall, between admission and 48 hours, procoagulant potential, as represented by MaxR and MaxL parameters for thrombin and FXa, in non-survivors decreased while in survivors they increased (p < 0.05). In patients that survived, there was a positive correlation between FX levels and MaxLFXa (r = 0.96) and reversed in mortality (r= -0.91). CONCLUSIONS: Thrombin and FXa generation are increased in burn patients at admission compared to mean physiological simulations. Over the first 48 hours, burn survivors became more procoagulant while non-survivors became less procoagulant. Differences between survivors and non-survivors appear to be present in the underlying dynamics that contribute to FXa dynamics. Understanding how the individual specific balance of procoagulant and anticoagulant proteins contributes to thrombin and FXa generation could ultimately guide therapy and potentially reduce burn injury-related morbidity and mortality.


Assuntos
Queimaduras/sangue , Queimaduras/fisiopatologia , Coagulantes/análise , Análise de Variância , Área Sob a Curva , Testes de Coagulação Sanguínea/métodos , Queimaduras/enzimologia , Coagulantes/sangue , Estudos de Coortes , Fator Xa/análise , Humanos , Projetos Piloto , Curva ROC , Trombina/análise , Fatores de Tempo
7.
MedEdPORTAL ; 14: 10704, 2018 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-30800904

RESUMO

Introduction: Team-based learning (TBL) is an effective way to teach medical students a challenging topic: coagulation. This TBL requires students to discuss a differential diagnosis, order and analyze laboratory tests, and decide upon appropriate treatment. Methods: The coagulation TBL was utilized in a hematology/oncology system-based medical course. The TBL began with Individual and Group Readiness Assurance Tests (IRAT and GRAT, respectively) consisting of the same 10 multiple-choice questions. Next came a team application activity with the goal of evaluating a bleeding patient. Each team was given the clinical case and a whiteboard. Each team recorded a differential diagnosis and chose relevant laboratory tests from 20 hematology/coagulation assays placed in case-authoring software. Next, teams recorded the laboratory results, final diagnosis, and treatment on the whiteboards. Teams then voted for the best whiteboard. After discussing the highly voted whiteboard, instructors provided case discussion and elaboration about all 20 laboratory tests and their interpretation. Results: The IRAT average score was 77.0% compared to the GRAT group average of 99.5% for the year 2016-2017. Instructors noted great enthusiasm and teamwork. Institutional module evaluation feedback results showed that students were pleased and felt competent analyzing laboratory tests in a bleeding patient. Discussion: TBL provides a powerful way of teaching students the clinical reasoning approach to a bleeding patient and the appropriate use of laboratory test ordering and analysis. It is enjoyable and interactive and teaches students how to narrow their differential diagnosis by effective laboratory utilization.


Assuntos
Técnicas de Laboratório Clínico/métodos , Coagulantes/análise , Hemostasia/fisiologia , Aprendizagem Baseada em Problemas/métodos , Competência Clínica/normas , Técnicas de Laboratório Clínico/tendências , Coagulantes/sangue , Currículo/tendências , Diagnóstico Diferencial , Avaliação Educacional/métodos , Retroalimentação , Humanos , Inquéritos e Questionários
8.
Food Sci Technol Int ; 23(3): 254-264, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28359206

RESUMO

Free fatty acids and sensory profiles were obtained for cheeses made with raw goat milk and vegetable coagulant, derived from the cardoon flower ( Cynara cardunculus), at different ripening times (7 and 20 days). A solid-liquid phase extraction method followed by solid-phase extraction and gas chromatography was used. Profiles were also obtained with cheeses made with commercial coagulant, traditional kid rennet paste, and mixture coagulant (vegetable coagulant-kid rennet). The use of vegetable coagulant and vegetable coagulant-kid rennet is common in traditional Protected Designation of Origin cheeses such as " Queso Flor de Guía" and " Queso Media Flor de Guía" (Spain). Contents of short-chain free fatty acids (7.5-22.5 mmol·kg-1), medium-chain free fatty acids (0.4-3.7 mmol·kg-1), and long-chain free fatty acids (0.2-2.1 mmol·kg-1) varied depending on the coagulant type and the ripening time. Vegetable coagulant cheeses present odour intensity and flavour intensity much higher than commercial coagulant cheeses in the sensory analysis for cheeses obtained with seven days of ripening, but the values decrease when increasing the ripening time. Multivariate analysis allowed us to differentiate cheese samples according to the ripening time when using lipolytic profile and according to the coagulant type using the sensory profile.


Assuntos
Queijo/análise , Coagulantes/análise , Leite/química , Verduras/química , Animais , Quimosina/química , Coagulantes/química , Ácidos Graxos/análise , Ácidos Graxos/química , Ácidos Graxos não Esterificados/análise , Ácidos Graxos não Esterificados/química , Aromatizantes/análise , Aromatizantes/química , Flores/química , Manipulação de Alimentos/métodos , Microbiologia de Alimentos , Qualidade dos Alimentos , Tecnologia de Alimentos/métodos , Cabras , Lipólise , Leite/metabolismo , Paladar
9.
Sci Rep ; 6: 36027, 2016 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-27786274

RESUMO

The use of endangered animal products in traditional Chinese medicine (TCM) and other ethno-medicines is culturally widespread across many regions of Asia. In the present study, traditional efficacies of seven types of animal horn including antipyretic, sedative and procoagulant activities were evaluated. Shotgun proteomic analysis was performed on material from horns following separation into soluble and insoluble fractions. Over 200 proteins were identified in each sample using nano LC-MS/MS, and these were classified according to their molecular function and cellular component using principal component analysis (PCA). The results indicated that seven horns showed antipyretic, sedative and procoagulant effect. Proteomic analysis showed that YH and WBH were similar to RH in terms of protein profile, and GH was similar to SAH. In addition, YH and GH were similar to RH in their cellular component classification profile. PCA based on the composition of keratin and keratin-associated proteins showed that constituents of WBH and GH were similar to RH and SAH, respectively. This is the first analysis of the protein content of animal horns used in TCM, and it is effective to substitute the horn of endangered animals with sustainable alternatives from domestic animals.


Assuntos
Fatores Biológicos/análise , Fatores Biológicos/farmacologia , Cornos/química , Proteoma/análise , Animais , Antipiréticos/análise , Antipiréticos/farmacologia , Ásia , Cromatografia Líquida , Coagulantes/análise , Coagulantes/farmacologia , Hipnóticos e Sedativos/análise , Hipnóticos e Sedativos/farmacologia , Proteômica , Espectrometria de Massas em Tandem
10.
Water Sci Technol ; 74(2): 491-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27438255

RESUMO

Coagulant dosing control in drinking and wastewater treatment plants (WWTPs) is often limited to flow proportional concepts. The advanced multi-parameter-based dosing control systems have significantly reduced coagulant consumption and improved outlet qualities. Due to the long retention time in separation stages, these models are mostly based on feed-forward (FF) models. This paper demonstrates the improvement of such models with feed-back (FB) concepts with simplifications, making it possible to use even in systems with long separation stages. Full-scale case studies from a drinking water treatment plant and a WWTP are presented. The model qualities were improved by the dosage adjustment of the FB model, ranging from 66% to 197% of the FF model. Hence, the outlet qualities became more stable and coagulant consumption was further reduced in the range of 3.7%-15.5%.


Assuntos
Coagulantes/análise , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/análise , Poluentes Químicos da Água/química , Purificação da Água/métodos , Coagulantes/química , Coagulantes/metabolismo , Modelos Teóricos , Eliminação de Resíduos Líquidos/instrumentação , Purificação da Água/instrumentação
12.
Haemophilia ; 22(5): 713-20, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27217097

RESUMO

INTRODUCTION: Maintaining haemostasis in surgery is challenging for hereditary rare bleeding disorders in which multi-coagulation-factor concentrates are the only therapeutic option. Hereditary factor X (FX) deficiency affects 1:500 000 to 1:1 000 000 individuals, and no specific replacement FX concentrate has been available. A high-purity, plasma-derived FX concentrate (pdFX) has been developed for patients with hereditary FX deficiency. AIM: Our objective was to assess the safety and efficacy of pdFX in subjects with FX deficiency undergoing surgery. METHODS: Subjects with hereditary mild-to-severe FX deficiency (basal plasma FX activity [FX:C] <20 IU dL(-1) ) undergoing surgery received pdFX preoperatively to raise FX:C to 70-90 IU dL(-1) and postoperatively to maintain levels >50 IU dL(-1) until the subject was no longer at risk of bleeding due to surgery. Efficacy of pdFX was assessed by blood loss during surgery, requirement for blood transfusion, postoperative bleeding from the surgical or other sites, and changes in haemoglobin levels. Safety was assessed by adverse events (AEs), development of inhibitors, and clinically significant changes in laboratory parameters. RESULTS: Five subjects (aged 14-59 years) underwent seven surgical procedures (four major and three minor). Treatment duration was 1-15 days. For each procedure, pdFX treatment was assessed as "excellent" in preventing bleeding and achieving haemostasis. No blood transfusions were required, no AEs related to pdFX were observed, and no clinically significant trends were found in any laboratory parameters. CONCLUSION: These data demonstrate that pdFX is safe and effective as replacement therapy in five subjects with mild-to-severe FX deficiency undergoing surgery on seven occasions.


Assuntos
Coagulantes/uso terapêutico , Deficiência do Fator X/tratamento farmacológico , Fator X/uso terapêutico , Adolescente , Adulto , Coagulantes/análise , Coagulantes/isolamento & purificação , Fator X/análise , Fator X/isolamento & purificação , Deficiência do Fator X/patologia , Feminino , Hemoglobinas/análise , Hemorragia/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
13.
Haemophilia ; 22(5): 806-12, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27217329

RESUMO

INTRODUCTION: Although the variability in factor VIII (FVIII):C measurement is well recognized, this has not been widely reported for post-FVIII infusion samples. AIM/METHODS: Three samples from haemophilia A patients were distributed in a UK National External Quality Assessment Scheme survey, each after treatment with either ReFacto AF, Kogenate FS or Advate. Fifty-two UK haemophilia centres performed FVIII assays using one-stage (n = 46) and chromogenic (n = 10) assays. Centres calibrated assays with the local plasma standard and with ReFacto AF laboratory standard for the ReFacto AF sample. RESULTS/CONCLUSIONS: Chromogenic assays gave significantly higher results than one-stage assays (P < 0.0001, 32% difference) in the post-Kogenate sample but not in the post-ReFacto AF (11% higher by chromogenic assay, ns) or post-Advate samples (3% lower by chromogenic, ns) when assays were calibrated with plasma standards. Twenty centres used all Instrumentation Laboratory (IL)-activated partial thromboplastin time reagents (Synthasil)/IL deficient plasma/reference plasma) in the one-stage assay and 15 used all Siemens reagents (Actin FS/Siemens deficient plasma/reference plasma); this made a significant difference to results post-ReFacto AF (41% higher by IL reagents, P < 0.0001) and Advate (39% higher by IL reagents, P < 0.0001), but not Kogenate (7% higher by IL, ns) when calibrated with plasma standards. Differences between results obtained with different one-stage assay reagents for monitoring Advate have implications for dosing patients. Furthermore, there was considerable inter-laboratory variation as indicated by CVs in the range 15-26% for chromogenic assay and 12-19% for one-stage assay results. This study suggests that external quality assessment schemes should offer participation in post-FVIII infusion schemes where haemophilic patients are monitored.


Assuntos
Testes de Coagulação Sanguínea , Coagulantes/análise , Fator VIII/análise , Testes de Coagulação Sanguínea/normas , Compostos Cromogênicos/química , Coagulantes/normas , Coagulantes/uso terapêutico , Fator VIII/normas , Fator VIII/uso terapêutico , Hemofilia A/tratamento farmacológico , Humanos , Tempo de Tromboplastina Parcial , Kit de Reagentes para Diagnóstico
14.
Haemophilia ; 22(4): 514-20, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26930418

RESUMO

INTRODUCTION: We previously showed that pharmacokinetic-guided prophylaxis (PKP) allows the dosing interval to be extended while maintaining a specific trough level. However, the associations of peak factor VIII (FVIII) levels and area under the curve (AUC) with breakthrough bleeding have not been investigated. AIM: The aim of this study was to analyse data from the PKP arm to determine whether peak FVIII levels, AUC and time with FVIII levels in a haemostatically effective range are independent predictors of bleeding during prophylaxis. METHODS: Post hoc analysis of the association of FVIII levels and AUC with annualized bleeding rate in 34 patients on PKP. RESULTS: During 1 year of PKP, 131 bleeding episodes occurred in 24/34 patients. Average peak FVIII levels ranged from 24 to 168 IU dL(-1) , with higher values associated with a decreased risk for all bleeding (joint and non-joint; P < 0.01) and joint bleeding (P < 0.01). Following rFVIII infusion, median percent of time spent with FVIII levels >20 IU dL(-1) was 22%; median AUC was 1363. Both values were significantly associated with a lower ABR when targeting a 1% trough at 72 h. CONCLUSION: When PKP was administered every third day, higher peak FVIII levels, higher AUC and more time spent per week with FVIII levels >20 IU dL(-1) provided increased protection from joint and non-joint bleeding. These data highlight the potential impact of variability in individual pharmacokinetic and bleeding risk and support the need for high peak levels and AUC in some patients treated every third day. The findings do not necessarily apply to alternate-day or other prophylactic dosing regimens.


Assuntos
Coagulantes/uso terapêutico , Fator VIII/uso terapêutico , Hemofilia A/tratamento farmacológico , Hemorragia/prevenção & controle , Adolescente , Adulto , Área Sob a Curva , Criança , Coagulantes/análise , Coagulantes/farmacocinética , Fator VIII/análise , Fator VIII/farmacocinética , Hemofilia A/patologia , Humanos , Articulações , Masculino , Pessoa de Meia-Idade , Curva ROC , Risco , Índice de Gravidade de Doença , Adulto Jovem
15.
Thromb Res ; 139: 102-10, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26916304

RESUMO

INTRODUCTION: Coagulation factor concentrates like factor IX (FIX) and prothrombin complex concentrate (PCC) can contain anticoagulant substances that may hamper their procoagulant effectiveness in the treatment of hemophilia B or reversal of oral anticoagulation, as well as the laboratory assessment thereof. The aim of the present study was to evaluate the influence of anticoagulant heparin supplement on the prohemostatic potential of different PCCs and FIX concentrates. MATERIALS AND METHODS: Prohemostatic potential was evaluated in vitro employing PT/aPTT, thrombography (TGA) and thromboelastography (TEG) with FIX deficient plasma, vitamin K antagonist (VKA)-anticoagulated plasma and plasma anticoagulated with rivaroxaban. RESULTS: Most PCCs contained heparin, while heparin was detected in 1 out of 4 examined FIX concentrates. All heparin-containing clotting factor concentrates showed severely hampered prohemostatic effects when therapeutic doses were added to anticoagulated plasmas. Upon heparin removal, comparable prohemostatic effects were observed. Of importance is the notion that the anticoagulant effect of heparin was enhanced by rivaroxaban, resulting in a 7 fold increased PT sensitivity towards heparin in the presence of 500µg/L rivaroxaban. CONCLUSIONS: Compositional differences between clotting factor concentrates should be taken into account. Therapeutic levels of heparin may be co-infused when treating emergency bleeds with high prohemostatic drug doses, particularly those recommended in the reversal of non-VKA anticoagulants such as rivaroxaban by PCC. Given the relative short half-life of heparin compared to vitamin K-dependent clotting factors, an anticoagulant heparin effect shortly after concentrate infusion should be considered clinically and while interpreting laboratory coagulation parameters.


Assuntos
Anticoagulantes/farmacologia , Fatores de Coagulação Sanguínea/farmacologia , Coagulação Sanguínea/efeitos dos fármacos , Coagulantes/farmacologia , Fator IX/farmacologia , Heparina/farmacologia , Anticoagulantes/análise , Fatores de Coagulação Sanguínea/análise , Testes de Coagulação Sanguínea , Coagulantes/análise , Combinação de Medicamentos , Fator IX/análise , Hemofilia B/tratamento farmacológico , Heparina/análise , Humanos
17.
Biologicals ; 41(6): 393-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24051302

RESUMO

BACKGROUND: Studies have demonstrated that traces of activated factor XI (FXIa) present in specific brands of intravenous immunoglobulin (IVIG) concentrates may pose a thrombogenic risk. AIM: To characterize procoagulant activity during fractionation and the elimination capacity of the Flebogamma(®) DIF (Grifols' IVIG) manufacturing process. METHODS: Flebogamma(®) DIF fractionation steps included cryoprecipitate supernatant (Cryo/S), Fraction (Fr) I supernatant, and Fr II + III suspension. Purification steps included ultrafiltrate I, acid treatment, and pasteurization. Samples were assessed for total protein, IgG, and procoagulant activation markers. RESULTS: Cryo/S showed no procoagulant activity for prekallikrein activator (PKA), kallikrein-like, and non-activated partial thromboplastin time (NaPTT) with normal (-PPP) or FXI-deficient (-FXI) platelet poor plasma. Thrombin generation test (TGT)-PPP and TGT-FXI were <83-148 and <53-197 nM thrombin, respectively. Shortened NaPTTs (100-296 s), high PKA (51-119 IU/mL), kallikrein-like activities (0.043-0.075 ΔAU/min), positive TGTs (98-298 nM), and FXIa (9.5-14.0 ng/mL) were detected in Fr II + III. After pasteurization, no residual evidence of any procoagulant activity marker was observed, including the final IVIG concentrate at 5% or 10% protein. Results were similar in Fr II + III from different IVIG manufacturing facilities. CONCLUSIONS: The Flebogamma(®) DIF production process is capable of eliminating procoagulant activity because of its purification steps.


Assuntos
Coagulantes/isolamento & purificação , Contaminação de Medicamentos/prevenção & controle , Fator XIa/isolamento & purificação , Imunoglobulinas Intravenosas/isolamento & purificação , Fracionamento Químico/métodos , Coagulantes/análise , Fator XIa/análise , Humanos , Imunoglobulinas Intravenosas/análise , Imunoglobulinas Intravenosas/normas , Controle de Qualidade , Reprodutibilidade dos Testes
18.
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1484529

RESUMO

The venom of the family Viperidae, including the saw-scaled viper, is rich in serine proteinases and metalloproteinases, which affect the nervous system, complementary system, blood coagulation, platelet aggregation and blood pressure. One of the most prominent effects of the snake venom of Echis carinatus (Ec) is its coagulation activity, used for killing prey. Materials and methods Subfractions F1A and F1B were isolated from Ec crude venom by a combination of gel chromatography (Sephadex G-75) and ion exchange chromatography on a DEAE-Sepharose (DE-52). These subfractions were then intravenously (IV) injected into NIH male mice. Blood samples were taken before and after the administration of these subfractions. Times for prothrombin, partial thromboplastin and fibrinogen were recorded. Results and conclusions Comparison of the prothrombin time before and after F1A and F1B administrations showed that time for blood coagulation after injection is shorter than that of normal blood coagulation and also reduced coagulation time after Ec crude venom injection. This difference in coagulation time shows the intense coagulation activity of these subfractions that significantly increase the coagulation cascade rate and Causes to quick blood coagulation. The LD50 of the Ec crude venom was also determined to be 11.1 μg/mouse. Different crude venom doses were prepared with physiological serum and injected into four mice. Comparison of the prothrombin times after injection of subfractions F1A and F1B showed that the rate of mouse blood coagulation increases considerably. Comparing the partial thromboplastin times after injecting these subfractions with this normal test time showed that the activity rate of intrinsic blood coagulation system rose sharply in mice. Finally, by comparing the fibrinogen time after subfraction injections and normal test time, we can.


Assuntos
Animais , Coagulantes/análise , Homeostase , Metaloproteases/análise , Serina Proteases , Cromatografia/métodos , Toxicophis pugnax/análise
19.
Haemophilia ; 19(2): 304-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23174010

RESUMO

Factor-Eight-Inhibitor-Bypassing-Activity (FEIBA) is a bypassing-agent used to control spontaneous bleeding or cover surgical interventions in Haemophiliacs who develop neutralizing antibodies against FVIII/FIX. The market lot-release of FEIBA is dependent on specific clot-based assays, carried out by both the manufacturer and regulatory authorities, relative to manufacturer's in-house standards, which are produced on a small-scale and are replaced frequently. We sought to standardize the FEIBA assay by developing a FEIBA primary standard which would be internationally available in sufficiently large quantities, with a predicted lifetime of many years. A collaborative study involving the manufacturer and three regulatory authorities, was carried out in which a candidate material, sample B (06/172), was calibrated by assays relative to the manufacturer's in-house FEIBA standards (C and D). All laboratories used their routine validated methods (16 APTT-assays, 8 ACTIN-FS-assays and 27 DAPTTIN-assays). Intra-laboratory geometric coefficients of variation (GCVs) for candidate B ranged from 3% to 29% (GCVs <9% from majority of labs). Assessment of inter-laboratory variability gave overall GCV values of 6.9% and 4.4% relative to standards C and D, respectively, for all methods. There was good agreement in potency estimation between laboratories using each of the three methods, with the overall potencies by the three methods differing by less than 10% of the overall mean, giving an overall combined potency of 28.0 units per ampoule. All participants agreed that candidate B (06/172) be established as the 1st NIBSC Working Standard for FEIBA with an assigned potency of 28.0 units per ampoule, based on combined results for both methods, relative to either standard C or D.


Assuntos
Fatores de Coagulação Sanguínea/uso terapêutico , Coagulantes/uso terapêutico , Tempo de Tromboplastina Parcial , Análise de Variância , Fatores de Coagulação Sanguínea/análise , Fatores de Coagulação Sanguínea/normas , Calibragem , Coagulantes/análise , Coagulantes/normas , Padrões de Referência , Procedimentos Cirúrgicos Operatórios
20.
Basic Clin Pharmacol Toxicol ; 111(4): 268-74, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22682331

RESUMO

Research into Australian elapid venoms has mainly focused on the seven genera of greatest clinical significance: Acanthophis, Hoplocephalus, Notechis, Oxyuranus, Pseudechis, Pseudonaja and Tropidechis. However, even small species represent a potential for causing severe clinical envenoming. Further, owing to taxonomic distinctiveness, these species are a potential source of novel toxins for use in drug design and development. This is the first study to characterize the venoms of Cryptophis boschmai, Denisonia devisi, Echiopsis curta, Hemiaspis signata and Vermicella annulata. MALDI analysis of each venom, over the range of 4-40 kDa, indicated components in the weight range for three finger toxins (6-8 kDa) and phospholipase A(2) (PLA(2) ; 12-14 kDA). Interestingly, C. boschmai venom was the only venom, which contained components > 25 kDa. All venoms (10 µg/ml) demonstrated in vitro neurotoxicity in the chick biventer cervicis nerve-muscle preparation, with a relative rank order of: H. signata ≥ D. devisi ≥ V. annulata = E. curta > C. boschmai. CSL polyvalent antivenom neutralized the inhibitory effects of C. boschmai venom but only delayed the inhibitory effect of the other venoms. All venoms displayed PLA(2) activity but over a wide range (i.e. 1-621 µmol/min./mg). The venoms of C. boschmai (60 µg/kg, i.v.), D. devisi (60 µg/kg, i.v.) and H. signata (60 µg/kg, i.v.) produced hypotensive effects in vivo in an anaesthetized rat preparation. H. signata displayed moderate pro-coagulant activity while the other venoms were weakly pro-coagulant. This study demonstrated that these understudied Australian elapids have varying pharmacological activity, with notable in vitro neurotoxicity for four of the venoms, and may produce mild to moderate effects following systemic envenoming.


Assuntos
Venenos Elapídicos/toxicidade , Elapidae/classificação , Neurotoxinas/toxicidade , Animais , Antivenenos/farmacologia , Austrália , Galinhas , Coagulantes/análise , Coagulantes/metabolismo , Venenos Elapídicos/química , Masculino , Junção Neuromuscular/efeitos dos fármacos , Neurotoxinas/química , Fosfolipases A2/metabolismo , Ratos
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