Effect of prostacyclin on platelet-activating factor induced rabbit and platelet aggregation

Platelet-activating factor antagonism: a new concept in the management of regional myocardial ischemia-reperfusion injury

Reperfusion therapies for treatment of myocardial infarction successfully reduce patient mortality; however, regional myocardial ischemia-reperfusion (RMIR) causes its own expression of cardiovascular dysfunction, including myocardial depression, hemodynamic instability, and dysrhythmias, which have increased patient mortality within the first 24 h after starting reperfusion therapy. Current evidence suggests that the release of oxygen-derived reactive substances and subsequent inflammatory mediators during ischemia-reperfusion contribute toward this injury. Platelet-activating factor (PAF), a mediator released during RMIR, has been emphasized by many investigators as playing a central role in causing RMIR injury. Similar cardiovascular dysfunctions that occur during RMIR, including myocardial depression, hemodynamic instability, and dysrhythmias, occur after administration of PAF and are ameliorated with PAF antagonists. Further, PAF antagonists have been shown to be cardioprotective and improve survival when administered before onset of reperfusion. A variety of phospholipid analogues, naturally derived compounds, and synthetic compounds have been developed that form the different classes of PAF antagonists, each with unique antagonizing properties. Several of these compounds have successfully passed safety and efficacy testing in humans; however, to date, no clinical trials have investigated the protective effects of PAF antagonists against RMIR injury. A current theory in the pathogenesis of RMIR injury considers the ischemic and necrotic portion of the myocardium and regional dysfunction due to tissue necrosis to be solely responsible for global cardiac dysfunction leading to hemodynamic instability and death. Evidence now suggests, however, that the global dysfunction is also due to the effect of inflammatory mediators such as PAF, thromboxanes, leukotrienes, and endothelins that are released during RMIR and are distributed throughout the heart on reperfusion. Antagonizing a central inflammatory mediator such as PAF, as adjunct treatment with currently used reperfusion therapies, improves cardiovascular function and survival in animals and should be introduced into clinical trials to investigate if similar protective effects can be provided in humans.

Platelet-activating factor and cardiac diseases: therapeutic potential for PAF inhibitors

Platelet-activating factor (PAF) is a potent phospholipid mediator released from inflammatory cells in response to diverse immunologic and non-immunologic stimuli. Animal studies have implicated PAF as a major mediator involved in coronary artery constriction, modulation of myocardial contractility and the generation of arrhythmias which may bear on cardiac disorders such as ischemia, infarction and sudden cardiac death. PAF effects are induced by direct actions of PAF on cardiac tissue to modify chronotropic and inotropic activity, or indirectly via the release of eicosanoids such as thromboxane A2 (TXA2), leukotrienes (LT) or cytokines (TNF alpha). The development of selective, high affinity PAF receptor antagonists has permitted investigations on the role of PAF in experimental animal models of cardiac injury. In vivo and in vitro studies strongly suggest that PAF receptor antagonists might convey therapeutic benefits in ischemic conditions and certain arrhythmias. In addition, PAF antagonists might have a cardiac allograft-preservation effect. Although clinical studies with PAF receptor antagonists in patients with cardiac diseases have not yet been reported, the experimental results to date suggest that PAF receptor antagonists might be useful in some specific cardiac disorders in humans.

Platelet-activating factor in stroke and brain injury

Platelet-activating factor, an endogenous phospholipid of proinflammatory, hemostatic, and vasoactive properties, is synthesized by neurons and in injured brain. Platelet-activating factor is released together with eicosanoids such as thromboxane A2, prostacyclin, and leukotrienes. Its effects in neurons are mediated through a specific receptor coupled to phospholipase C and phosphoinositol metabolism. The cerebrovascular effects of platelet-activating factor include disruption of the blood-brain barrier, edema formation, and vasospasm. It has also been described to possess direct toxicity to neuronal cells in culture. Discovery and development of several highly potent and selective antagonists to platelet-activating factor receptors facilitated experimental studies underscoring the role of this factor as an endogenous mediator in cerebral disorders, particularly cerebral ischemia and trauma. Significant biochemical, microvascular, functional, and behavioral recovery has been demonstrated using these antagonists in an array of experimental models of focal and global ischemia in the central nervous system (CNS). Clearly, studies of platelet-activating factor in experimental models of CNS ischemia and reperfusion injury open a new perspective on phospholipid metabolism in stroke and offer an exceptionally promising therapeutic prospect. Data supporting this factor as a mediator of specific pathological sequelae in stroke and neuroinjury are surveyed in this review. We discuss the mechanisms and significance of platelet-activating factor-mediated effects and propose directions for future studies.

Effects of BN 52063 and other agents inhibiting platelet-activating factor-induced contractile responses in rat portal vein

Platelet-activating factor (PAF-acether) is a potent agonist (EC50: 3.2 x 10(-8) M) of isolated rat portal vein. BN 52063 (composed of BN 52020, BN 52021 and BN 52022; molar ratio 2:2:1) specifically inhibits PAF-acether (10(-7) M) induced tone (IC50: 3.9 x 10(-5) M). Salbutamol (IC50: 3.1 x 10(-7) M), forskolin (IC50: 3.1 x 10(-6) M) and theophylline (IC50: 2.25 x 10(-4) M) are also effective in inhibiting PAF-acether-induced contractile responses and all excepting forskolin, show a certain specificity in this action. The basal myogenic activity of the rat portal vein is dose-dependently decreased by salbutamol (IC50: 1.2 x 10(-7) M), forskolin (IC50: 2.6 x 10(-6) M) and theophylline (IC50: 2.3 x 10(-4) M) whereas BN 52063 has no effect. The data suggest that rat portal veins possess specific PAF-acether receptors sensitive to BN 52063 and that PAF-acether effects could be inhibited by compounds which can bypass these putative receptors and modulate cAMP levels.

Mechanism of action of the platelet aggregation inhibitor purified from Agkistrodon halys (mamushi) snake venom

The platelet aggregation inhibitor purified from Agkistrodon halys snake venom inhibited rabbit platelet aggregations induced by thrombin, sodium arachidonate, collagen or ionophore A-23187. The IC50 was about 11 micrograms/ml in platelet aggregation regardless of which aggregation inducer was used. beta-Mercaptoethanol abolished both the phospholipase A enzymatic and platelet aggregation inhibitory activities of this venom inhibitor. p-Bromophenacyl bromide-treated venom inhibitor lost almost completely its phosphilipase A enzymatic activity, but retained its platelet aggregation inhibitory effect. In the presence of EGTA, the venom inhibitor still showed the same inhibitory activity on thrombin-, sodium arachidonate-, collagen- or ionophore A23187-induced platelet aggregations triggered by successive addition of Ca2+. The activation of platelet phospholipase A and the serotonin release reaction triggered by Ca2+ influx were unaffected by this venom inhibitor. It also inhibited the clot retraction of platelet-rich plasma. It is concluded that the inhibitory effect of the venom inhibitor on platelet aggregation is independent of its phospholipase A enzymatic activity. Its mode of action is different from those of other known platelet inhibitory drugs. This venom inhibitor possibly acts on a common step subsequent to platelet shape change, leading to inhibition of platelet aggregation.

Influence of the pure synthetic PAF (platelet aggregating factor) on clot retraction and platelet aggregation

Pure synthetic platelet aggregating factor (PAF) (1-O-Hexadecyl-2-acetyl-sn-glycero-3-phosphorylcholine) induces a dose-dependent platelet aggregation in platelet-rich plasma (PRP) and in gel-filtered platelets. Irreversible platelet aggregation was observed at final concentrations of PAF higher than 2 X 10-(7) mol/l, while reversible or two-wave aggregation was obtained with lower final concentrations. The second wave was inhibited by acetylsalicylic acid, indomethacin, dipyridamole, EDTA, EGTA, theophylline, caffeine, PGE1 and verapamil. PAF does not induce reptilase clot retraction (RCR); however, it does not inhibit RCR induced by ADP or thrombin. Since all substances known to activate platelets also induce RCR, the lack of this activity by PAF would support the existence of a third pathway in platelets.

Inhibitory effect of prostacyclin (PGI2) on neutropenia induced by intravenous injection of platelet-activating-factor (PAF) in the rabbit

Intravenous injection into rabbits of 1-O-octadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine (synthetic Platelet-Activating Factor (PAF)) or PAF derived from rabbit basophils caused acute thrombocytopenia and neutropenia which was consequent to the formation of intravascular polymorphonuclear neutrophil (PMN) aggregates and to their sequestration in the microvasculature, primarily of the lung. Infusion of prostacyclin (PGI2; 10 ng/Kg/min to 50 ng/Kg/min) inhibited in a dose-dependent manner PAF-induced thrombocytopenia and neutropenia as well as the sequestration of PMN in the pulmonary capillary network.

Effects of thromboxane synthetase inhibition on arachidonate metabolism and platelet behaviour

1 The effects of the thromboxane synthetase inhibitor dazoxiben (UK 37248) on arachidonic acid and collagen-induced platelet aggregation and arachidonate acid metabolism were studied both in vitro and ex vivo in the presence and absence of sources of prostaglandin I2 synthetase. 2 In platelets activated by exogenous arachidonic acid, the anti-aggregatory activity of dazoxiben was weak compared with indomethacin, despite comparable inhibition of TXB2 production. This was due to the accumulation of pro-aggregatory metabolites, principally endoperoxides. 3 The anti-aggregatory activity of dazoxiben, both in vitro and ex vivo, was higher and more consistent when platelets were stimulated by collagen, threshold levels of which resulted in an endoperoxide accumulation only 2-3% of that achieved with exogenous arachidonic acid. 4 The anti-aggregatory activity of dazoxiben is enhanced if drug equilibration is facilitated by prolonging the preincubation time from 2 to 15 minutes. 5 Incubation of platelets with pig aortic microsomes, which act both as aggregant and a source of PGI2 synthetase, facilitates the conversion to PGI2 of some endoperoxides accumulated after dazoxiben, resulting in augmented anti-aggregatory activity. 6 Leukocytes as well as blood vessels have the capacity to generate PGI2 from platelet derived endoperoxides. This was demonstrated by the increases in 6-keto-PGF1 alpha accompanying decreased TXB2 production in clotted whole blood from volunteers treated with dazoxiben. 7 It was concluded that a closer approach to in vivo conditions allowing a fuller expression of the mechanism of action of dazoxiben could be achieved in vitro by stimulating platelets with a pathophysiological activator such as collagen in the presence of a source of PGI2 synthetase.

A scanning electron microscopic investigation of effects of prostacyclin on platelet retention in glass bead columns

As whole blood passes through a column of glass beads, platelets are activated and all 3 basic platelet properties (adhesion, release reaction and aggregation) displayed, an aspect similar to platelets being involved in a hemostatic process. For this reason, we chose the platelet retention test as the tool to study the effect of synthetic prostacyclin (PGI2) on platelet function and behavior. PGI2 inhibited platelet retention with its major impact on platelet aggregation. The extent of inhibition was not proportional to the concentration of PGI2. It appears that 2 levels of platelet aggregation take place inside the column. One, triggered by a weak stimulus, is readily inhibitable by low concentrations of PGI2. The other, brought about by a strong stimulus, requires higher concentrations of PGI2 to achieve complete inhibition. Even with as much as 100 ng PGI2/ml blood, a 15% retention remained which probably represented platelet adhesion to glass beads. Scanning electron microscopic examination of glass beads showed massive platelet aggregation and adhesion in control blood samples. No platelet aggregate was observed on beads filtered with blood containing 20 ng/ml or more PGI2. Individual platelets were found on glass beads filtered with samples containing any concentrations of PGI2; these platelets exhibited extensive morphologic changes.