To define the interaction of fibrinolytic components with platelets or coagulation factors on thrombus formation, we investigated mouse deficient in tissue plasminogen activator (tPA -/-) or urokinase plasminogen activator (uPA -/-) and in their wild-type control (tPA +/+, uPA +/+). A thrombus was induced in the murine carotid artery using photochemical reaction. Blood flow was monitored and the time needed before the vessel became completely obstructed was within 12 min in all types of mice. When DX-9065a, a selective factor Xa inhibitor, or GR144053, a platelet glycoprotein (GP) complex IIb/IIIa antagonist was applied, the time required to occlusion was prolonged in a dose-dependent manner in all types of mice. When a factor Xa inhibitor was injected in tPA -/- mice, the estimated ED50 was not changed. However, when GR144053 was injected in tPA -/- mice, the most significant changes were observed: the estimated ED51 was 19.6 times higher than the one in tPA +/+ mice. Platelet aggregation, hemostasis tests, and bleeding times were not significantly different among the different types of mice. In conclusion, the antithrombotic effect of platelet inhibition by a GPIIb/IIIa antagonist, is severely affected by the absence or presence of tPA production. On the contrary, the inhibition of factor Xa shows a stable antithrombotic effect with or without tPA. Thus the lack of tPA, but not of uPA, significantly affects antithrombotic efficacy.
Thrombosis in the inner ear is regarded as one of the causes of equilibrium dysfunction. We have established an experimental thrombosis model by producing a photochemical reaction between rose bengal and green light, and have evaluated the dysfunction with a new rotatory test system. Hamsters were treated with tissue-type plasminogen activator (tPA) in doses of 0, 0.13, 0.26, and 0.52 mg/kg. The equilibrium dysfunction of the hamsters was evaluated by scoring their behavior according to visual observation and by measuring their time on the rotatory test system. Treatment of animals with sufficient tPA (> or = 0.26 mg/kg) caused a significant amelioration of the behavior and a concomitant significant prolongation of time on the rotating globe. These findings suggest that the equilibrium dysfunction induced by the photochemical reaction was due to the thrombi formed, and that our test system may provide a useful tool for evaluating equilibrium dysfunction in hamsters.
Using a contact Nd-YAG laser, we vaporized the pathological inferior turbinates of 24 patients with perennial allergic rhinitis and hypertrophic rhinitis resistant to medical treatment. The patients were 18 males and 6 females, aged 4.67 years. This operation was performed as one day out patient surgery in 20 of the 24 patients. About two weeks after the treatment, 18 out of 22 patients no longer needed anti-allergic or any other drugs. One month after the treatment, 13 out of 17 patients were in no need of any drugs. One patient had been under treatment for nine months. We conclude that contact Nd-YAG laser surgery is useful for the treatment of turbinate dysfunction in patients with perennial allergic rhinitis and hypertrophic rhinitis resistant to medical treatment.
The antithrombotic effect of GR144053, which inhibits platelet aggregation by binding to the fibrinogen receptor (glycoprotein IIb/IIIa), was investigated in vitro and in vivo by using hamsters. This compound inhibited the platelet aggregation induced by adenosine diphosphate (ADP; 2.5 μM) with a mean inhibitory concentration (IC50) value of 2.2 ± 0.4 × 10−5M. Vascular injury was inflicted in one carotid artery by using a modified catheter to produce endothelial denudation. In the control group, arterial blood flow was interrupted 4.4 ± 2.3 min (n = 12) after the injury. When GR144053 continuously infused intravenously at doses of 0 (saline) 0.1, 0.3, and 1.0 mg/kg/h (n = 8, each), the time that elapsed before the vessel became completely obstructed was prolonged in a dose-dependent manner. In separate experiments, reperfusion could be obtained by continuous infusion of tissue-type plasminogen activator (tPA; 0.52 mg/kg) starting 30 min after the initiation of thrombus formation. When GR144053 (0.3 and 1.0 mg/kg/h) was infused in addition to tPA, the incidence of reperfusion and the later patency of the reperfused artery were much improved as compared with tPA alone. The bleeding time at the end of tPA infusion was significantly prolonged in the presence of the highest dose of GR144053. Next, neointima formation was evaluated 2 weeks after the vascular injury. When GR144053 (0.3 mg/kg/h) was continuously infused i.v. by an implanted osmotic pump for 14 days, the neointimal area was significantly reduced. In separate hamsters, the proliferating index of smooth muscle cells (SMCs) by using bromodeoxyuridine (BrdU) was investigated, and treatment with both tPA and GR144053 significantly decreased the SMC proliferation index in vivo. However, in the in vitro experiments using a hamster SMC line, GR144053 did not have an inhibitory effect on SMC proliferation. These findings suggest that GR144053 inhibits platelet activation on the injured artery and improves vascular patency after thrombolysis with tPA, which furthermore results in suppression of neointima formation.
