RESUMO
Objetivo: Analisar os testes de coagulação: tempo de protrombina (TP) e tempo de tromboplastina parcial (TTP) em diferentes tempos de centrifugação da amostra da biológica, com relação ao protocolo padrão do Clinical Laboratory Standards Institute (CLSI). Métodos: As amostras foram divididas em cinco alíquotas de 1 mL. Foi realizada a centrifugação em 15, 10, 5, 2 e 1 minuto, com velocidade de 1500 g. O TP e TTP foram imediatamente analisados em aparelho automatizado. Os plasmas foram analisados para presença de elementos residuais: eritrócitos, leucócitos e plaquetas. Resultados: Observou-se alteração dos valores do TP nos tempos de centrifugação 10, 5, 2 e 1 minuto e do TTP em 5, 2 e 1 minuto, com relação ao protocolo padrão. Na interpretação de Bland Altman, observou-se um viés significativo do limite clínico aceitável para o TP e para o TTP em todos os tempos de centrifugação, com relação ao protocolo padrão. Apenas no tempo de centrifugação de 15 minutos não foram encontradas células residuais nas amostras analisadas. Conclusão: O tempo de centrifugação de 15 minutos é o ideal para remoção completa das células sanguíneas residuais e para garantia da confiabilidade dos resultados dos testes de coagulação TP e TTP.
Objective: To analyze the coagulation tests: prothrombin test (PT) and partial thromboplastin time (PTT) in different centrifugation times of the sample, in relation to the standard protocol of the Clinical Laboratory Standards Institute (CLSI). Methods: The selected samples were splitted up into five aliquots of 1 mL. Centrifugation of these aliquots was carried out at 15, 10, 5, 2 and 1 minute at 1500 g. The PT and PTT were analyzed in an automated apparatus. The plasmas were analyzed for presence of residual elements: erythrocytes, leukocytes and platelets. Results: The results showed a change in the values of PT at the 10, 5, 2 and 1 minute centrifugation times and the PTT at 5, 2 and 1 minutes, relative to the standard protocol. In the interpretation of Bland Altman, a significant bias of the acceptable clinical limit for TP and TTP at all centrifugation times was observed, relative to the standard protocol. Only in the 15 minute centrifugation time no residual cells were found in the analyzed samples. Conclusion: The present study demonstrated that the 15-minute centrifugation time is ideal for complete removal of residual blood cells and to ensure the reliability of the results of the PT and PTT coagulation
Assuntos
Humanos , Masculino , Feminino , Tempo de Protrombina , Testes de Coagulação Sanguínea , CentrifugaçãoRESUMO
En la década de los años sesenta, se describió la cascada de la coagulación como una secuencia de eventos enzimáticos iniciada por dos vías, la intrínseca y la extrínseca, las cuales convergían en una vía común para generar una enzima multifuncional, denominada trombina. La principal función de esta enzima consistía en transformar el fibrinógeno, en fibrina, una proteína que se polimeriza espontáneamente para formar la base estructural del coágulo. Posteriormente, se propuso el Modelo Celular según el cual la coagulación no es la consecuencia de vías de activación enzimáticas secuenciales, sino de una red de interacciones entre proteínas plasmáticas y transmembranas, así como, varios tipos celulares, que permiten la formación de complejos enzimáticos altamente eficientes con la finalidad de generar trombina. Esta revisión explica en detalle ambos enfoques, además, aborda las diferentes funciones que cumple la trombina dentro de la hemostasia y los mecanismos de inhibición que regulan la coagulación. Finalmente, se describen diferentes pruebas empleadas en la actualidad para evaluar la funcionalidad del sistema de coagulación, como: el tiempo de tromboplastina parcial activado, el tiempo de protrombina, el tiempo de trombina, el tiempo de reptilasa, el tiempo de coagulación por ecarina y el uso de sustratos cromogénicos para evaluar cada factor de la coagulación. Finalmente, dado a que la generación de trombina es clave dentro de la coagulación y a que el potencial de generar trombina puede indicar propensión a desarrollar eventos trombóticos o hemorrágicos, en este trabajo se presentan los métodos existentes para determinar la generación de trombina.
In the sixties, the clotting cascade was proposed, which describes the coagulation process as a sequence of enzymatic events initiated by two different pathways, the intrinsic and the extrinsic pathways, converging on a common pathway, to generate a multifunctional enzyme, thrombin, whose main function is to convert fibrinogen into fibrin, a protein that polymerizes spontaneously to form the building block of a hemostatic clot. Later, it was proposed a cell-based model of the hemostasis according to that coagulation does not occur as a consequence of linear sequential enzyme activation pathways, but rather via a network of simultaneous interactions between plasmatic and transmembrane proteins, as well as several cellular types, that allow the formation of highly efficient enzymatic complexes that lead to thrombin generation. In this review, we summarize these two approaches highlighting the functions of thrombin within the hemostasis and the inhibition mechanisms that regulate the blood coagulation. Moreover, we described different tests that are used to assess the function of the coagulation system, such as: activated partial thromboplastin time, prothrombin time, thrombin time, reptilase time, ecarin clotting time, and the use of chromogenic substrates to evaluate individual coagulation factors. Finally, because of thrombin generation is a fundamental part of the blood coagulation and, an estimation of how well a particular individual can generate thrombin may correlate with either a risk of bleeding or thrombosis, we also include the existing methods to evaluate the potential of thrombin generation in an individual.
Assuntos
Humanos , Coagulação Sanguínea/fisiologia , Testes de Coagulação Sanguínea , Testes de Coagulação Sanguínea/métodos , Fibrina/fisiologia , Trombina/fisiologiaRESUMO
The reportedly low standard quality of heparin (HEP) for use in cardiac surgerieshas led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) fromseaweeds have been regarded as promising substitutes for HEP. The aim of this study was tosequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed byfractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate theanticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) usingnormal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions werechemically characterized by chemical composition and agarose gel electrophoresis. The yield was4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl,respectively, were observed on chromatography profiles; however, differences in charge densitiespatterns and degree of resolution among them were revealed by electrophoresis. SPs were capableof modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C.cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.(AU)
O baixo padrão dequalidade outrora declarado da heparina (HEP) para o uso em cirurgias cardíacas tem levadopreocupação nos mercados nacional e internacional. Os polissacarídeos sulfatados (PSs) de algasmarinhas têm sido considerados como promissores substitutos para HEP. Objetivou-se a extrairsequencialmente PSs totais (PSTs) da clorofícea Caulerpa cupressoides com papaína em tampãoacetato de sódio 100 mM (pH 5,0) contendo cisteína 5 mM e EDTA 5 mM, fracionar porcromatografia de troca iônica (DEAE-celulose) e avaliar o potencial anticoagulante das frações dePS por meio do tempo de tromboplastina parcial ativada (TTPA), utilizando plasma humanonormal e comparando-se à HEP padrão (193 IU mg-1). As frações obtidas foram caracterizadasquimicamente em composição química e por eletroforese em gel de agarose. O rendimento dePSTs foi 4,61% e os perfis cromatográficos, em DEAE-celulose, indicaram a separação de trêsfrações de PS (F I; F II e F III) eluídas nas concentrações 0,50; 0,75 e 1,00 M de NaCl,respectivamente, revelando, por eletroforese, diferenças em termos de densidade de cargas e graude resolução. Os PSs foram capazes de modificar o TTPA somente nas frações eluídas com 0,75M de NaCl, cujas atividades foram 23,37 e 25,76 IU mg-1, respectivamente, quando a densidadede cargas foi pré-requisito para atividade. Portanto, C. cupressoides é uma fonte de PSs com baixospotenciais anticoagulantes comparados à HEP.(AU)
Assuntos
Lycopodium , Polissacarídeos , Alga MarinhaRESUMO
The reportedly low standard quality of heparin (HEP) for use in cardiac surgeries has led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) from seaweeds have been regarded as promising substitutes for HEP. The aim of this study was to sequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100 mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed by fractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate the anticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) using normal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions were chemically characterized by chemical composition and agarose gel electrophoresis. The yield was 4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl, respectively, were observed on chromatography profiles; however, differences in charge densities patterns and degree of resolution among them were revealed by electrophoresis. SPs were capable of modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and 25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C. cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.
O baixo padrão de qualidade outrora declarado da heparina (HEP) para o uso em cirurgias cardíacas tem levado preocupação nos mercados nacional e internacional. Os polissacarídeos sulfatados (PSs) de algas marinhas têm sido considerados como promissores substitutos para HEP. Objetivou-se a extrair sequencialmente PSs totais (PSTs) da clorofícea Caulerpa cupressoides com papaína em tampão acetato de sódio 100 mM (pH 5,0) contendo cisteína 5 mM e EDTA 5 mM, fracionar por cromatografia de troca iônica (DEAE-celulose) e avaliar o potencial anticoagulante das frações de PS por meio do tempo de tromboplastina parcial ativada (TTPA), utilizando plasma humano normal e comparando-se à HEP padrão (193 IU mg-1). As frações obtidas foram caracterizadas quimicamente em composição química e por eletroforese em gel de agarose. O rendimento de PSTs foi 4,61% e os perfis cromatográficos, em DEAE-celulose, indicaram a separação de três frações de PS (F I; F II e F III) eluídas nas concentrações 0,50; 0,75 e 1,00 M de NaCl, respectivamente, revelando, por eletroforese, diferenças em termos de densidade de cargas e grau de resolução. Os PSs foram capazes de modificar o TTPA somente nas frações eluídas com 0,75 M de NaCl, cujas atividades foram 23,37 e 25,76 IU mg-1, respectivamente, quando a densidade de cargas foi pré-requisito para atividade. Portanto, C. cupressoides é uma fonte de PSs com baixos potenciais anticoagulantes comparados à HEP.
Assuntos
Coagulação Sanguínea , ClorófitasRESUMO
The reportedly low standard quality of heparin (HEP) for use in cardiac surgeries has led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) from seaweeds have been regarded as promising substitutes for HEP. The aim of this study was to sequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100 mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed by fractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate the anticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) using normal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions were chemically characterized by chemical composition and agarose gel electrophoresis. The yield was 4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl, respectively, were observed on chromatography profiles; however, differences in charge densities patterns and degree of resolution among them were revealed by electrophoresis. SPs were capable of modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and 25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C. cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.
The reportedly low standard quality of heparin (HEP) for use in cardiac surgeries has led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) from seaweeds have been regarded as promising substitutes for HEP. The aim of this study was to sequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100 mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed by fractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate the anticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) using normal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions were chemically characterized by chemical composition and agarose gel electrophoresis. The yield was 4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl, respectively, were observed on chromatography profiles; however, differences in charge densities patterns and degree of resolution among them were revealed by electrophoresis. SPs were capable of modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and 25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C. cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.
RESUMO
The reportedly low standard quality of heparin (HEP) for use in cardiac surgeries has led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) from seaweeds have been regarded as promising substitutes for HEP. The aim of this study was to sequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100 mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed by fractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate the anticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) using normal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions were chemically characterized by chemical composition and agarose gel electrophoresis. The yield was 4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl, respectively, were observed on chromatography profiles; however, differences in charge densities patterns and degree of resolution among them were revealed by electrophoresis. SPs were capable of modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and 25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C. cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.
The reportedly low standard quality of heparin (HEP) for use in cardiac surgeries has led to concern in the Brazilian and international markets. Sulfated polysaccharides (SPs) from seaweeds have been regarded as promising substitutes for HEP. The aim of this study was to sequentially extract total SPs (TSPs) from Caulerpa cupressoides (Chlorophyceae) with papain in 100 mM sodium acetate buffer (pH 5.0) containing 5 mM cysteine and 5 mM EDTA, followed by fractionation by ion-exchange chromatography (DEAE-cellulose), and then evaluate the anticoagulant potential of SP fractions by activated partial thromboplastin time (APTT) using normal human plasma and compare it to standard HEP (193 IU mg-1). The obtained fractions were chemically characterized by chemical composition and agarose gel electrophoresis. The yield was 4.61%, and three fractions of SP (F I, F II and F III) eluted with 0.50, 0.75 and 1.00 M of NaCl, respectively, were observed on chromatography profiles; however, differences in charge densities patterns and degree of resolution among them were revealed by electrophoresis. SPs were capable of modifying APTT only in fractions eluted with 0.75 M of NaCl, whose activities were 23.37 and 25.76 IU mg-1, respectively, and the charge density was prerequisite to activity. Therefore, C. cupressoides is a source of SPs possessing low anticoagulant potential compared to HEP.