Background: The affect of acetaldehyde-treated heparin on thrombin activity has been investigated using factor II-deficient human plasma.
Methods: It was observed that 0.021 units of heparin exerts a marked inhibition of thrombin activity (1.03 units) as measured by clotting times, prolonging the clotting times from 9.6 +/- 0.1 seconds to 24.8 +/- 0.1 seconds. However, when the heparin is preincubated with 447 mmol/L acetaldehyde at RT for 30 minutes prior to mixing with thrombin, a clotting time in excess of 200 seconds is observed. Clotting times remain elevated with heparin-acetaldehyde mixtures of 89.4, 17.9, 3.6, and 0.72 mmol/L acetaldehyde, with corresponding clotting times of > 200, 156.0 +/- 2.1, 81.6 +/- 1.0, 38.8 +/- 0.6 seconds, respectively. At 140 mumol/L acetaldehyde-heparin mixtures, the clotting time was 17.0 +/- 2.0 seconds.
Results: These data support the hypothesis from this laboratory that acetaldehyde-modified heparin enhances coagulation time. They further indicate that thrombin is targeted by the acetaldehyde-treated heparin. Heparin-acetaldehyde mixtures also reacted with plasma prior to the addition of thrombin to modestly prolong coagulation time. Similarly, but more effectively, thrombin/heparin mixtures increased the clotting time of acetaldehyde-exposed plasma. These data further suggest the possibility that reactions of acetaldehyde and heparin are not restricted to those with thrombin, and that they may extend to other blood factors/proteins.
Conclusions: The amount of heparin (0.021 units) required to substantially affect clotting time of thrombin (1.03 units) is substantially lower than that required to prolong clotting of 0.1 mL of whole plasma (0.36 units), by an order of magnitude. It is inferred that heparin may interact with numerous cationic proteins or proteins with cationic domains in blood plasma, among them being the clotting factors.