Thromb Haemost 2001; 86(02): 616-622
DOI: 10.1055/s-0037-1616095
Review Article
Schattauer GmbH

High Affinity Binding of Heparin by Necrotic Tumour Cells Neutralises Anticoagulant Activity

Implications for Cancer Related Thromboembolism and Heparin Therapy
Sumihito Morita*
1   Thrombosis Research Institute, London and Imperial College School of Medicine, Hammersmith Hospital, London, UK
,
Milena A. Gebska
1   Thrombosis Research Institute, London and Imperial College School of Medicine, Hammersmith Hospital, London, UK
,
Ajay K. Kakkar
1   Thrombosis Research Institute, London and Imperial College School of Medicine, Hammersmith Hospital, London, UK
,
Michael F. Scully
1   Thrombosis Research Institute, London and Imperial College School of Medicine, Hammersmith Hospital, London, UK
› Author Affiliations
Further Information

Publication History

Received 13 November 2000

Accepted after resubmission 20 January 2001

Publication Date:
12 December 2017 (online)

Summary

We have observed a striking neutralisation of the anticoagulant activity of unfractionated heparin in the presence of a pancreatic carcinoma cell line (MIA PaCa-2) due to binding of around 9 g of heparin per 107 cells (apparent Kd, 30 nM). The loss of anticoagulant activity was less marked in the presence of low molecular weight forms of heparin. Binding to the cell blocked acceleration of the thrombin:anti-thrombin interaction by heparin. Neutralisation of heparin activity was also shown to occur in the presence of a number of other tumour cell lines. FACS analysis demonstrated that live cells did not bind heparin and high affinity binding only occurred to dead MIA PaCa-2 cells. Heparin binding proteins accumulating in cell medium were identified as histone and ribosomal proteins that will become exposed during necrosis. The release of these proteins from cells within the necrotic core of a tumour or from cells killed during chemotherapy may abrogate the heparan sulphate/antithrombin system and possibly contribute to the idiopathic thromboembolism often associated with cancer (Trousseau’s syndrome). The findings also suggest a reason for the reported advantage of LMWH over UFH in treating venous thromboembolism in cancer patients and in improving patient survival.

* Present address: Dr. S. Morita, Hamamatsu University School of Medicine, Shizuoka-ken, Japan


 
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