Protamine and Heparin Interactions: A Narrative Review
| Autor: | Martina Crivellari, Giovanni Landoni, Jacopo D’Andria Ursoleo, Luca Ferrante, Alessandro Oriani |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Annals of Cardiac Anaesthesia, Vol 27, Iss 3, Pp 202-212 (2024) |
| Druh dokumentu: | article |
| ISSN: | 0971-9784 0974-5181 |
| DOI: | 10.4103/aca.aca_117_23 |
| Popis: | Protamine, first isolated from salmon fish sperm and now produced through recombinant biotechnology, is an antidote that neutralizes the anticoagulant properties of heparin. Protamine function is based on the capacity to dissociate the heparin–antithrombin III (AT III) complex (an important link that promotes blood fluidification by inhibiting coagulation), forming the inactive heparin–protamine complex. Protamine has itself dose-dependent anticoagulant properties: It interferes with coagulation factors and platelet function; it stimulates fibrinolysis; it can lead to thrombocytopenia and reduction in thrombin-related platelet aggregation; it decreases platelet response to thrombin receptor agonist in a dose-dependent manner. In this review, we will focus on protamine and its interaction with heparin. Notably, protamine is able to antagonize not only unfractionated heparin (UFH) but also low molecular weight heparins to various degrees. Protamine-allergic and anaphylactoid systemic reactions may affect up to 1 in 10 people and should be prevented and treated early. |
| Databáze: | Directory of Open Access Journals |
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