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Blood, Vol. 92 No. 9 (November 1), 1998:
pp. 3240-3249
Induction of Fibrinogen Binding and Platelet Aggregation as a
Potential Intrinsic Property of Various Glycoprotein IIb/IIIa
( IIb 3) Inhibitors
Karlheinz Peter,
Meike Schwarz,
Jari Ylänne,
Benedikt Kohler,
Martin Moser,
Thomas Nordt,
Peter Salbach,
Wolfgang Kübler, and
Christoph Bode
From the Department of Internal Medicine III, University of
Heidelberg, Heidelberg, Germany; and the Department of Biochemistry,
University of Helsinki, Helsinki, Finland.
The blockade of platelet integrin glycoprotein (GP) IIb/IIIa is a
promising new antiplatelet strategy. The binding of ligands or of the
ligand-mimetic peptide RGD causes a conformational change of GP
IIb/IIIa from the nonactivated to the activated state. Because several
blocking agents/inhibitors are ligand-mimetics, the current study
evaluates whether these agents have the intrinsic property to activate
GP IIb/IIIa. Fibrinogen binding to GP IIb/IIIa on platelets or on CHO
cells expressing recombinant GP IIb/IIIa was evaluated by flow
cytometry or 125I-labeled fibrinogen. Incubation with the
monoclonal antibody (MoAb) fragment c7E3 (abciximab) results in
fibrinogen binding to GP IIb/IIIa and in the access of ligand-induced
binding sites. At low concentrations (0.01 to 0.1 µg/mL), this
intrinsic activating property of c7E3 can result in platelet
aggregation. The disintegrin flavorodin and the RGD analogue fradafiban
also induce fibrinogen binding, whereas the blocking MoAbs 2G12 and P2
and the activation-specific MoAb PAC-1 do not. Aspirin and indomethacin
cannot block c7E3-induced fibrinogen binding to GP IIb/IIIa, but can
inhibit c7E3-induced platelet aggregation. Thus, we conclude that GP
IIb/IIIa inhibitors can demonstrate an intrinsic activating property,
which can result in fibrinogen binding to GP IIb/IIIa and consequently
in platelet aggregation. Cyclooxygenase inhibitors can inhibit platelet
aggregation caused by GP IIb/IIIa inhibitors. Further studies will have
to evaluate the clinical relevance of the potential intrinsic
activating property of GP IIb/IIIa inhibitors and define consequences
for the future drug development and evaluation of these potent
antiplatelet agents.
© 1998 by The American Society of Hematology.

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