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Blood, 15 November 2004, Vol. 104, No. 10, pp. 3173-3180.
Prepublished online as a Blood First Edition Paper on February 5, 2004; DOI 10.1182/blood-2003-11-3994.

Submitted November 21, 2003
Accepted January 26, 2004
Transgenic Mice Studies Demonstrate a Role for Platelet Factor 4 in Thrombosis: Dissociation between Anticoagulant and Antithrombotic Effect of Heparin
Don E Eslin, Chunyan Zhang, Kathleen J Samuels, Lubica Rauova, Li Zhai, Stefan Niewiarowski, Douglas B Cines, Mortimer Poncz, and M A Kowalska*
Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; University of Pennsylvania School of Medicine, Philadelphia, PA, USA
Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
Temple University School of Medicine, Philadelphia, PA, USA
University of Pennsylvania School of Medicine, Philadelphia, PA, USA
* Corresponding author; email: kowalska{at}email.chop.edu.
The platelet-specific chemokine Platelet Factor 4 (PF4) is released in large amounts at sites of vascular injury. PF4 binds to heparin with high affinity, but its in vivo biological role has not been defined. We studied the role of PF4 in thrombosis using heterozygote and homozygote PF4 knockout mice (mPF4+/- and mPF4-/-, respectively) and transgenic mice over-expressing human PF4 (hPF4+). None of these lines had an overt bleeding diathesis, but in a FeCl3 carotid artery thrombosis model, all showed impaired thrombus formation. This defect in thrombus formation in the mPF4-/- animals was corrected by infusing hPF4 over a narrow concentration range. The thrombotic defect in the mPF4+/- and mPF4-/- animals was particularly sensitive to infusions of the negatively-charged anticoagulant heparin. However, the same amount of heparin paradoxically normalized thrombus formation in the hPF4+ animals, although these animals were anticoagulated systemically. Upon infusion of the positively-charged protein, protamine sulfate, the reverse was observed with mPF4+/- and mPF4-/- animals having improved thrombosis, while hPF4+ animals having worsened thrombus formation. These studies support an important role for PF4 in thrombosis, and show that neutralization of PF4 is an important component of heparin's anticoagulant effect. The mechanisms underlying these observations of PF4 biology and their clinical implications remain to be determined.

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