Abstract
Low-molecular weight heparins (LMWH) are anticoagulants that have shown anti-inflammatory activity in several experimental models. Hot water burn inflammatory model accurately simulates human clinical situations allowing its use for nociception test and evaluation of anti-inflammatory drugs. The present study aims to evaluate the enoxaparin pretreatment on local and systemic inflammation biomarkers in the animal burn model. Inflammation was induced by submersing the rat left hind paw in water at 60o C for 60 s. C-reactive protein (CRP) and thrombin–antithrombin complex (TAT) were estimated by immunosorbent assay, fibrinogen (Fg) by the gravimetric method and paw oedema by orthogonal digital photography. Highest values of paw oedema, CRP and TAT were observed at 4 h post-burn while Fg peak occurs at 12 h post-burn; enoxaparin pretreatment decreased oedema (− 32.1%), and concentration of TAT (− 66.7%), PCR (− 37.9%) and Fg (− 8%). This study shows that enoxaparin has local and systemic anti-inflammatory effects and should be considered as a potential adjuvant drug for the treatment of burns.
Similar content being viewed by others
References
Abbas S, Schaalan M, Bahgat A, El-Denshary E (2014) Possible potentiation by certain antioxidants of the anti-inflammatory effects of diclofenac in rats. Sci World J. https://doi.org/10.1155.2014.731462
Abe W, Ikejima K, Lang T, Okumura K, Enomoto N, Kitamura T, Takei Y, Sato N (2007) Low molecular weight heparin prevents hepatic fibrogenesis caused by carbontetrachloride in the rat. J Hepatol 46:286–294
Ahmed T, Gonzalez BJ, Danta I (1999) Prevention of exercise-induced bronchoconstriction by inhaled lowmolecular-weight heparin. Am J Respir Crit Care Med 160:576–581
Benson A, Dickson W, Boyce D (2006) ABC of wound healing: burns. BMJ 332(7542):649–652
Borensztajn K, Peppelenbosch MP, Spek CA (2008) Factor Xa: at the crossroads between coagulation and signaling in physiology and disease. Trends Mol Med 14:429–440
Bosco-Bruno R, Barrios E, Eblen Zajjur A (2012) Efecto de la indometacina sobre la expresión de proteínas y del canal de sodio Nav1.3 en el asta dorsal medular de ratas, inducidos por una inflamación periférica aguda. VITAE Acad Bioméd Digit 49:1–11
Cade JF, Buchanan MR, Boneu B, Ockelford P, Cater CJ, Cerskus AL, Hirsh J (1984) A comparison of the antithrombotic and haemorrhagic effects of low molecular weight heparin fractions: the influence of the method of preparation. Thromb Res 35:613–625
Cermak J, Key N, Bach R, Balla J, Jacob H, Vercellotti G (1993) C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 82:513–520
Chen C, Nan B, Lin P, Yao Q (2008) C-reactive protein increases plasminogen activator inhibitor-1 expression in human endothelial cells. Thromb Res 122:125–133
Chen Y, Wang J, Yao Y, Yuan W, Kong M, Lin Y, Geng D, Nie R (2009) CRP regulates the expression and activity of tissue factor as well as tissue factor pathway inhibitor via NF-kappaB and ERK 1/2 MAPK pathway. FEBS Lett 583:2811–2818
Christoffersen B, Jensen SJ, Ludvigsen TP, Nilsson SK, Grossi AB, Heegaard PM (2015) Age- and sex-associated effects on acute-phase proteins in Gottingen minipigs. Comp Med 65:333–341
Chu A (2010) Blood Coagulation as an Intrinsic Pathway for Proinflammation: a Mini review. Inflamm Allergy Drug Targets 9:32–44
Cicala C, Morello S, Alfieri A, Vellecco V, Marzocco S, Autore G (2007) Haemostatic imbalance following carrageenan induced rat paw oedema. Eur J Pharm 577:156–161
Cirino G, Cicala C, Bucci M, Sorrentino L, Ambrosini G, De Dominicis G, Altier D (1997) Factor Xa as an interface between coagulation and inflammation. J Clin Invest 99:2446–2451
Czaplinski M, Abad C, Eblen-Zajjur A (2005) Normal expression and Inflammation-induced changes of Na and Na/K ATPase activity in spinal dorsal horn of the rat. Neurosci Lett 374(2):147–151
De Jonge E, Dekkers PE, Creasey AA, Hack CE, Paulson SK, Karim A, Kesecioglu J, Levi M, van Deventer SJ, van der Poll T (2001) Tissue factor pathway inhibitor does not influence inflammatory pathways during human endotoxemia. J Infect Dis 183:1815–1818
Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008) Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med 36:296–327
Derhaschnig U, Pernerstorfer T, Knechtelsdorfer M, Hollenstein U, Panzer S, Jilma B (2003) Evaluation of anti-inflammatory and antiadhesive effects of heparins in human endotoxemia. Crit Care Med 31:1108–1112
Dittmeier M, Kraft P, Schuhmann M, Fluri F, Kleinschnitz C (2016) Pretreatment with rivaroxaban attenuates stroke severity in rats by a dual antithrombotic and anti-inflammatory mechanism. Thromb Haemost 115:1–9
Dotan I, Hershkoviz R, Karmeli F, Brazowski E, Peled Y, Rachmilewitz D, Halpern Z (2001) Heparin and low-molecular-weight heparin (enoxaparin) significantly ameliorate experimental colitis in rats. Aliment Pharm Ther 15:1687–1697
Duboscq C, Ceresetto J, Stemmelin G, Shanley C, Rabinovich O, Palmer S, Bullorsky EO (2013) Effect of first and second generation LMWH on thrombin generation parameters. Hematología 17:231–237
Eblen-Zajjur A, Marín R, Vanegas H, Proverbio F, Proverbio T (2015) Diurnal changes in ouabain-sensitive Na+, K+- atpase activity in the rat spinal dorsal horn. Neurochem J 9:266–270
Ellinghaus P, Perzborn E, Hauenschild P, Gerdes C, Heitmeier S, Visser M, Summer H, Laux V (2016) Expression of pro-inflammatory genes in human endothelial cells: comparison of rivaroxaban and dabigatran. Thromb Res 142:44–51
Ernst E (1993) Fibrinogen as a cardiovascular risk factor-interrelationship with infections and inflammation. Eur Heart J 14:82–87
Esmon CT (2005) The interactions between inflammation and coagulation. Br J Haematol 131:417–430
Esmon CT (2008) Crosstalk between inflammation and thrombosis. Maturitas 61:122–131
Esmon CT (2014) Targeting factor Xa and thrombin: impact on coagulation and beyond. Thromb Haemost 111:625–633
Foley J, Conway E (2016) Cross talk pathways between coagulation and inflammation. Circ Res 118:1392–1408
Gao Y, Xu C, Yu K, Li G, Wan F, Liu S, Lin J, Liu H, Zhang J, Li X, Liang S (2010) Effect of tetramethylpyrazine on DRG neuron P2x3 receptor involved intransmitting pain after burn. Burns J Int Soc Burn Inj 36:127–134
Glykys J, Guadama M, Marcano L, Ochoa E, Eblen-Zajjur A (2003) Inflammation induced increase of fluoride resistant acid phosphatase (FRAP) activity in the spinal dorsal horn in rats. Neurosci Lett 337:167–169
Gray E, Mulloy B, Barrowcliffe TW (2008) Heparin and low-molecular-weight heparin. Thromb Haemost 99:807–818
Hammer R, Harper D, Ryan P (2001) PAST: paleontological statistics software package for education and data analysis. Palaeontol Electron 4:9
Hernandez L, Lundberg U, Arocha-Pinango C (2000) Experimental thrombosis I: relation with fibrinogen and other haemostatic parameters. Thromb Res 99:295–305
Hirsh J, Raschke R (2004) Heparin and low-molecular- weight heparin: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:188S–203S
Hu ZQ, Kobayashi K, Zenda N, Shimamura T (1997) Tumor necrosis factor-alpha- and interleukin-6-triggered mast cell development from mouse spleen cells. Blood 89:526–533
Iba T, Takayama T (2009) Enoxaparin attenuates endothelial damage with less bleeding compared with unfractionated heparin in endotoxemic rats. Shock 32:530–534
Iba T, Okamoto K, Ohike T, Tajirika T, Aihara K, Watanabe S, Kayhanian H (2012) Enoxaparin and fondaparinux attenuates endothelial damage in endotoxemic rats. J Trauma 72:177–182
Kawabata A, Kuroda R, Nishikawa H, Asai T, Kataoka K, Taneda M (1999) Enhancement of vascular permeability by specific activation of protease-activated receptor-1 in rat hindpaw: a protective role of endogenous and exogenous nitric oxide. Br J Pharmacol 126:1856–1862
Kearon C, Ginsberg JS, Julian JA, Douketis J, Solymoss S, Ockelford P, Jackson S, Turpie AG, MacKinnon B, Hirsh J, Gent M (2006) Comparison of fixed-dose weight-adjusted unfractionated heparin and low-molecular-weight heparin for acute treat-ment of venous thromboembolism. JAMA 296:935–942
Kinoshita T, Sawai N, Hidaka E, Yamashita T, Koike K (1999) Interleukin-6 directly modulates stem cell factor-dependent development of human mast cells derived from CD34(+) cord blood cells. Blood 94:496–508
Kowal-Vern A, Gamelli R, Walenga J, Hoppensteadt D, Sharp-Pucci M, Schumacher H (1992) The effect of burn wound size on hemostasis: a correlation of the hemostatic changes to the clinical state. J Trauma 33(1):50–57
Koyama K, Madoiwa S, Nunomiya S, Koinuma T, Wada Sakata A, Ohmori T, Mimuro J, Sakata Y (2014) Combination of thrombin-antithrombin complex, plasminogen activator inhibitor-1, and protein C activity for early identification of severe coagulopathy in initial phase of sepsis: a prospective observational study. Crit Care 18:R13
La Greca R (2012) Potential of inflammatory biomarkers in the early detection of cardiovascular disease. Rev Med Clin Condes 23:666–671
Ley para la Protección de la Fauna Doméstica Libre y en Cautiverio (LPDF). Gaceta Oficial N° 39.338 del 04 de enero de 2010.
Lever R, Page CP (2002) Novel drug development opportunities for heparin. Nat Rev Drug Discov 1:140–148
Levi M (2010) The coagulant response in sepsis and inflammation. Hämostaseologie 30:10–16
Li J, Guo Z, Gao X, Bian Q, Jia M, Lai X, Wang T, Bian X, Wang H (2015) Low molecular weight heparin (LMWH) improves peritoneal function and inhibits peritoneal fibrosis possibly through suppression of HIF-1alpha VEGF and TGF-beta1. Public Libr Sci 10:e0118481
Licari L, Kovacic J (2009) Thrombin physiology and pathophysiology. J Vet Emerg Crit Care 19:11–22
Manduteanu I, Voinea M, Antohe F, Dragomir E, Capraru M, Radulescu L, Simionescu M (2003) Effect of enoxaparin on high glucoseinduced activation of endothelial cells. Eur J Pharmacol 477:269–276
Moilanen E (2014) Two faces of inflammation: an immunopharmacological view. Basic Clin Pharmacol Toxicol 114:2–6
Nan B, Yang H, Yan S, Lin P, Lumsden A, Yao Q, Chen C (2005) C-reactive protein decreases expression of thrombomodulin and endothelial protein C receptor in human endothelial cells. Surgery 138:212–222
Nasiripour S, Gholami K, Mousavi S, Mohagheghi A, Radfar M, Abdollahi M, Khazaeipour Z, Vahabzadeh G, Mojtahedzadeh M (2014) Comparison of the effects of enoxaparin and heparin on inflammatory biomarkers in patients with ST-segment elevated myocardial infarction: a prospective open label pilot clinical trial. Iran J Pharm Res 13:583–590
National Institute of Health. Guide for the care and use of laboratory animals Washington: National Academy Press (2011) https://grants.nih.gov/grants/olaw/Guidefor-the-Care-and-use-of-laboratoryanimals.pdf. Accessed 15 April 2017
National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals. Guide for the Care and Use of Laboratory Animals. 8th edition. Washington (DC): National Academies Press (US); 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK54050/. https://doi.org/10.17226/12910
Ning F, Wang X, Shang L, Wang T, Lv C, Qi Z, Wua D (2015) Low molecular weight heparin may prevent acute lung injury induced by sepsis in rats. Gene 557:88–91
Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update. J Clin Invest 111:1805–1812
Perzborn E, Heitmeier S, Buetehorn U, Laux V (2014) Direct thrombin inhibitors, but not the direct factor Xa inhibitor rivaroxaban, increase tissue factor-induced hypercoagulability in vitro and in vivo. J Thromb Haemost 12:1054–1065
Porumb V, Trandabst A, Terinte C, Caruntu I, Porumb-Andrese E, Dimofte M, Pieptu D (2017) Design and testing of an experimental steam-induced burn model in rats. Biomed Res Int. https://doi.org/10.1155/2017/9878109
Ratnoff OD, Menzie C (1951) A new method for the determination of fibrinogen in small samples of plasma. J Lab Clin Med 37:316–320
Rosenthal N, Brown S (2007) The mouse ascending: perspectives for human-disease models. Nat Cell Biol 9(9):993–999
Roumen-Klappe EM, den Heijer M, van Uum SH, van der Ven-Jongekrijg J, van der Graaf F, Wollersheim H (2002) Inflammatory response in the acute phase of deep vein thrombosis. J Vasc Surg 35:701–706
Salba MJ Jr (2001) Heparin in the treatment of burns: a review. Burns 27:349–358
Shastri MD, Stewart N, Horne J, Zaidi STR, Sohal SS, Peterson GM, Korner H, Gueven N, Patel RP (2015) Non-anticoagulant fractions of enoxaparin suppress inflammatory cytokine release from peripheral blood mononuclear cells of allergic asthmatic individuals. PLoS One. https://doi.org/10.1371/journal.ph0128803
Soares-Campelo A, Soares- Campelo M, de Castro Britto G, Ayala A, Guimaraes S, Leitao de Vasconcelos P (2011) An optimized animal model for partial and total skin thickness burns studies. Acta Cirurgica Brasileira 26(1):38–42
Spronk H, de Jong A, Crijns H, Schotten U, Van Gelder I, ten Cate H (2014) Pleiotropic effects of factor Xa and thrombin: what to expect from novel anticoagulants. Cardiovasc Res 101:344–351
Ten Cate H, Hemker C (2016) Thrombin generation and atherothrombosis: what does the eviden indicate? J Am Heart Asoc 5:1–8
Torkvist L, Thorlacius H, Sjoqvist U, Bohman L, Lapidus A, Flood L, Agren B, Raud J, Löfberg R (1999) Low molecular weight heparinas adjuvant therapy in active ulcerative colitis. Aliment Pharmacol Ther 13:1323–1328
Torres W, Mendoza L, Vicci H, Eblen-Zajjur A, Navarro M (2016) Assessment of local and systemic inflammatory parameters of peripheral burn in an animal model. Rev Peru Med Exp Salud Pública 33:713–718
Tsukada S, Enomoto N, Takei Y, Hirose M, Ikejima K, Kitamura T, Sato N (2003) Dalteparin sodium prevents liver injury due to lipopolysaccharide in rat through suppression of tumor necrosis factor-alpha production by Kupffer cells. Alcohol Clin Exp Res 27:7S–11S
Vazquez E, Navarro M, Salazar Y, Crespo G, Bruges G, Osorio C, Tortorici V, Vanegas H, López M (2015) Systemic changes following carrageenan-induced paw inflammation in rats. Inflamm Res 64:333–342
Vicci H, Navarro M, Eblen-Zajjur A (2015) Thrombin beyond clotting. VITAE Academia Biomédica Digital 63:1–13
Vila V, Martínez-Sales V, Réganon E, Peris E, Pérez F, Ruano M, Aznar J (2001) Effects of unfractionated and low molecular weight heparins on plasma levels of hemostatic factors in patients with acute coronary syndromes. Haematologica 86:729–734
Walker H, Mason A (1968) A standard animal burn. J Trauma Inj Infect Crit Care 8(6):1049–1051
Wang S, Zhang L, Ma Y, Chen L, Tian Y, Mao J, Martyn J (2011) Nociceptive behavior following hindpaw burn injury in young rats: response to systemic morphine. Pain Med 12:87–98
Wu J, Stevenson MJ, Brown JM, Grunz EA, Strawn TL, Fay WP (2008) C-reactive protein enhances tissue factor expression by vascular smooth muscle cells: mechanisms and in vivo significance. Arterioscler Thromb Vasc Biol 28:698–704
Young E (2008) The anti-inflammatory effects of heparin and related compounds. Thromb Res 122:743–752
Acknowledgements
We are grateful to the Central Biotherius of Faculty of Health Sciences of Carabobo University for the contribution of experimental animals.
Funding
This study was partially funded by the Scientific and Humanistic Development Council and by the Research Office of the Health Sciences Faculty, Carabobo University, Venezuela.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interests
The authors declare no conflict of interests.
Ethical approval
All applicable international, national and/or institutional guidelines for the care and use of animals were followed.
Rights and permissions
About this article
Cite this article
Vicci, H., Eblen-Zajjur, A., López, M. et al. Enoxaparin pretreatment effect on local and systemic inflammation biomarkers in the animal burn model. Inflammopharmacol 27, 521–529 (2019). https://doi.org/10.1007/s10787-018-0444-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10787-018-0444-6