Thromb Haemost 2008; 99(03): 570-575
DOI: 10.1160/TH07-06-0424
Wound Healing and Inflammation/Infection
Schattauer GmbH

Concentration-dependent roles for heparin in modifying liopolysaccharide-induced activation of mononuclear cells in whole blood

Helene Hochart
1   Thrombosis and Haemostasis Research Group, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin
,
Vincent P. Jenkins
1   Thrombosis and Haemostasis Research Group, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin
2   National Centre for Hereditary Coagulation Disorders, St James's Hospital, Dublin
,
Roger J. S. Preston
1   Thrombosis and Haemostasis Research Group, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin
,
Owen P. Smith
3   Department of Paediatric Haematology and Oncology, Our Lady’s Hospital for Sick Children, Dublin; Ireland
,
Barry White
1   Thrombosis and Haemostasis Research Group, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin
2   National Centre for Hereditary Coagulation Disorders, St James's Hospital, Dublin
,
James O’Donnell
1   Thrombosis and Haemostasis Research Group, Institute of Molecular Medicine, Trinity Centre for Health Sciences, Trinity College Dublin
2   National Centre for Hereditary Coagulation Disorders, St James's Hospital, Dublin
› Author Affiliations
Further Information

Publication History

Received: 25 June 2007

Accepted after major revision: 16 January 2008

Publication Date:
07 December 2017 (online)

Summary

In addition to their anticoagulant activity,unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) have important immunomodulatory properties. However, different studies have reported conflicting pro- and anti-inflammatory effects in association with heparin. Moreover, the molecular basis for these heparin effects on inflammation remains unclear.It was the objective of this study to determine how UFH and LMWH regulate lipopolysaccharide (LPS)-induced activation of human mononuclear cells in whole blood, and define the role of lipopolysaccharide- binding protein (LBP) in mediating this effect. Whole blood was pre-treated with UFH or LMWH (0.1–200 IU/ml), prior to stimulation with LPS (10 ng/ml). After six hours, monocyte pro-inflammatory cytokine (interleukin (IL)-1β, IL-6, IL-8, and TNF-α) secretion was determined by plasma ELISA. Parallel experiments using THP-1 cell line and primary monocytes were performed under serum-free conditions, in the presence or absence of LBP (50–100 nM). Under serum-free conditions, heparin demonstrated dose-dependent anti-inflammatory effects,significantly reducing secretion of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, and TNF-α) in response to LPSstimulation of THP-1 cells and primary monocytes. In contrast, in the presence of LBP, both UFH and LMWH demonstrated dose-dependent pro-inflammatory effects at all heparin concentrations. In ex-vivo whole blood experiments, pro-inflammatory effects (increased IL-1β and IL-8 following LPS-stimulation) of heparin were also observed,but only at supra-therapeutic doses (10–200 IU/ml). Our data demonstrate that in the absence of LBP, the direct effect of heparin on LPS-stimulated monocytes is anti-inflammatory. However in whole blood, the immunomodulatory effects of heparin are significantly more complex, with either pro- or anti-inflammatory effects dependent upon heparin concentration.

 
  • References

  • 1 Jackson RL, Busch SJ, Cardin AD. Glycosaminoglycans: molecular properties, protein interactions, and role in physiological processes. Physiol Rev 1991; 71: 481-539.
  • 2 Hirsh J, Raschke R, Warkentin TE. et al. Heparin: mechanism of action, pharmacokinetics, dosing considerations, monitoring, efficacy, and safety. Chest 1995; 108 (Suppl. 01) 258S-75S.
  • 3 Barrow RT, Parker ET, Krishnaswamy S. et al. Inhibition by heparin of the human blood coagulation intrinsic pathway factor X activator. J Biol Chem 1994; 269: 26796-26800.
  • 4 Hyslop S, de NG. Heparin, polycations, and atherosclerosis. Semin Thromb Hemost 1993; 19: 89-98.
  • 5 Nelson RM, Venot A, Bevilacqua MP. et al. Carbohydrate- protein interactions in vascular biology. Annu Rev Cell Dev Biol 1995; 11: 601-631.
  • 6 Hogasen AK, Abrahamsen TG. Heparin suppresses lipopolysaccharide-induced monocyte production of several cytokines, but simultaneously stimulates C3 production. Thromb Res 1995; 80: 179-184.
  • 7 Attanasio M, Gori AM, Giusti B. et al. Cytokine gene expression in human LPS- and IFNgamma-stimulated mononuclear cells is inhibited by heparin. Thromb Haemost 1998; 79: 959-962.
  • 8 Gori AM, Attanasio M, Gazzini A. et al. Cytokine gene expression and production by human LPS-stimulated mononuclear cells are inhibited by sulfated heparin- like semi-synthetic derivatives. J Thromb Haemost 2004; 2: 1657-1662.
  • 9 Sternbergh WC, III Sobel M, Makhoul RG. Heparinoids with low anticoagulant potency attenuate postischemic endothelial cell dysfunction. J Vasc Surg 1995; 21: 477-483.
  • 10 Kouretas PC, Kim YD, Cahill PA. et al. Nonanticoagulant heparin prevents coronary endothelial dysfunction after brief ischemia-reperfusion injury in the dog. Circulation 1999; 99: 1062-1068.
  • 11 Thourani VH, Brar SS, Kennedy TP. et al. Nonanticoagulant heparin inhibits NF-kappaB activation and attenuates myocardial reperfusion injury. Am J Physiol Heart Circ Physiol 2000; 278: H2084-H2093.
  • 12 Heinzelmann M, Bosshart H. Heparin binds to lipopolysaccharide (LPS)-binding protein, facilitates the transfer of LPS to CD14, and enhances LPS-induced activation of peripheral blood monocytes. J Immunol 2005; 174: 2280-2287.
  • 13 Schumann RR, Leong SR, Flaggs GW. et al. Structure and function of lipopolysaccharide binding protein. Science 1990; 249: 1429-1431.
  • 14 Lamping N, Dettmer R, Schroder NW. et al. LPSbinding protein protects mice from septic shock caused by LPS or gram-negative bacteria. J Clin Invest 1998; 101: 2065-2071.
  • 15 Wright SD, Ramos RA, Tobias PS. et al. CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science 1990; 249: 1431-1433.
  • 16 Gutsmann T, Muller M, Carroll SF. et al. Dual role of lipopolysaccharide (LPS)-binding protein in neutralization of LPS and enhancement of LPS-induced activation of mononuclear cells. Infect Immun 2001; 69: 6942-6950.
  • 17 Wurfel MM, Monks BG, Ingalls RR. et al. Targeted deletion of the lipopolysaccharide (LPS)-binding protein gene leads to profound suppression of LPS responses ex vivo, whereas in vivo responses remain intact. J Exp Med 1997; 186: 2051-2056.
  • 18 Freedman MD. Pharmacodynamics, clinical indications, and adverse effects of heparin. J Clin Pharmacol 1992; 32: 584-596.
  • 19 Hochart H, Jenkins PV, Smith OP. et al. Low-molecular weight and unfractionated heparins induce a downregulation of inflammation: decreased levels of proinflammatory cytokines and nuclear factor-kappaB in LPS-stimulated human monocytes. Br J Haematol 2006; 133: 62-67.
  • 20 Hirsh J, Raschke R. Heparin and low-molecularweight heparin: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126 (Suppl. 03) 188S-203S.
  • 21 Rietschel ET, Brade H. Bacterial endotoxins. Sci Am 1992; 267: 54-61.
  • 22 Rietschel ET, Kirikae T, Schade FU. et al. Bacterial endotoxin: molecular relationships of structure to activity and function. FASEB J 1994; 8: 217-225.
  • 23 Ulevitch RJ, Tobias PS. Receptor-dependent mechanisms of cell stimulation by bacterial endotoxin. Annu Rev Immunol 1995; 13: 437-457.
  • 24 Yao J, Mackman N, Edgington TS. et al. Lipopolysaccharide induction of the tumor necrosis factor-alpha promoter in human monocytic cells. Regulation by Egr-1, c-Jun, and NF-kappaB transcription factors. J Biol Chem 1997; 272: 17795-17801.
  • 25 Carcillo JA, Cunnion RE. Septic shock. Crit Care Clin 1997; 13: 553-574.
  • 26 Oelschlager C, Romisch J, Staubitz A. et al. Antithrombin III inhibits nuclear factor ?B activation in human monocytes and vascular endothelial cells. Blood 2002; 99: 4015-4020.
  • 27 Tobias PS, Mathison JC, Ulevitch RJ. A family of lipopolysaccharide binding proteins involved in responses to gram-negative sepsis. J Biol Chem 1988; 263: 13479-13481.
  • 28 Gaffney PR, O’Leary JJ, Doyle CT. et al. Response to heparin in patients with ulcerative colitis. Lancet 1991; 337: 238-239.
  • 29 Evans RC, Wong VS, Morris AI. et al. Treatment of corticosteroid-resistant ulcerative colitis with heparin– a report of 16 cases. Aliment Pharmacol Ther 1997; 11: 1037-1040.
  • 30 Ang YS, Mahmud N, White B. et al. Randomised comparison of unfractionated heparin with corticosteroids in severe inflammatory bowel disease. Aliment Pharmacol Ther 2000; 14: 1015-1022.
  • 31 Gaffney A, Gaffney P. Rheumatoid arthritis and heparin. Br J Rheumatol 1996; 35: 808-809.
  • 32 Page CP. Inhibition of natural anti-inflammatory mechanism by beta 2-agonists. Lancet 1991; 337: 1285-1286.