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16 protocols using fragmin

1

Heparin-based Compound Characterization

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Low-molecular weight heparin dalteparin was from injectable Fragmin® (Pfizer; lot Y08663). BMH was obtained from a commercial supplier (Kin Master, Vila Annes, Brazil). The synthetic pentasaccharide Arixtra® was from GlaxoSmithKline (London, UK). Heparinases I (EC 4.2.2.7), II and III (EC 4.2.2.8) were purchased from Grampian Enzymes (Aberdeen, Scotland, UK), while recombinant human heparanase, covalently linking the 8 and 50 kDa subunits to produce active single-chain heparanase molecules [42 (link)], was kindly provided by Israel Vlodavsky. All other reagents and chemicals were of HPLC grade or higher quality.
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2

Sperm Chromatin Decondensation Protocol

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For the decondensation of sperm chromatin we adopted a protocol published elsewhere [36 (link)]. Briefly, aliquots from sorted populations containing approximately 1 x 106 spermatozoa were washed with 4 ml of PBS 1x/0.5% HSA and chromatin stabilization was performed by incubation in 500 μl of 0.5% PFA at 4°C for 10 minutes. Samples were then centrifuged and resuspended in the decondensation solution (PBS 1x containing 5 mM dithiothreitol (DTT, Carl Roth, Karlsruhe, Germany); 0.1% Triton and 100U/ml of low molecular weight heparin (Fragmin, Pfizer, New York, NY, USA) or in PBS containing 0.5% HSA in case of the non decondensed samples. During decondensation (30 minutes in the dark at 25°C), every 10 minutes, spermatozoa were counted under the microscope to exclude loss of cells. Microscopic analysis revealed that the number and the integrity of the PI-dimmer and PI-brighter spermatozoa were maintained during the process. Finally the samples were centrifuged and fixed in PFA 3.7% overnight at 4°C. To verify whether the sperm DNA was efficiently decondensed, aliquots of decondensed and non-decondensed samples were re-stained with PI and flow cytometry analysis was performed. A significant increase in the PI-fluorescence of the decondensed population was observed in all cases. These samples were subsequently used to test the influence of chromatin decondensation in TUNEL results.
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3

SEC Analysis of Protein-Heparin Interactions

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SEC experiments were carried out on a Varian ProStar 215 solvent delivery system, coupled to a Varian ProStar 320 UV/VIS detector set at a wavelength of 280 nm. Separation was performed using a BioSep 5-μm SEC-s2000 145 Å, 300 × 4.6-mm LC column (Phenomenex, Torrance, CA). 50 mm sodium phosphate buffer, pH 6.65, containing 150 mm NaCl was used as eluent buffer. Flow rate was set at 0.5 ml/min. Proteins were injected at 0.1 mg/ml concentration in the presence or absence of 1 mg/ml low-molecular-mass heparin (commercial name Fragmin®, Pfizer). Molecular masses of proteins were calculated using the calibration curve provided by the manufacturer.
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4

Anticoagulant Effects on MMP-9 Expression

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In the initial experiments, 2 × 106 THP-1, Jurkat, or HT cells/well were starved in individual cultures overnight. Afterwards, cells were stimulated with 3.2 mg EDTA (Sigma Aldrich, Darmstadt, Germany), 10 µL HMWH (=50 IU; Ratiopharm, Ulm, Germany) or LMWH (Clexane; Sanofi-Aventis, Frankfurt, Germany or Fragmin; Pfizer, Berlin, Germany), or 220 µL citrate (Sarstedt) per well and harvested after 0, 4, 6, and 24 h for the analysis of MMP-9 mRNA expression.
In double co-culture experiments, THP-1 and Jurkat, THP-1 and HT, or Jurkat and HT cells were cultivated together (in total 2 × 106 cells/well, i.e., 1 × 106 cells per cell line). Following starvation overnight, cells were stimulated with the respective anticoagulants and harvested at the indicated time points. In addition, supernatants of the respective double co-cultures were collected for the analysis of secreted proteins.
Furthermore, in a triple co-culture experiment a mixture of the three cell lines used was seeded with 2.1 × 106 cells/well (i.e., 0.7 × 106 cells per cell line) and starved overnight. Then, the respective anticoagulant was added and the cells were harvested and the supernatant collected at the indicated time points.
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5

Comparative Analysis of Clinical Heparin Preparations

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Clinically used LMWH preparations investigated were Innohep (tinzaparin sodium, LEO Pharma), Clexane (enoxaparin sodium, Sanofi), and Fragmin (dalteparin sodium, Pfizer), along with a porcine mucosal UFH (heparin sodium, Wockhardt, UK) [currently being investigated by nebulisation in a UK human clinical trial]. Further heparin preparations investigated were a porcine mucosal UFH preparation (Celsus, USA) and both a bovine lung heparin (Calbiochem) and a bovine mucosal heparin (15/110, NIBSC, UK).
Specific anticoagulant activity for the UFH preparations was measured as described in the United States Pharmacopeia (USP), n.d , a general monograph for the assay of heparin. The MWs for the UFH and LMWH samples were measured as previously described (Mulloy & Hogwood, 2015 (link)). The specific activity of the clinical LMWHs was taken from the clinical product information (Clexane, 100 IU·mg−1; Innohep, 100 IU·mg−1; Fragmin 130 IU·mg−1).
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6

Anticoagulant and Antiangiogenic Compound Preparation

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Tinzaparin solution (20,000 IU/ml Innohep, LeoPharma Ballerup, Denmark) and Dalteparin solution (25,000 IU/ml Fragmin, Pfizer, Tadworth, UK) were diluted in sterile phosphate buffered saline (PBS) as required. Apixaban and Rivaroxaban were obtained as pure compounds from, Bistrol-Myers Squibb (New York, USA) and Bayer (Leverkusen, Germany) respectively. These were then dissolved gradually in dimethyl sulfoxide (DMSO; 0.1% v/v final concentration) and then diluted to 4 mg/ml in PBS. Controls were also prepared by diluting DMSO. Bevacizumab solution (25 µg/ml Avastin; Roche, Welwyn Garden City, UK) was diluted in sterile PBS as required.
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7

Blood Collection and Characterization in Mice

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Mice were anaesthetized by subcutaneous injection of 100 mg/kg body weight ketamine and 0.5 mg/kg body weight medetomidine. Blood was taken through retro-orbital puncture, with 9 volumes collected into one volume of 129 mM trisodium citrate66 (link), after which mice were euthanized by cervical dislocation. Where indicated, blood was collected into 300 µl PPACK/fragmin anticoagulant solution, containing saline, H-Phe-Pro-Arg chloromethyl ketone (PPACK, 40 μM), low molecular weight heparin (fragmin, 40 U/ml, Pfizer, Capelle a/d IJssel, The Netherlands) and heparin (5 units/ml, Sigma-Aldrich, St. Louis MO, USA)67 (link). For the preparation of washed platelets, blood was collected 6:1 (vol./vol.) into acid citrate-dextrose solution (ACD, 80 mM sodium citrate, 52 mM citric acid, 183 mM D-glucose). Hematological blood parameters were determined in citrated blood using a Sysmex blood analyzer (Europe, Norderstedt, Germany). Platelet-free plasma (citrated) was stored at − 80 °C for later assessment of lipids and coagulation parameters.
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8

Heparinase-based Dalteparin Characterization

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Dalteparin samples used in the present study were from different lots of injectable Fragmin® (Pfizer), named as follows: Frag-1 (lot 96223A51), Frag-2 (lot 96218B51), Frag-3 (lot 96231A51), Frag-4 (lot 96238A51), Frag-5 (lot 96240B51), Frag-6 (lot 96242A51), Frag-7 (lot 96228A51), Frag-8 (lot 96235A51), Frag-9 (lot 96225A51), Frag-10 (lot 96246A51) and Frag-11 (lot Z06358). Heparinases I (EC 4.2.2.7), II and III (EC 4.2.2.8) were purchased from Grampian Enzymes (Aberdeen, Scotland, UK). Dibutylamine (>99.5%), methanol (LC-MS grade), acetonitrile (LC-MS grade), acetic acid (glacial 99.9%), formic acid (98-100%), ammonium chloride (>99.5%), potassium phosphate monobasic were purchased from Sigma-Aldrich (Milan, Italy); sodium acetate was from Merck (Milan, Italy), and calcium acetate (>97%) from BDH (VWR Milan, Italy).
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9

Platelet Activation Measurement by Flow Cytometry

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Citrated tail blood was diluted 25 times in Tyrode HEPES pH 7.45 (5 mmol/L HEPES, 136 mmol/L NaCl, 2.7 mmol/L KCl, 0.42 mmol/L NaH2PO4, 2 mmol/L MgCl2, 0.1% glucose and 0.1% bovine serum albumin) in the presence of PPACK (20 µmol/L) and fragmin (20 U/mL, Pfizer). The blood was activated for 10 minutes with various concentrations of cross‐linked collagen‐related peptide (CRP‐XL, from Cambridge University), 2‐methylthio‐adenosine‐5'‐diphosphate (2‐MeSADP, BioConnect), or the protease activated receptor 4 (PAR4) agonist AYPGKF. Platelets were labelled with anti‐GPIIbIIIa (JON/A; Emfret, PE, 1:10 dilution) and anti‐P‐selectin (CD62P; Emfret, FITC, 1:10 dilution), and activation measured with an Accuri C6 flow cytometer (Becton Dickinson).
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10

Postoperative Thromboprophylaxis Regimens

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Patients were randomly allocated into 3 groups according to the different prophylactic regimens. In group A (90 patients, 110 cases), subcutaneous injection of 5,000 international units (IU) of Fragmin (dalteparin, LMWH; Pfizer, New York, USA) was given daily for 2 postoperative days, which was followed by 5 days of 100 mg aspirin (AA; Bayer, Leverkusen, Germany) therapy. In group X7 (92 patients, 110 cases), a shorter regimen of 10 mg Xarelto (rivaroxaban, factor Xa-inhibitor, Bayer) was given orally for 7 days postoperatively. In group X10 (86 patients, 110 cases), 10 mg Xarelto was given orally for 10 days postoperatively. Prophylaxis was started at 6 hours after the end of surgery. For all patients, intermittent pneumatic compression was applied immediately after surgery and maintained for 7 days. However, a compression stocking was not applied. A continuous passive motion machine was used at 1 day postoperatively.
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