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Critical Reviews™ in Biomedical Engineering
SJR: 0.207 SNIP: 0.376 CiteScore™: 0.79

ISSN Print: 0278-940X
ISSN Online: 1943-619X

Critical Reviews™ in Biomedical Engineering

DOI: 10.1615/CritRevBiomedEng.v28.i12.260
pages 157-158

Anticoagulants, Blood Hemostasis and Tissue Oxygenation: Protein С Benefits

Duane F. Bruley
Department of Chemical and Biochemical Engineering, University of Maryland Baltimore County, Baltimore, Maryland, 21250, USA

ABSTRACT

The control of blood hemostasis is critical for tissue health, including its oxygenation. When there is an imbalance between coagulants and anticoagulants in the plasma, at least two major pathological conditions can develop. First, if there is a deficiency of coagulants, such as factor VIII, the patient becomes a hemophiliac with excessive bleeding in the joints. Second, if there is a deficiency of an anticoagulant, such as protein C, a hyper-coagulable situation develops and typically the patient suffers a deep-vein-thrombosis (DVT).
This presentation deals primarily with the hyper-coagulable case and the resulting tissue oxygen deprivation due to blood clotting (agglutination). My first work with Dr. Melvin H. Knisely in 1962 (Medical School of South Carolina) started because he convinced me of the necessity of a good oxygen supply to the dssue for normal functioning, and he showed that many pathological states lead to blood agglutination and therefore poor oxygen transport to the tissue. Our goal was to use experimental and theoretical approaches (combine medical science and bioengineering) to better understand conditions that cause oxygen deficiency in tissue, the resulting damage, and in particular how to prevent and cure the phenomenon.
Our intention then and now is to investigate the safest and most effective therapy for the prevention and treatment of blood clotting in order to maintain normal oxygen transport (also other anabolites and metabolites) to the tissue.
Even though there are numerous anticoagulants/antithrombotics available today, we have focused our work on protein C. Protein С is the pivotal anticoagulant in the human coagulation cascade. It is a natural andcoagulant/antithrombotic with little or no bleeding side effects. Other anticoagulants, such as heparin, low-molecular-weight heparin, coumadin, and all others being used clinically today can lead to serious bleeding complications.
Protein C could be the ultimate anticoagulant and antithrombotic. It is present in human blood plasma at an average concentration of 4 mg/l with an in vivo half-life of 6 hours.


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