Low molecular weight heparins and their non-antithrombotic effects on wound healing
Authors:
T. Toporcer; L. Lakyová; J. Radoňak
Authors‘ workplace:
Univerzita Pavla Jozefa Šafárika v Košiciach, Lekárska fakulta, I. chirurgická klinika
Published in:
Čas. Lék. čes. 2009; 148: 481-488
Category:
Review Article
Overview
Heparin and low molecular weight heparins (LMWHs) are commonly indicated drugs for surgery and non-surgery patients because of their effectiveness and safety in prevention and therapy of deep vein thrombosis. While the effect of LMWHs on coagulation cascade is commonly known, some other effects of these drugs are unknown.
Many papers present anti-inflammatory effects of LMWHs. Affecting of inflammation takes place on more levels. LMWHs block penetration of neutrophils into the tissue by inhibiting their adhesion to endothelial cells, by blocking of chemoatractants and by decreasing of elastases production. LMWHs affect production and activity of tumour necrosis factor α, interleukins 6 and 8 and interferon γ. LMWHs also decrease vascular permeability and stable structure of capillary basal membrane.
The effect of LMWHs on angiogenesis is not fully understood. While positive effect on fibroblast growth factor is frequently presented, the effect on vascular endothelial growth factor is controversial at least. Opinions concerning the effect on fibroblast growth and collagen production are also ambiguous. However, most of papers indicate positive effect of LMWH on this part of wound healing. Number of studies that point to the divergences of the effects of individual LMWHs is growing, thus explaining the differences between individual studies.
Small uncontrolled clinical studies show the possible utilization of LMWH in chronic wound treatment, especially in inflammatory bowel diseases treatment. However, for their practical application, more studies are needed.
Key words:
low molecular weight heparins, anti-inflammatory effects, angiogenesis, wound healing. To.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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