ORAL CONTRACEPTIVE HORMONES AND BLOOD COAGULABILITY.
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Biomedical subjects
Publications and source records attributed to L POLLER.
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In view of the possible relationship to thrombosis the ;anti-heparin' activity of blood protein fractions was studied. Serum and plasma were separated by continuous paper curtain electrophoresis and two different groups of fractions with anti-heparin activity found. One group was associated with the fast gamma globulins and the other with the alpha globulins. The fast gamma activity appeared to be identical with the contact activation product (activated factors XI and XII). The alpha globulin activity is different from any of the known serum clotting factors. This activity may be due to a previously unrecognized clotting factor or may be a coagulant property of certain blood proteins which act by binding heparin. The clinical implications of these findings are discussed. It is suggested that the fast gamma globulin anti-heparin fraction may be identical with Wessler's serum thrombotic accelerator and the alpha globulin activity is a separate entity.
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Sodium-alpha-naphthylamine-4-sulphonate (Naphthionin) appears to shorten the bleeding time in normal subjects and to be of value in the management of the bleeding defect in patients with thrombocytopenia when given by intravenous or intramuscular injection. A good response was achieved in three patients suffering from severe haemorrhage and the prolonged bleeding time in other cases of thrombocytopenia was shortened. There is no evidence that Naphthionin is of value in haemostasis in other patients in whom haemorrhage is not due directly to thrombocytopenia.
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Leucocyte alkaline phosphatase activity has been determined in a normal group, a group of pregnant patients, and a group of patients with ectopic pregnancy.A great rise in alkaline phosphatase occurred in pregnant patients in their third trimester, but the results were only slightly raised in the ectopic group. Five of six consecutive cases gave results which fell within the normal range. The method is not considered to be of value in the diagnosis of ectopic pregnancy.
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Stored serum reduces the anticoagulant effect of heparin on the clotting times of normal plasma. This is also well marked with sera from patients with Christmas (factor IX) deficiency, with factor VII-deficient sera, and in sera derived from patients treated with phenindione with a gross defect in thromboplastin generation. The possible relationship between antiheparin activity of serum and heparin resistance in recent thrombosis is discussed. The antiheparin agent resembles factor VII and Christmas factor in being present in excess in serum, adsorbed and subsequently eluted from alumina. Unlike these, however, it does not appear to be appreciably reduced by phenindione treatment. It appears to have some properties in common with those described for the thrombotic agent of serum described by Wessler and his colleagues. It may play a part in the increased coagulability associated with thrombosis from the release of serum products into the circulation, although its relationship to the production of thrombosis in man remains to be established.