Low molecular weight heparins and their non-antithrombotic effects on wound healing

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 t...

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Bibliographic Details
Published inČasopis lékařů českých Vol. 148; no. 10; p. 481
Main Authors Toporcer, T, Lakyová, L, Radonak, J
Format Journal Article
LanguageSlovak
Published Czech Republic 2009
Subjects
Animals
Anti-Inflammatory Agents - pharmacology
Anticoagulants - pharmacology
Heparin, Low-Molecular-Weight - pharmacology
Humans
Neovascularization, Physiologic - drug effects
Wound Healing - drug effects
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Summary: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 alpha, interleukins 6 and 8 and interferon gamma. 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.
ISSN:0008-7335