Deadly dose: Rensselaer heparin expert helps uncover source of lethal contaminationApril 28, 2008Troy, N.Y. -- The mysterious death of patients around the world following a routine dosage of the common blood thinner, heparin, sent researchers on a frantic search to uncover what could make the standard drug so toxic. A researcher at Rensselaer Polytechnic Institute was among a small group of scientists with the expertise and the high-tech equipment necessary to determine the source of the contamination. Robert J. Linhardt, the Ann and John H. Broadbent Jr. '59 Senior Constellation Professor of Biocatalysis and Metabolic Engineering at Rensselaer, is part of an international team that recently announced it had uncovered the source of the deadly contamination. On April 23, the team led by researchers at the Massachusetts Institute of Technology (MIT), described the source in the journal Nature Biotechnology -- a complex carbohydrate named oversulfated chondroitin sulfate, which has a structure so similar to heparin it was nearly undetectable to less advanced technology. "Days after the deaths were first linked to heparin, we had the drugs in our hands from the FDA and our nuclear magnetic resonator (NMR) was set into motion to break down the structure of the drug and determine what could possibly be the source of the contamination," Linhardt said. "Now that we know the most likely source of the contamination, we are developing much stronger monitoring systems to ensure that this type of contamination is detected before it reaches patients." Although extremely close in chemical structure to heparin, the contaminant caused severe allergic reaction in many patients who were receiving routine treatment for kidney dialysis, heart surgery, and other common medical issues. The researchers' extremely detailed structural analysis of the drug, using technology such as the NMR, was able to detect the minute differences between the contaminated drug and a normal dosage of heparin. And while Linhardt and others are developing more sophisticated detection systems, Linhardt also is helping lead the race for a safer, man-made alternative to the traditional biologic heparin. Biological heparin is currently developed by purifying the scrapings of pig and cow intestines. "This contamination is unfortunately a sign that the way we currently manufacture heparin is simply unsafe," he said. "Because we rely on animals, we open ourselves up for spreading prions and diseases like mad cow disease through these animals. And because most of the raw material is imported, we often can't be sure of exactly what we are getting." Linhardt is helping lead the global race to develop a synthetic alternative to heparin that could help eliminate the potential for contamination and adverse affects of biologic heparin. His lab developed the first fully synthetic heparin in amounts large enough for human dosage in 2005, and he continues to work to get the product further tested and commercialized. "A synthetic heparin is built using sugars and enzymes found in the human body," Linhardt said of his recipe for synthetic heparin. "So instead of taking pig intestines and trying to purify it over and over again to reduce it down to just heparin, we are building heparin from scratch with no foreign material present. This method ensures that we know exactly what is in the drug and have complete control over its ingredients." Rensselaer Polytechnic Institute |
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| Related Heparin Current Events and Heparin News Articles Scientists successfully reprogram blood cells Researchers have transplanted genetically modified hematopoietic stem cells into mice so that their developing red blood cells produce a critical lysosomal enzyme -preventing or reducing organ and central nervous system damage from the often-fatal genetic disorder Hurler's syndrome. Investigation of contaminated heparin syringes highlights medication safety issues An outbreak of bloodstream infections appears to have been caused by the contamination of pre-filled heparin and saline syringes made by a single company. Drug-eluting stents better than bare-metal stents for heart attack patients Late-breaking data from the landmark HORIZONS-AMI clinical trial, presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, demonstrated that after two years, in heart attack patients, the use of a drug-eluting stent (paclitaxel) was safer and more effective than a bare-metal stent; and that the administration of the anticoagulant medication bivalirudin enhanced safety and efficacy compared to the use of heparin + GPIIb/IIIa inhibitors. Otamixaban for the treatment of patients with non-ST-elevation acute coronary syndromes Data from a phase II trial of an investigational intravenous drug designed to block the formation of blood clots shows potential to reduce the risk of death, a second heart attack, or other coronary complications compared with the current standard of care in patients presenting with acute coronary syndromes (heart attacks or unstable angina). Patient safety advanced by revised heparin standards Continuing to help ensure the identity, purity and quality of heparin, the U.S. Pharmacopeial (USP) Convention has revised written and physical standards for the widely used blood thinner. 'Artificial Golgi' may provide new insight into key cell structure Scientists in New York and North Carolina are reporting assembly of the first functioning prototype of an artificial Golgi organelle. Research highlights new approaches to prevent blood clots Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured. Simple new method detects contaminants in life-saving drug The blood-thinning drug heparin is highly effective when used to prevent and treat blood clots in veins, arteries and lungs, but earlier this year its reputation as a lifesaver was sullied when contaminated heparin products caused serious allergic reactions that led to a large number of deaths. HORIZONS AMI will help set guidelines for drug and stent therapy The HORIZONS AMI clinical trial measuring the safety and efficacy of the use of the medication bivalirudin compared to standard drug therapy - heparin and glycoprotein IIb/IIIa inhibitors -- in heart attack patients who receive angioplasty, found that after 1 year, use of bivalirudin resulted in significantly lower rates of all-cause death, death from cardiac causes, and major bleeding. Safety of antithrombotic treatment in acute coronary syndromes The management of acute coronary syndromes (with or without ST segment elevation) requires the use of anticoagulants, antiplatelet agents (aspirin, clopidogrel and/or glycoprotein (GP) IIb/IIIa inhibitors), beta-blockers, thrombolytics in some cases, and revascularization / reperfusion. More Heparin Current Events and Heparin News Articles |
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