Human platelet factor 4 and protamine sulphate interaction with glycosaminoglycans in the rabbit

We studied the action of protamine sulphate on human platelet factor 4 (PF4) kinetics in rabbits in the presence of various glycosaminoglycans (CAGs). The animals pretreated with heparin showed high initial PF4 levels with a subsequent slow monoexponential clearance. The PF4 kinetics, in the presence of heparan and dermatan sulphate, reflected the different affinities that PF4 has for these GAGs. Protamine, at dosages that totally neutralized 1000 USP units of heparin pretreatment, caused an immediate disappearance in the circulating PF4. However, a second heparin injection 10 min after protamine, induced a PF4 peak release. It is possible that protamine displaced the PF4 from the binding sites of heparin, releasing it for storage in the body 'pool', from where it can be harvested again. The action of protamine on PF4 kinetics in the rabbits pretreated with 30 mg heparan sulphate was similar to that obtained with heparin pretreatment; however, a higher dose of protamine was required to obtain the optimal effect. After a 20 mg dose of protamine, unexpectedly, a bolus of heparin did not produce any peak release of PF4 in the rabbits pretreated with 30 mg of dermatan sulphate. Although part of the protamine will displace PF4 from the binding sites of the dermatan sulphate molecule, the remaining part of protamine could probably be bound to this GAG without losing its activity so that, upon subsequent heparin injection, it is immediately neutralized, rendering it unavailable for further PF4 harvesting.