Pf4

FIGURE 3 Atomic force microscopy of PF4 (upper panel) and PF4/UFH complexes (lower panel) shows the structural changes that PF4 undergoes when it complexes to UFH. PF4 molecules maintain a certain distance to each other due to their strong positive charges. When charges are neutralized by negatively charged heparin, PF4 molecules form linear, ridge- like clusters. Abbreviations: PF4, platelet factor 4; UFH, unfractionated heparin. Source: From Greinacher et al., 2006.

FIGURE 3 Atomic force microscopy of PF4 (upper panel) and PF4/UFH complexes (lower panel) shows the structural changes that PF4 undergoes when it complexes to UFH. PF4 molecules maintain a certain distance to each other due to their strong positive charges. When charges are neutralized by negatively charged heparin, PF4 molecules form linear, ridge- like clusters. Abbreviations: PF4, platelet factor 4; UFH, unfractionated heparin. Source: From Greinacher et al., 2006.

that blood obtained from some patients with acute myocardial infarction contains anti-PF4/heparin antibodies, despite apparent absence of previous exposure to heparin (Suzuki et al., 1997). Perhaps, antibodies with cross-reactivity to PF4— heparin complexes may have been generated against such endogenous GAG-PF4 complexes, even without preceding heparin treatment. Whether such antibodies contribute to the pathogenesis of cardiac ischemia is not established. A retrospective analysis of patients with acute coronary syndrome found that the presence of anti-PF4/heparin antibodies at onset was associated with a higher risk of acute myocardial infarction and death (Williams et al., 2003). This observation requires prospective confirmation.

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