Pentosan Polysulfate and Heparin Exhibit Comparable Interactions with Platelet Factor 4, Suggesting a Potential Risk of Thrombocytopenia

Nizzolo S, Zanzoni S, Holthoff HP, Girasole M, Gruber R, Lenhart D, Yates E, Guerrini M, Bertini S · ACS Omega

PPS binds platelet factor 4 and forms antigenic complexes recognized in immunoassays, with interaction strength between low-molecular-weight and unfractionated heparin and rising with molecular weight — a mechanistic basis for HIT-like reactions that the authors say warrants platelet monitoring with parenteral dosing.

Population

PPS, its size-separated fractions, and heparins characterized against platelet factor 4

Intervention

Biophysical binding and immunoassay studies of PPS–PF4 complexes

Comparator

Unfractionated and low-molecular-weight heparins

Limitations

Biophysical and immunoassay work, not clinical events; two authors are employees of bene PharmaChem, a PPS manufacturer.