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The secret weapon of anticoagulants: Why is heparin known as the "source of life"
Heparin, an anticoagulant discovered in the early 1900s, has become an indispensable life support tool in the medical community. The impact of its mechanism of action and scope of use on medical effects cannot be underestimated. Especially in the treatment of acute conditions such as heart attacks and unstable angina, heparin provides vital help. However, the history, mechanisms, and risks of use of this widely used drug may not be fully understood.
The history of heparin
The discovery of heparin dates back to 1916, when it was first proposed by Jay McLean and William Henry Howell. Over time, clinical testing of heparin officially began in 1935. Initial studies were conducted on cells isolated from dog livers, which is where the name comes from, the Greek word for liver (hēpar).
"Heparin is not only a drug that targets coagulation, but its history is also a prosperous scientific development process."
Medical uses of heparin
As an anticoagulant, heparin’s main function is to prevent blood clotting, especially in the following situations:
- Acute coronary syndrome (e.g., NSTEMI)
- Atrial fibrillation
- Deep vein thrombosis and pulmonary embolism.
Heparin is not only used therapeutically but is often used in routine medical procedures such as heart surgery and dialysis. Patients who are unable to take oral medications often need to give heparin via intravenous or subcutaneous injection, which is particularly important in emergency situations.
Side effects of heparin
Despite its wide range of medical applications, heparin still needs to be administered with caution. Common side effects include pain at the injection site, bleeding, and low platelets. The most notable side effect is heparin-induced thrombocytopenia (HIT), an immune response that can worsen a patient's condition.
"The use of heparin requires careful monitoring, especially in certain high-risk groups."
Physiological effects of heparin
The normal role of heparin in the human body is not yet fully understood. Preliminary research suggests that heparin is mainly one of the defense mechanisms that assists the body in resisting infection. The fact that heparin is found in many organisms, including some invertebrates that lack blood clotting systems, suggests that its function may have evolved to be antimicrobial rather than just anticoagulant.
Synthesis and Pharmacology
Pharmacologically, the structure of heparin is a polymer with a molecular weight ranging from 3 to 30 kDa. Due to its high negative charge, heparin does not work well when administered orally and must therefore be given by injection. Based on molecular size, heparin can be divided into unfractionated heparin (UFH) and low molecular weight heparin (LMWH), with the latter providing more predictable efficacy.
Global dependence and new challenges
Heparin is produced from the meat processing industry, mainly from the intestinal tissue of pigs or cattle. However, affected by the COVID-19 epidemic, the heparin supply chain has been severely squeezed, especially during the epidemic, meat processing plants have become virus hotspots, further worsening the shortage of heparin. In some poorer countries, this has led to huge challenges in non-pandemic health care services such as heart surgery.
Conclusion
As an ancient and classic anticoagulant, heparin’s effectiveness has been verified by countless studies and clinical practices. In the post-COVID-19 medical system, how to ensure a stable supply of this precious resource and ensure its safe use will be an important issue for the global medical community. Should we rethink how we deliver heparin to ensure more lives are protected in the future?
