Heparin and Related Substances: Physiology and Pathophysiology in General and in Human Reproduction - Part 1

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2016; 13 (2): 38-48

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Keywords: antiphospolipid syndrome,  cancer,  embryonic development,  Endometrium,  fetal development,  heparan sulfate glycans,  Heparin,  heparinoids,  history,  human reproduction,  immunology,  measurement,  rheology

Although heparin is usually associated with blood clotting and thrombosis prevention, its anti-coagulatory properties play an extremely significant role in clinical routine. However, it appears to have little importance in rheological homeostatis, particularly since heparin and related substances can also be found in simpler organisms without clotting mechanisms. In fact, heparin and heparan sulfate glycans are proteoglycans that have a long history in the development of species. Accordingly, their primary effects are electrostatic, not receptor-mediated, and they exhibit binding via their pronounced electronegativity. They exist in free form and as membrane-bound molecules. In physiological terms, heparin and heparinoids are immunological co-factors involved in inflammation and wound healing; they play significant roles in embryo development and organogenesis, serve as “homing factors,” and are involved at various points in carcinogenesis. They show diverse interactions with cytokines, growth factors and other mediators that are important in the implantation process and its control and continue to be so throughout pregnancy. It can be assumed that reproduction is a key focus of physiological functions; this would explain why heparin is so effective above and beyond its anti-coagulatory effects, e.g. in treating anti-phospholipid syndrome. To date no clear confirmation of the existence of a heparin deficiency syndrome has been possible, although initial results from studies concerning the general administration of heparin during pregnancy point in this direction