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O objetivo desse estudo foi avaliar o comportamento da coagulação sanguínea em dois graus de profundidade de hemodiluição superficial com Ht de 30% e profunda com Ht de 20%, nas situações in vivo e in vitro, tendo como grupo controle os próprios pacientes não hemodiluídos. Para isso foram selecionados 13 pacientes ASA I ou II, submetidos à cirurgia de grande porte. A hemodiluição in vivo foi realizada segundo a fórmula de Gross até a obtenção dos hematócritos pretendidos. O sangue retirado foi reposto com solução de ringer com lactato na proporção de 3 ml para cada ml de sangue retirado e foi devolvido ao paciente ao final do procedimento anestésico. Avaliação hemodinâmica foi realizada continuamente e registrada a cada 15 minutos. Foram colhidos exames para os testes de coagulação nos momentos M1 antes da hemodiluição, M2 hemodiluição até hemataócrito de 30% e M3 hemodiluição até hematócrito de 20%. A hemodiluição in vitro foi realizada com a adição de ringer lactato a volume de sangue previamente colhido. O volume de ringer lactato acrescentado obedeceu à fórmula C1V1 = C2V2, onde C1 é o hematócrito inicial, o V1é o volume de sangue no tubo de ensaio, C2 é o hematócrito pretendido e V2 o volume final do tubo de ensaio. Amostras de sangue para os testes de coagulação foram colhidas em M2 e M3. A média de idade foi de 39,85 ± 18,39. O volume de sangue retirado para o obtenção dos hematócritos de 30% e 20% foi de 1158,5 ± 425,79 ml e 2211,31 ± 726.22 ml, respectivamente. Não houve diferença entre a pressão arterial média e a frequência cardíaca nos 3 momentos. Houve diminuição da temperatura em M2. A contagem de plaquetas diminuiu em M2 e M3. Os testes de coagulação in vivo mostraram aumento do TP, INR, TTPA, TT tanto em M2 quanto em M3. Houve diminuição da concentração de fibrinogênio em M2 e M3. Os testes de coagulação in vitro apresentaram comportamento semelhante. Quando se comparou o TP in vivo com o TP in vitro houve diferença estatística em M3. Nos demais testes in vivo comparados com os in vitro não houve diferença estatística em todos os momentos analisados. Conclui-se que a hemodiluição afeta os testes de coagulação e que a hemodiluição in vivo ou in vitro apresenta o mesmo comportamento no tocante aos testes de coagulação. / The objective of the present study was to evaluate the behavior of blood clotting at two hemodilution levels - superficial with 30% hematocrit (Ht), and profound with 20% Ht, in in vivo and in vitro situations, with the same non-hemodiluted patients serving as the control group. Thirteen ASA I or ASA II patients submitted to major surgery were selected for this purpose. In vivo hemodilution was performed by the formula of Gross until the intended hematocrits were obtained. The blood removed was replaced with Ringer lactate solution at the proportion of 3 ml per ml removed blood and was returned to the patient at the end of the anesthetic procedure. Continuous hemodynamic evaluation was performed and recorded at 15 minute intervals. Samples were obtained for the clotting tests at time T1 before hemodilution, T2 hemodilution to 30% hematocrit, and T3 - hemodilution to 20% hematocrit. In vitro hemodilution was performed by the addition of Ringer lactate to a previously collected blood volume. The added Ringer lactate followed the formula C1V1 = C2V2, where C1 is the initial hematocrit, V1 is the blood volume in the test tube, C2 is the intended hematocrit, and V2 the final volume in the test tube. Blood samples for the clotting tests were obtained at T2 and T3. Mean patient age was 39.85 ± 18.39 years. The blood volume removed for the determination of 30% and 20% hematocrit was 1158.5 ± 425.79 ml and 2211.31 ± 726.22 ml, respectively. There was no difference in mean arterial pressure or heart rate at the 3 times. There was a fall in temperature at T3 and a fall in platelet count at T2 and T3. The in vivo clotting tests showed an increase of PT, INR, APTT, TT at both T2 and T3. There was a reduction of fibrinogen concentration at T2 and T3. The in vitro clotting tests showed a similar behavior. When TP in vivo was compared to TP in vitro a statistically significant difference was observed at T3. No statistically significant differences were observed between the remaining in vivo and in vitro tests. We conclude that hemodilution affects the clotting tests and that in vivo or in vitro hemodilution presents the same behavior regarding clotting tests.

O objetivo desse estudo foi avaliar o comportamento da coagulação sanguínea em dois graus de profundidade de hemodiluição superficial com Ht de 30% e profunda com Ht de 20%, nas situações in vivo e in vitro, tendo como grupo controle os próprios pacientes não hemodiluídos. Para isso foram selecionados 13 pacientes ASA I ou II, submetidos à cirurgia de grande porte. A hemodiluição in vivo foi realizada segundo a fórmula de Gross até a obtenção dos hematócritos pretendidos. O sangue retirado foi reposto com solução de ringer com lactato na proporção de 3 ml para cada ml de sangue retirado e foi devolvido ao paciente ao final do procedimento anestésico. Avaliação hemodinâmica foi realizada continuamente e registrada a cada 15 minutos. Foram colhidos exames para os testes de coagulação nos momentos M1 antes da hemodiluição, M2 hemodiluição até hemataócrito de 30% e M3 hemodiluição até hematócrito de 20%. A hemodiluição in vitro foi realizada com a adição de ringer lactato a volume de sangue previamente colhido. O volume de ringer lactato acrescentado obedeceu à fórmula C1V1 = C2V2, onde C1 é o hematócrito inicial, o V1é o volume de sangue no tubo de ensaio, C2 é o hematócrito pretendido e V2 o volume final do tubo de ensaio. Amostras de sangue para os testes de coagulação foram colhidas em M2 e M3. A média de idade foi de 39,85 ± 18,39. O volume de sangue retirado para o obtenção dos hematócritos de 30% e 20% foi de 1158,5 ± 425,79 ml e 2211,31 ± 726.22 ml, respectivamente. Não houve diferença entre a pressão arterial média e a frequência cardíaca nos 3 momentos. Houve diminuição da temperatura em M2. A contagem de plaquetas diminuiu em M2 e M3. Os testes de coagulação in vivo mostraram aumento do TP, INR, TTPA, TT tanto em M2 quanto em M3. Houve diminuição da concentração de fibrinogênio em M2 e M3. Os testes de coagulação in vitro apresentaram comportamento semelhante. Quando se comparou o TP in vivo com o TP in vitro houve diferença estatística em M3. Nos demais testes in vivo comparados com os in vitro não houve diferença estatística em todos os momentos analisados. Conclui-se que a hemodiluição afeta os testes de coagulação e que a hemodiluição in vivo ou in vitro apresenta o mesmo comportamento no tocante aos testes de coagulação. / The objective of the present study was to evaluate the behavior of blood clotting at two hemodilution levels - superficial with 30% hematocrit (Ht), and profound with 20% Ht, in in vivo and in vitro situations, with the same non-hemodiluted patients serving as the control group. Thirteen ASA I or ASA II patients submitted to major surgery were selected for this purpose. In vivo hemodilution was performed by the formula of Gross until the intended hematocrits were obtained. The blood removed was replaced with Ringer lactate solution at the proportion of 3 ml per ml removed blood and was returned to the patient at the end of the anesthetic procedure. Continuous hemodynamic evaluation was performed and recorded at 15 minute intervals. Samples were obtained for the clotting tests at time T1 before hemodilution, T2 hemodilution to 30% hematocrit, and T3 - hemodilution to 20% hematocrit. In vitro hemodilution was performed by the addition of Ringer lactate to a previously collected blood volume. The added Ringer lactate followed the formula C1V1 = C2V2, where C1 is the initial hematocrit, V1 is the blood volume in the test tube, C2 is the intended hematocrit, and V2 the final volume in the test tube. Blood samples for the clotting tests were obtained at T2 and T3. Mean patient age was 39.85 ± 18.39 years. The blood volume removed for the determination of 30% and 20% hematocrit was 1158.5 ± 425.79 ml and 2211.31 ± 726.22 ml, respectively. There was no difference in mean arterial pressure or heart rate at the 3 times. There was a fall in temperature at T3 and a fall in platelet count at T2 and T3. The in vivo clotting tests showed an increase of PT, INR, APTT, TT at both T2 and T3. There was a reduction of fibrinogen concentration at T2 and T3. The in vitro clotting tests showed a similar behavior. When TP in vivo was compared to TP in vitro a statistically significant difference was observed at T3. No statistically significant differences were observed between the remaining in vivo and in vitro tests. We conclude that hemodilution affects the clotting tests and that in vivo or in vitro hemodilution presents the same behavior regarding clotting tests.

A linear diffusion test in sedimentation tubes filled with caseinagar gel successfully measured milk clotting enzymes at concentrations of 10-4 to 1 X 10-l rennin units/ml with 95% accuracy. Diffusion rates were unaffected by diluting enzyme samples with whey, 3% NaCl, and water, The distribution of rennet, porcine pepsin, mucor pusillus var Lindt (MP) protease, and rennet-pepsin mixtures between curd and whey was determined on milk coagulated at pH 5.2, 6.0, 6.4, and 6.6. The procedure accounted for 100 + 7% of the added enzymes. The distribution of rennet was pH dependent with 31% and 72% in curd and whey respectively at pH 6.6, and 864 and 174 respectively at pH 5.2. The distribution of MP protease was independent of pH with approximately 154 and 85% in the curd and whey at all pH values. Pepsin behaved similar to rennet but was unstable above pH 6.0. During Cheddar cheese making, 7% and 58% of the original rennet, 6% and 93% of the original MP protease, and 5% and 17% of the original rennet-pepsin mix was active in the curd and whey respectively at dipping. After overnight pressing, 6% of the rennet, 3% of MP protease, and 4% of the rennet-pepsin mix remained active in the cheese. At dipping only 9% of the original pepsin was detected in the whey. Pepsin was unstable at pH values used to release the enzyme from the curd and could not be quantitated.

Eliminating calcium chloride and replacing whole casein with k-casein eliminated clouding and sharpened diffusion boundaries in casein-agar gels used for the estimation of residual milk clotting enzymes in curd and whey. It also eliminated the need for a highly purified calcium-free agar. The substrate contained .54 percent k-casein, 3.6 percent sodium acetate, .73 percent bacto-agar and 95.13 percent water. The pH was adjusted to 5.9 with .lN hydrochloric acid. Proteases derived from Mucor pusillus var Lindt, Mucor Miehei and Endothia parasitica, as well as rennet, procine and bovine pepsins were used at recommended levels to set milk for Cheddar cheese manufacture. Whey samples from each lot were taken at draining and adjusted to pH 5.2, 5.6, 6.0, 6.2, 6.6 and 7.0 prior to being heated to 68.3C, 71.1C and 73.9C for .25, .5, 1, 5, and 10 minutes. Enzyme activities were assayed before and after heating. Mucor miehei protease was the most heat stable at all pH values followed by Mucor pusillus protease, rennet, bovine pepsin, E. parasitica protease and porcine pepsin. The heat stability of all enzymes except E. parasitica protease decreased with increasing pH, E. parasitica protease decreased with decreasing pH. All enzymes were inactivated at the minimum heat treatment at pH 7.0 except E. parasitica protease which was most stable at that pH. At pH 5.2 M. miehei protease persisted after a 10 minute treatment at 73.9C.

Platelet-rich plasma (PRP) is the cell free plasma, which has an enriched concentration of platelets and clotting factors with the ability to enhance the natural healing process. PRP is often used by physicians in an office setting to accelerate the healing of a variety of sports related injuries, chronic wounds and enhance skin rejuvenation. PRP mimics the wound healing cascade by enhancing the recruitment, proliferation and differentiation of cells involved in tissue regeneration. Although PRP is used to enhance healing, the efficacy thereof is debated as no clear-cut set of parameters is available that device manufacturers and protocols should follow. The lack of uniformity in the PRP preparation methods results in differing PRP volume, platelet contents and unavoidably platelet-derived growth factors. Therefore, the aim of this study was to develop a simple and rapid method for preparing autologous PRP in an office setting using a tabletop centrifuge for point-of-care use. The simplified preparation procedure involved a single centrifugation step of 18 ml of whole blood, which sufficiently enriched the platelet content in the PRP fraction. As activated platelets express and release growth factors and cytokines that mediate the different phases of the wound healing cascade, the extracted PRP fraction was activated with an ethanol, calcium chloride (CaCl2) and platelet poor plasma (PPP) preparation in glass containers, without the collection of additional blood as required in some protocols. The activated PRP formed a fibrin clot, trapping the degranulating platelets and its released growth factors. The concentration of TGF- 1 obtained from the fibrin clot was 45.49 ± 3.80 ng/ml, in range with the available literature. During the in vitro studies, the extracted PRP by the developed method was able to significantly induce cell proliferation in a dose dependent manner. Cells enumerated with the crystal violet assay indicated that the cells treaded with 5% or 10% PRP significantly increased the percentage of viable cells to 165-176% and 156-158%, when compared to the positive controls. Cells enumerated with the MTT-assay indicated that the cells treaded with 5% or 10% PRP increased the percentage of viable cells to 79-91% and 87-105% which is comparable to that of the positive control. Data from the cellular proliferation assays indicate that sufficient plateletderived growth factors had been obtained with the preparation procedure. Furthermore, data from the in vivo studies indicated that the extracted PRP was able to augment soft tissue regeneration and bone formation. Treatment with the activated PRP resulted in symptom reduction and accelerated healing of various injuries. The simplified preparation and the use of the provided study product packaged in a kit developed during this study will enable physicians to easily obtain autologous PRP, in an office setting for point-of-care use, with the ability to induce tissue regeneration. / Dissertation (MSc)--University of Pretoria, 2013 / gm2014 / Pharmacology / unrestricted

This work reviews studies of bovine K-casein and specifically K-casein macropeptide. Properties of K-casein, its structure and heterogeneity, proteolytic activity of some milk clotting enzymes on K-casein, and K-casein sensitive bonds are discussed. Macropeptides of other species are also presented. The carbohydrate moieties of bovine macropeptide together with their biological and physiological functions are reviewed. Macropeptides were produced by enzymic hydrolysis from whole casein solution using crystalline chymosin (EC 3.4.23.4). Trichloroacetic acid (final concentrations 2, 8 and 12%) was added after 5, 30 and 60 min of incubation to precipitate protein and inactivate the enzyme. The filtrate was then exhaustively dialyzed against distilled water to remove trichloroacetic acid and small molecules. The dialyzate was lyophilized and stored at -20deg;c until required for analysis. These macropeptides were then compared using RP-HPLC with macropeptides obtained from purified K-casein isolates by the same method (15 min incubation). Proteolytic activity of some milk-clotting enzymes (chymosin, Mucor miehei rennet and Endothia parasitica rennet) and some proteinases (trypsin and chymotrypsin) on K-casein and macropeptide isolated from K-casein was followed by RP-HPLC. The milk-clotting enzymes were standardized to the same clotting activity using a Formagraph. Each enzyme was incubated with .5 mix-casein and macropeptide solutions (10 mg in 1 ml .05 MpH 6.6 phosphate buffer) at 37°C for various incubation times. Reactions were stopped by addition .5 ml of 8 Murea containing 10-5 Mpepstatin or .025 ml pepstatin (1 mg pepstatin in 1 ml methanol). These reaction mixtures were separated into fractions using RP-HPLC and chromatograms of the different enzymes compared.

Die Dicklegung der Milch, ausgehend von der hydrolytischen Spaltung des κ-Caseins, stellt den ersten essentiellen Schritt in der Käseherstellung dar. Dabei finden Gerinnungsenzyme verschiedener Herkunft Anwendung, deren neueste Varianten auf Grundlage des aktuellen Forschungsstandes umfassend charakterisiert werden. Verschiedene Kälberlabpräparate, mikrobielle Gerinnungsenzyme aus Rhizomucor miehei und mit Hilfe von gentechnisch modifizierten Mikroorganismen gewonnenes Chymosin (FPC) aus Rind und Kamel werden mittels HPLC und Elektrophorese hinsichtlich ihrer Zusammensetzung analysiert. Die neueste Generation mikrobieller Enzyme weist im Gegensatz zur herkömmlichen Variante keine Nebenkomponenten und damit einen höheren Aufreinigungsgrad auf. Die unspezifische proteolytische Aktivität wird durch fluorimetrische Quantifizierung der in 12 % TCA löslichen Stickstoffkomponenten bestimmt, die nach Inkubation rekonstituierter Magermilch bei 32 °C und pH 6,5 über 24 h mit den Enzymen freigesetzt werden. Mikrobielle Gerinnungsenzyme besitzen eine signifikant höhere unspezifische proteolytische Aktivität gegenüber chymosinbasierten Präparaten, deren Auswirkung sich bei Erhöhung der zugegebenen Enzymmenge besonders ausgeprägt darstellen. Oszillationsrheometrische Analysen lassen bei gleicher Enzymaktivität eine geringere Gelfestigkeit nach 40 min bei Einsatz von mikrobiellen Präparaten im Vergleich zu Kälberlab und bovinem FPC erkennen. Zusätzlich wird eine Abhängigkeit der Flockungszeit und der Gelfestigkeit vom eingesetzten Substrat beobachtet, die für Chymosin aus Kamel besonders stark ausgeprägt ist. Die Substratspezifität dieses Enzyms ist weder mit der des bovinen Chymosins noch mit der der mikrobiellen Gerinnungsenzyme identisch. Im Rahmen von Käsungsversuchen im Labor-, Pilot- und Industriemaßstab wird eine signifikant höhere Käseausbeute (0,50 - 1,19 %) bei Verwendung vom traditionellem Kälberlab im Vergleich zur neuesten Generation der kommerziellen mikrobiellen Substitute ermittelt. Im Verlaufe der Reifung von Schnittkäse wird durch mikrobielles Gerinnungsenzym gegenüber Kälberlab eine signifikant höhere Menge an Nichtproteinstickstoff freigesetzt sowie ein unterschiedliches Profil an Proteinabbauprodukten gebildet. Die höhere proteolytische Aktivität resultiert in einer signifikant stärker ausgeprägten Bitterkeit der mit mikrobiellem Gerinnungsenzym hergestellten Käse nach 12 Wochen Reifungszeit. / Clotting of milk caused by hydrolytic cleavage of κ-casein is the first important step in cheese milk processing. This cleavage is caused by clotting enzymes of different origin, which are comprehensively characterized by considering results of latest investigations. The composition of selected calf rennets, microbial coagulants derived from Rhizomucor miehei and genetically engineered chymosin (FPC) derived from cow and camel is analyzed by HPLC and electrophoresis. In contrast to conventional products, the latest generation of microbial coagulants does not show minor components in a detectable amount because of a sufficient purification. The unspecific proteolytic activity is determined by fluorimetric quantification of 12 % tricloric-acid-soluble nitrogen, which is released by the enzymes from reconstituted skim milk, pH 6.5, after incubation at 32 °C for 24 h. Microbial coagulants show a significantly higher unspecific proteolysis as compared to chymosin-based clotting enzymes, especially when the enzymes are added in amount higher than used during cheese-making. Small amplitude oscillation rheometry analysis showed a lower gel firmness after 40 min of gelling when microbial coagulants were applied instead of calf rennet or FPC. Furthermore, flocculation time, gel formation time and gel firmness additionally depends on the test substrate, and this dependency is exceptionally pronounced when camel chymosin was used. The substrate specificity of this enzyme is neither identical to that of bovine chymosin nor to that of microbial coagulants. Cheese making experiments in laboratory-, pilot- and commercial-scale revealed a significantly higher cheese yield (0.50 - 1.19 %) when using calf rennet instead of microbial coagulant of the latest generation. During ripening of semi-hard cheese a higher amount of non-protein-nitrogen was released and a different electrophoretic casein degradation profile was generated when using microbial enzymes. Enhanced proteolysis is responsible for a significantly higher pronounced bitterness of microbial produced cheese after 12 weeks of maturation.

Die Dicklegung der Milch, ausgehend von der hydrolytischen Spaltung des κ-Caseins, stellt den ersten essentiellen Schritt in der Käseherstellung dar. Dabei finden Gerinnungsenzyme verschiedener Herkunft Anwendung, deren neueste Varianten auf Grundlage des aktuellen Forschungsstandes umfassend charakterisiert werden. Verschiedene Kälberlabpräparate, mikrobielle Gerinnungsenzyme aus Rhizomucor miehei und mit Hilfe von gentechnisch modifizierten Mikroorganismen gewonnenes Chymosin (FPC) aus Rind und Kamel werden mittels HPLC und Elektrophorese hinsichtlich ihrer Zusammensetzung analysiert. Die neueste Generation mikrobieller Enzyme weist im Gegensatz zur herkömmlichen Variante keine Nebenkomponenten und damit einen höheren Aufreinigungsgrad auf. Die unspezifische proteolytische Aktivität wird durch fluorimetrische Quantifizierung der in 12 % TCA löslichen Stickstoffkomponenten bestimmt, die nach Inkubation rekonstituierter Magermilch bei 32 °C und pH 6,5 über 24 h mit den Enzymen freigesetzt werden. Mikrobielle Gerinnungsenzyme besitzen eine signifikant höhere unspezifische proteolytische Aktivität gegenüber chymosinbasierten Präparaten, deren Auswirkung sich bei Erhöhung der zugegebenen Enzymmenge besonders ausgeprägt darstellen. Oszillationsrheometrische Analysen lassen bei gleicher Enzymaktivität eine geringere Gelfestigkeit nach 40 min bei Einsatz von mikrobiellen Präparaten im Vergleich zu Kälberlab und bovinem FPC erkennen. Zusätzlich wird eine Abhängigkeit der Flockungszeit und der Gelfestigkeit vom eingesetzten Substrat beobachtet, die für Chymosin aus Kamel besonders stark ausgeprägt ist. Die Substratspezifität dieses Enzyms ist weder mit der des bovinen Chymosins noch mit der der mikrobiellen Gerinnungsenzyme identisch. Im Rahmen von Käsungsversuchen im Labor-, Pilot- und Industriemaßstab wird eine signifikant höhere Käseausbeute (0,50 - 1,19 %) bei Verwendung vom traditionellem Kälberlab im Vergleich zur neuesten Generation der kommerziellen mikrobiellen Substitute ermittelt. Im Verlaufe der Reifung von Schnittkäse wird durch mikrobielles Gerinnungsenzym gegenüber Kälberlab eine signifikant höhere Menge an Nichtproteinstickstoff freigesetzt sowie ein unterschiedliches Profil an Proteinabbauprodukten gebildet. Die höhere proteolytische Aktivität resultiert in einer signifikant stärker ausgeprägten Bitterkeit der mit mikrobiellem Gerinnungsenzym hergestellten Käse nach 12 Wochen Reifungszeit. / Clotting of milk caused by hydrolytic cleavage of κ-casein is the first important step in cheese milk processing. This cleavage is caused by clotting enzymes of different origin, which are comprehensively characterized by considering results of latest investigations. The composition of selected calf rennets, microbial coagulants derived from Rhizomucor miehei and genetically engineered chymosin (FPC) derived from cow and camel is analyzed by HPLC and electrophoresis. In contrast to conventional products, the latest generation of microbial coagulants does not show minor components in a detectable amount because of a sufficient purification. The unspecific proteolytic activity is determined by fluorimetric quantification of 12 % tricloric-acid-soluble nitrogen, which is released by the enzymes from reconstituted skim milk, pH 6.5, after incubation at 32 °C for 24 h. Microbial coagulants show a significantly higher unspecific proteolysis as compared to chymosin-based clotting enzymes, especially when the enzymes are added in amount higher than used during cheese-making. Small amplitude oscillation rheometry analysis showed a lower gel firmness after 40 min of gelling when microbial coagulants were applied instead of calf rennet or FPC. Furthermore, flocculation time, gel formation time and gel firmness additionally depends on the test substrate, and this dependency is exceptionally pronounced when camel chymosin was used. The substrate specificity of this enzyme is neither identical to that of bovine chymosin nor to that of microbial coagulants. Cheese making experiments in laboratory-, pilot- and commercial-scale revealed a significantly higher cheese yield (0.50 - 1.19 %) when using calf rennet instead of microbial coagulant of the latest generation. During ripening of semi-hard cheese a higher amount of non-protein-nitrogen was released and a different electrophoretic casein degradation profile was generated when using microbial enzymes. Enhanced proteolysis is responsible for a significantly higher pronounced bitterness of microbial produced cheese after 12 weeks of maturation.