Sepsis/endotoxemia associates with coagulation abnormalities. We showed previously that exogenous choline treatment reversed the changes in platelet count and function as well as prevented disseminated intravascular coagulation (DIC) in endotoxemic dogs. The aim of this follow-up study was to evaluate the effect of treatment with choline or cytidine-5′-diphosphocholine (CDP-choline), a choline donor, on endotoxin-induced hemostatic alterations using thromboelastography (TEG). Dogs were randomized to six groups and received intravenously (iv) saline, choline (20 mg/kg) or CDP-choline (70 mg/kg) in the control groups, whereas endotoxin (0.1 mg/kg, iv) was used alone or in combination with choline or CDP-choline at the same doses in the treatment groups. TEG variables including R- and K-time (clot formation), maximum amplitude (MA) and α-angle (clot stability), G value (clot elasticity), and EPL, A, and LY30 (fibrinolysis), as well as overall assessment of coagulation (coagulation index - CI), were measured before and at 0.5–48 h after the treatments. TEG parameters did not change significantly in the control groups, except for CI parameter after choline administration. Endotoxemia resulted in increased R-time and A value ( < 0.05), decreased K-time (P < 0.05), α-angle ( < 0.001) and CI values ( < 0.01) at different time points. Treatment with either choline or CDP-choline attenuated or prevented completely the alterations in TEG parameters in endotoxemic dogs with CDP-choline being more effective. These results confirm and extend the effectiveness of choline or CDP-choline in endotoxemia by further demonstrating their efficacy in attenuating or preventing the altered viscoelastic properties of blood clot measured by TEG.

中文翻译：

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血栓弹力图评估胆碱或 CDP-胆碱治疗对犬内毒素诱导的止血改变的有效性

败血症/内毒素血症与凝血异常有关。我们之前表明，外源性胆碱治疗可逆转内毒素血症犬血小板计数和功能的变化，并预防弥散性血管内凝血（DIC）。这项后续研究的目的是使用血栓弹力图 (TEG) 评估胆碱或胆碱供体胞苷-5'-二磷酸胆碱 (CDP-choline) 治疗对内毒素诱导的止血改变的影响。将狗随机分为六组，对照组接受静脉注射（iv）盐水、胆碱（20 mg/kg）或 CDP-胆碱（70 mg/kg），而单独使用内毒素（0.1 mg/kg，iv）或在治疗组中以相同剂量与胆碱或CDP-胆碱组合。 TEG 变量包括 R 和 K 时间（凝块形成）、最大振幅 (MA) 和 α 角（凝块稳定性）、G 值（凝块弹性）以及 EPL、A 和 LY30（纤维蛋白溶解）以及总体在治疗前和治疗后 0.5-48 小时测量凝血评估（凝血指数 - CI）。除了给予胆碱后 CI 参数外，对照组的 TEG 参数没有显着变化。内毒素血症导致不同时间点R-time和A值增加（<0.05），K-time减少（P<0.05），α-角（<0.001）和CI值（<0.01）减少。胆碱或 CDP-胆碱治疗可减弱或完全阻止内毒素血症犬 TEG 参数的变化，其中 CDP-胆碱更有效。这些结果通过进一步证明胆碱或 CDP-胆碱在减弱或防止 TEG 测量的血凝块粘弹性特性改变方面的功效，证实并扩展了胆碱或 CDP-胆碱在内毒素血症中的有效性。