Heparin:Structure, Function, and Clinical Implications

The International Symposium on Heparin, held May 13-15, 1974, in St. Louis, Missouri, as a part of the dedication of the Shoenberg Pavilion of the Jewish Hospital of St. Louis, was conceived as a forum to bring together physicians and scientists with a basic interest in the structure, function and clinical usefulness of heparin. Few naturally occurring substances have commanded the breadth of interest among members of the biomedical research community as this compound has. Aspects of its covalent and three-dimensional structure, its biosynthesis, its interaction with and effect on physiologically important moieties and its use as a therapeutic agent in a variety of disease states have been actively studied for the past several decades. Thus, the present state of these studies seemed to be a timely subject for discussion, not only to gather together in one place representative samples of the myriad of data on heparin but also to underscore the ever increasing necessity for communication between basic research and clinical practice.The content and organization of this monograph reflect the scope and importance of this substance. The first section deals with the molecular properties of heparin, including characterization of the basic structure, its biosynthetic origins, its determination and pharmacological standardization and the role of individual structural elements in its biological properties. The second section deals with the functional consequences of the interaction of heparin with various physiological entities including antithrombin III, platelets, and lipoprotein lipase. The last section deals with the several clinical uses of heparin, emphasizing not only the results of many trials but also the problems that remain to be elucidated.