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Dictionary of Allergies .. oversulphated chondroitin sulphate (OSCS)

OSCS may contaminate heparin, some lots of which  were associated with anaphylactic like reactions. There are some reports of deaths  after large doses of intravenous heparin administration (1, 2). The observed clinical adverse events have been attributed to the link between OSCS and  the activation of the contact system. It has been proposed Low-molecular weight heparins obtained by chemical and enzymatic depolymerization of heparin are also concerned. OSCS can directly activate the kinin–kallikrein pathway in human plasma, which can lead to the generation of bradykinin, a potent vasoactive mediator. In addition, OSCS induced generation of C3a and C5a, potent anaphylatoxins derived from complement proteins (3,4).

1. Zhang Z, Weiwer M, Li B, Kemp MM, Daman TH, Linhardt RJ. Oversulfated chondroitin sulfate: impact of a heparin impurity, associated with adverse clinical events, on low-molecular-weight heparin preparation. J Med Chem 2008;51:5498–5501.

2. Kishimoto TK, Viswanathan K, Ganguly T, Elankumaran S, Smith S, Pelzer K et al. Contaminated heparin associated with adverse clinical events and activation of the contact system. N Engl J Med 2008;358:2457–2467. 

3. Greinacher A, Warkentin TE. Contaminated heparin. N Engl J Med 2008;359:1291–1292; author reply 3.

4. Kakkar AK, Bonnefoi M. Contaminated heparin. N Engl J Med 2008;359:1292–1293; author reply 3.

Γκέλης Ν.Δ. - Λεξικό Αλλεργίας - Εκδόσεις ΒΕΛΛΕΡOΦΟΝΤΗΣ - Κόρινθος 2013

Gelis Ν.D. - Dictionary of Allergies - VELLEROFONTIS Publications - Corinth 2013