Origin of the gender differences of the natural resistance to antivitamin K anticoagulants in rats

Vitamin K antagonists (VKA) are used either in human medicine to prevent thromboembolic disorders or as rodenticides for pest control management. In rodents, female rats are described to be more tolerant to the action of vitamin K antagonists than males. Nevertheless, the mechanism of this greatest tolerance is still unknown and this study aims to identify the origin of this greatest tolerance after VKA administration. Therefore, difethialone, one of the most powerful VKA was used in this study.A possible difference in the pharmacokinetics of difethialone between males and females was first investigated. The determination of the pharmacokinetic parameters allowed to exclude a pharmacokinetic origin of the greatest tolerance of females to VKA. Thus, a natural resistance to difethialone of the liver VKOR activity, which is the target of VKA, was thus explored in females. The determination of Ki towards difethialone in liver microsomes allowed to also exclude this hypothesis. Therefore, equipment in vitamin K-dependent clotting factors and properties of vitamin K-dependent clotting factors were explored. Basal activity of clotting factors VII and X were found significantly higher in females of respectively 43% and 21%. Moreover, after VKA administration, half-lives of clotting factors II and X were found significantly longer in females of respectively 27% and 10% and a lag time of 4 h before the beginning of the decay of factor VII was observed only in females after difethialone administration. The greater tolerance of female rats to VKA is thus due a stronger basal pool of vitamin K-dependent clotting factors VII and X and to a slower decline of vitamin K-dependent clotting factors II, VII and X after VKA administration.