Fibrinolytics and antifibrinolytics [with 50 tables]

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Sprache:English
Veröffentlicht: Berlin [u.a.] Springer 2001
Schriftenreihe:Handbook of experimental pharmacology 146
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Datensatz im Suchindex

_version_ 1819633345650229248
adam_text FIBRINOLYTICS AN D ANTIFIBRINOLYTICS CONTRIBUTOR S F. BACHMANN , D.C. BERRIDGE , C. BODE , H . BOUNAMEAUX , F.J. CASTELLINO, J.H. CHESEBRO , A.C . CHIU, D. COLLEN, G.J. DEL ZOPPO , W. DIETRICH , P. DONNER , J.J. EMEIS , L. FLOHE , V. FUSTER , R. GALLO, W.A. GUNZLER , V. GUREWICH , E . HABER , S.B. HAWLEY, R. HAYES, T. HERREN , XL. HOOVER-PLOW, J. HORROW, T. KOOISTRA, E.K.O . KRUITHOF, H.R . LIJNEN, VJ . MARDER , L.A. MILES, K. PETER , E.F. PLOW, V.A. PLOPLIS, A . REDLITZ , M.S. RUNGE , CM . SAMAMA , M.M. SAMAMA , A.A . SASAHARA , W.-D. SCHLEUNIG, G.V.R.K. SHARMA , O. TABY, E.J. TOPOL, M. VERSTRAETE , S. XU E EDITOR : F. BACHMANN SPRINGER CONTENTS SECTION I: MOLECULAR BIOLOGY, BIOCHEMISTRY, PHYSIOLOGY, AND PHARMACOLOGY OF THE PLASMINOGEN-PLASMIN ENZYME SYSTEM CHAPTER 1 THE FIBRINOLYTIC SYSTEM AND THROMBOLYTIC AGENTS F. BACHMANN. WITH 1 FIGURE 3 A. THE FIBRINOLYTIC SYSTEM 3 B. MECHANISMS WHICH LEAD T O TH E LYSIS OF A THROMBU S 5 C. PATHOPHYSIOLOGY OF THE FIBRINOLYTIC SYSTEM 7 I. DECREASE D FIBRINOLYTIC ACTIVITY AND DEE P VENOUS THROMBOSIS 7 1. FAMILIAL THROMBOPHILI A WITH HIGH PAI-1 LEVELS 7 2. ACQUIRE D ASSOCIATION OF HYPOFIBRINOLYSIS AN D DEE P VENOUS THROMBOSIS 7 II. IMPAIRE D FIBRINOLYSIS AND CORONAR Y HEAR T DISEASE 9 D. THROMBOLYTIC THERAPY 10 I. BASIC CONSIDERATION S 10 1. THE PROTEOLYTIC STATE AND BLEEDING COMPLICATIONS 10 2. THROMBIN GENERATIO N AND REOCCLUSION 10 3. DELAY T O TREATMEN T 10 4. PLATELET ACTIVATION 11 5. CONTRAINDICATION S FOR THROMBOLYTIC THERAPY 11 6. FIBRIN SPECIFICITY 11 7. ANTIGENICITY 12 8. TREATMENT OF ELDERLY PATIENTS 12 E. MILESTONES IN THROMBOLYTIC THERAP Y OF ACUT E MYOCARDIAL INFARCTION 13 I. FIRST GENERATIO N AGENT S 13 II. SECOND GENERATIO N AGENT S 13 III. THIRD GENERATIO N AGENT S 13 IV. THE FUTUR E OF THROMBOLYTIC THERAP Y 15 XII CONTENTS LIST OF ABBREVIATION S AN D ACRONYM S 15 REFERENCE S 15 CHAPTE R 2 PLASMINOGEN AND STREPTOKINASE F.J. CASTELLINO AN D V.A. PLOPLIS . WITH 3 FIGURE S 25 A . PRIMAR Y STRUCTUR E OF HUMA N PLASMINOGE N 25 B. GEN E ORGANIZATIO N OF HUMA N PLASMINOGE N 28 C. THE ACTIVATIO N OF HUMA N PLASMINOGE N 29 I. GENERA L CONSIDERATION S 29 II . ACTIVATIO N OF HUMA N PLASMINOGE N BY TWO-CHAIN UROKINAS E AND TISSUE-TYP E PLASMINOGE N ACTIVATO R 33 1. MECHANIS M OF ACTIVATIO N OF HUMA N PLASMINOGE N 33 2. POSITIVE AND NEGATIV E ACTIVATIO N EFFECTORS 34 III . ACTIVATIO N OF HUMA N PLASMINOGE N BY SINGLE-CHAIN UROKINAS E 35 IV. ACTIVATIO N OF HUMA N PLASMINOGE N BY STREPTOKINAS E 36 1. STRUCTURA L AN D ACTIVATIO N FEATURE S OF STREPTOKINASE S .. . 36 2. MECHANIS M OF ACTIVATIO N OF HUMA N PLASMINOGE N BY HUMA N HOST-DERIVE D STREPTOKINAS E 39 3. FUNCTIONA L REGION S OF HUMA N PLASMINOGE N AN D HUMAN-DERIVE D STREPTOKINAS E THA T MEDIAT E ACTIVATIO N 41 V. ACTIVATIO N OF HUMA N PLASMINOGE N BY STAPHYLOKINAS E 42 D. SPONTANEOU S AN D INDUCE D PHENOTYPE S OF PLASMINOGE N DEFICIENCY 43 LIST OF ABBREVIATION S 44 REFERENCE S 45 CHAPTE R 3 TISSUE-TYPE PLASMINOGEN ACTIVATOR (TPA ) F. BACHMANN. WITH 2 FIGURES 57 A . MILESTONE S IN TISSUE-TYPE PLASMINOGE N ACTIVATO R (TPA ) RESEARC H 57 B. SOURCE S OF TPA 58 C. METABOLIS M OF TPA 59 D. STRUCTUR E AN D BIOCHEMISTR Y OF TPA 60 I. GEN E STRUCTUR E OF TPA 60 1. TRANSLATE D REGION S 60 2. 5 AN D 3 FLANKIN G REGION S 60 3. POLYMORPHISMS 62 II . PROTEI N STRUCTUR E OF TPA 62 1. PRIMAR Y AMIN O ACI D SEQUENC E 62 CONTENTS XIII A) THE FINGER DOMAI N 63 B ) THE EPIDERMA L GROWT H FACTOR DOMAIN 63 C) THE KRINGLE DOMAIN S 64 D ) THE PROTEAS E (CATALYTIC) DOMAI N 65 2. CRYSTAL STRUCTUR E OF TH E PROTEAS E DOMAIN 65 3. GLYCOSYLATION OF TPA 65 III. ENZYMATIC PROPERTIE S OF TPA 66 1. ENZYME KINETICS IN THE ABSENC E AND PRESENCE OF FIBRIN 66 2. DIFFERENCES BETWEEN SC-TPA AND TC-TPA 67 3. LOCALIZATION OF TH E EPITOPE S IN FIBRIN THAT ENHANC E THE RAT E OF PLASMINOGEN ACTIVATION BY TPA 68 IV. INTERACTION S OF TPA WITH SERPINS 68 E . THE TPA RECEPTOR S 70 I. ACTIVATION RECEPTOR S 70 II. CLEARANC E RECEPTOR S 71 1. THE MANNOS E RECEPTO R 71 2. THE LD L RECEPTOR-RELATE D PROTEIN (LRP, A 2 -MACROGLOBULIN RECEPTOR ) 72 F. PATHOPHYSIOLOGY OF TPA 72 I. INTRAVASCULAR FUNCTION OF TPA 72 II . OTHE R FUNCTIONS OF TPA 74 LIST OF SYMBOLS AND ABBREVIATION S 75 REFERENCES 76 CHAPTE R 4 URINARY-TYPE PLASMINOGEN ACTIVATOR (UPA ) W.A. GUNZLE R AND L. FLOHE . WITH 2 FIGURES 91 A . MILESTONE S IN UPA RESEARC H 91 B. NOMENCLATUR E OF UPA FORMS 92 C. SOURCE S OF UPA 93 D. ASSAY OF UPA 93 E. BIOCHEMISTR Y OF UPA 94 I. THE UPA GEN E 94 II. THE UPA STRUCTUR E 95 III . NON-PROTEI N COMPONENT S OF UPA 97 IV. PROTEOLYTI C CONVERSION S OF UPA 9S V. UPA ACTIVITY 99 F. PHYSIOLOGY OF UPA 100 I. INTRAVASCULA R AND INTRATUBULA R FUNCTION S OF UPA 102 II. ROL E OF UPA IN TISSUE REMODELIN G AND CELL MIGRATION ... . 102 LIST OF ABBREVIATION S 103 REFERENCE S 103 XIV CONTENTS CHAPTE R 5 THE INHIBITORS OF THE FIBRINOLYTIC SYSTEM E.K.O . KRUITHOF. WITH 1 FIGURE IL L A . INTRODUCTIO N .. . B. OH-ANTIPLASMIN I. GEN E AN D PROTEI N STRUCTUR E II. TARGET ENZYM E SPECIFICITY . III . A 2 -ANTIPLASMI N DEFICIENCIES 11 11 13 14 C. PLASMINOGEN ACTIVATO R INHIBITO R TYPE 1 114 I. GEN E STRUCTUR E 114 II. PROTEI N STRUCTUR E 115 III . TARGET ENZYM E SPECIFICITY OF PAI-1 116 IV. DEFICIENCIES, KNOCKOUT , AN D OVEREXPRESSIO N IN MICE V. ROLE OF PAI-1 IN CELL MIGRATIO N VI . DISTRIBUTIO N OF PAI-1 IN VIVO VII . GEN E REGULATIO N OF PAI-1 VIII . PAI-1 AS A MARKE R FOR VASCULAR AN D ARTERIA L DISEASE 16 16 17 18 18 18 19 IX. PAI-1 AN D TH E ACUT E PHAS E RESPONS E X. PAI-1 AN D SEPTICEMI A D. PLASMINOGEN ACTIVATO R INHIBITO R TYPE 2 119 I. GEN E AN D PROTEI N STRUCTUR E 119 II. TARGET ENZYM E SPECIFICITY 120 III . DISTRIBUTIO N OF PAI-2 IN VIVO 120 IV. GEN E REGULATIO N OF PAI-2 121 V. THE PHYSIOLOGICAL ROL E OF PAI-2 121 E. PLASMINOGEN ACTIVATO R INHIBITOR S IN PREGNANCY 121 F. THERAPEUTI C APPLICATION S OF PAI-1 AN D PAI-2 122 I. PAI-1 123 II. PAI-2 123 G. OTHE R PROTEAS E INHIBITOR S OF TH E FIBRINOLYTIC SYSTEM 123 H. INHIBITOR S OF PLASMINOGE N BINDIN G T O FIBRIN O R CELL SURFACES 124 I. HISTIDINE-RIC H GLYCOPROTEI N 124 II. LIPOPROTEIN(A ) 125 III . CARBOXYPEPTIDASE S 126 I. CONCLUSIONS 126 LIST OF ABBREVIATION S 127 REFERENCE S 127 CHAPTE R 6 ASSEMBLY OF THE PLASMINOGEN SYSTEM ON CELL SURFACES E.F. PLOW, A . REDLITZ , S.B. HAWLEY, S. XUE , T. HERREN , J.L. HOOVER-PLOW, AN D L.A . MILES . WITH 3 FIGURES 141 A . INTRODUCTIO N 141 B. PLASMINOGEN RECEPTOR S 142 CONTENTS XV I. GENERA L CHARACTERISTIC S 142 II . NATUR E OF PLASMINOGEN RECEPTOR S 143 III . REGULATIO N OF PLASMINOGEN RECEPTOR S 145 C. TPA RECEPTOR S 148 I. GENERA L CHARACTERISTIC S 148 II . RECOGNITIO N OF TPA 148 III . CELLULAR DISTRIBUTIO N OF TPA RECEPTOR S 148 1. ENDOTHELIA L CELLS 148 2. CIRCULATING BLOOD CELLS 149 3. CELLS OF NEURONA L ORIGIN 149 4. VASCULAR SMOOTH MUSCLE CELLS 149 5. TUMOR CELLS 149 D. UROKINAS E RECEPTOR S 150 I. GENERA L CHARACTERISTIC S 150 II . THE UROKINAS E RECEPTOR , UPA R 150 1. CELLULAR DISTRIBUTIO N OF UPA R 150 2. RECOGNITIO N SPECIFICITY OF UPA R 150 3. THE UPA R GEN E 151 4. THE UPA R PROTEI N 151 5. REGULATIO N OF UPA R EXPRESSIO N 153 6. NON-PROTEOLYTI C FUNCTION S OF UPA R 153 III . OTHE R UPA RECEPTOR S 154 E . FUNCTIONA L CONSEQUENCE S OF RECEPTO R OCCUPANCY 155 I. KINETIC CONSEQUENCE S 155 1. PLASMINOGEN RECEPTOR S 155 A) ENHANCE D PLASMINOGEN ACTIVATION 156 B ) AMPLIFICATION LOOP S 156 C) PROTECTIO N OF PLASMIN ACTIVITY 156 D ) ENHANCEMEN T OF PLASMIN ACTIVITY 156 2. UPA RECEPTOR S 156 3. TPA RECEPTOR S 157 II . FUNCTIONA L CONSEQUENCE S 157 LIST OF ABBREVIATION S 158 REFERENCE S 158 SECTION II: CLINICAL US E OF THROMBOLYTIC AGENTS IN ACUTE MYOCARDIAL INFARCTION CHAPTER 7 STREPTOKINASE AND ANISOYLATED LYS-PLASMINOGEN STREPTOKINASE ACTIVATOR COMPLEX V.J. MARDER AND F. BACHMANN. WITH 2 FIGURES 173 A . INTRODUCTIO N 173 I. PHARMACOLOGY 173 1. STREPTOKINAS E (SK) 173 XVI CONTENTS 2. ANISOYLATE D LYS-PLASMIN(OGEN ) STREPTOKINAS E ACTIVATO R COMPLE X (APSAC , ANISTREPLASE ) 174 II . TH E PROTEOLYTI C STAT E 174 III. FACTORS INFLUENCING TH E LYSIS OF THROMB I AN D EMBOL I 176 B. THERAPEUTI C RESULT S IN ACUT E MYOCARDIA L INFARCTION 177 I. STREPTOKINAS E 177 1. EARL Y STUDIE S WITH INTRAVENOU S STREPTOKINAS E 177 2. INTRACORONAR Y ADMINISTRATIO N 178 3. HIGH-DOS E INTRAVENOU S ADMINISTRATIO N OF STREPTOKINAS E 179 A) DOSE-RANGIN G STUDIE S AN D ANTI-S K ANTIBODIE S ... . 179 B ) PATENC Y VS RECANALIZATIO N RAT E 180 C) MORTALIT Y REDUCTIO N 182 D ) DELA Y T O TREATMEN T 183 E ) BLEEDIN G COMPLICATIO N 185 F) PATIEN T SELECTION , CONTRAINDICATION S 187 G) OTHE R SIDE EFFECTS 188 H) LABORATOR Y MONITORIN G 188 I) RETHROMBOSI S 188 II . ANISOYLATE D LYS-PLASMIN(OGEN ) STREPTOKINAS E ACTIVATO R COMPLE X (APSAC , ANISTREPLASE ) 189 1. RANDOMIZE D CLINICAL TRIALS 189 2. PRE-HOSPITA L TREATMEN T 189 LIST OF ABBREVIATION S 193 REFERENCE S 193 CHAPTE R 8 TISSUE-TYPE PLASMINOGEN ACTIVATOR (TPA ) D. COLLEN . WITH 2 FIGURE S 209 A . INTRODUCTIO N 209 B. DEVELOPMEN T OF TPA AS A THROMBOLYTI C AGEN T 212 I. ISOLATIO N AN D PURIFICATION OF TPA 212 II. CLONING AN D EXPRESSIO N OF TH E TPA CDN A 214 III . EXPERIMENTA L CORONAR Y THROMBOSI S MODEL S FOR AM I 215 IV. FIRST ADMINISTRATIO N OF TPA T O PATIENT S WITH AM I 215 C. CLINICAL TRIALS WITH TPA IN AM I 216 I. EARLY CLINICAL STUDIES IN AM I 216 II. TPA TRIALS, 1986-1989 218 III . TPA TRIALS, 1990-1995 220 IV. FURTHE R ATTEMPT S T O IMPROV E TH E EFFICACY OF THROMBOLYSI S AND T O REDUC E TH E INCIDENC E OF REOCCLUSIO N 221 LIST OF ABBREVIATION S 222 REFERENCE S 223 CONTENTS XVII CHAPTE R 9 UROKINASE AND SINGLE-CHAIN UROKINASE-TYPE PLASMINOGEN ACTIVATOR (PRO-UROKINASE) V. GUREWICH 231 A . HISTORY 231 B. NOMENCLATUR E 232 C. BIOCHEMISTRY OF PRO-UK/U K (SC-UPA/TC-UPA) 232 I. THE INTRINSIC ACTIVITY OF PRO-UK (SC-UPA) 233 II. FIBRINOLYSIS BY PRO-UK/U K (SC-UPA/TC-UPA) 234 III. CONTRASTIN G PROPERTIE S OF PRO-UK AND TPA 235 IV. PRO-UK/U K AND PLATELETS 237 D. PHARMACOKINETIC S 238 E. CLINICAL STUDIES IN ACUT E MYOCARDIAL INFARCTION 239 I. UROKINAS E 239 1. CONTROLLED TRIALS OF UK VS CONTROL S 239 2. PREHOSPITAL VS IN-HOSPITAL THROMBOLYSIS WITH UK 240 3. COMPARATIV E TRIALS OF UK VS SK OR TPA 240 II. PRO-UROKINAS E 241 1. EARLY DOSE-FINDING STUDIES 241 2. RANDOMIZE D TRIALS OF PRO-UK VS SK 243 3. RANDOMIZE D TRIAL OF PRO-U K VS TPA 245 HI. NON-SPECIFIC PLASMINOGEN ACTIVATION 245 IV. COMBINATION S OF PRO-U K AND UK OR TPA 246 1. EARLY DOSE-FINDING STUDIES OF PRO-UK AND UK 246 2. EARLY DOSE-FINDING STUDIES OF PRO-UK AND TPA 247 3. LARGER CLINICAL TRIAL WITH PRO-UK AND TPA 247 V. BOLUS ADMINISTRATION OF PRO-UK 248 VI. HEPARI N AND PRO-UK 248 F. SECOND GENERATIO N PRO-UK 24S G. CONCLUSIONS 249 LIST OF ABBREVIATION S 251 REFERENCES 251 CHAPTE R 10 COMPARATIVE EVALUATIONS OF TPA VS SK WITH PARTICULAR REFERENCE TO THE GUSTO-I TRIAL A.C. CHI L AND E.J. TOI OT . WITH 1 FIGURE 261 A. INTRODUCTION 261 B. EVOLUTION OF THROMBOLYTIC THERAPIE S 261 I. RATIONALE FOR THROMBOLYSIS 2M II. EARLY ANGIOGRAPHIC PATENCY TRIALS. TPA VS SK 2M III. ADJUNCTIVE THERAPIES : HEPARIN AND ASPIRIN 263 I V MAJOR COMPARATIV E THROMBOLYTIC TRIALS 264 XVIII CONTENTS C. THE GUSTO- I TRIAL 268 I. DESIGN OF TH E TRIAL 268 II . PRIMAR Y RESULT S OF GUSTO- I 271 III . THE GUSTO- I ANGIOGRAPHI C SUBSTUDY 274 IV. FURTHE R ANALYSIS OF GUSTO- I RESULT S 278 V. OTHE R GUSTO- I SUBSTUDIE S 278 VI . EPILOGU E 281 LIST OF ABBREVIATION S AN D ACRONYM S 281 REFERENCE S 282 CHAPTE R 11 CONJUNCTIVE THERAPY TO REDUC E THE OCCURRENCE OF CORONARY REOCCLUSION AFTER THROMBOLYTIC TREATMENT OF AMI R. HAYES, R. GALLO , V. FUSTER, AN D J. CHESEBRO. WITH 8 FIGURE S 287 A . INTRODUCTIO N 287 B. THE ROL E OF THROMBI N AN D PLATELET S IN THROMBU S FORMATIO N ... . 287 C. EVIDENC E FOR TH E EFFICACY OF THROMBOLYTI C THERAP Y 289 I. IMPORTANC E OF ACHIEVIN G PATENC Y OF TH E INFARCT RELATE D ARTER Y 290 II . LIMITATION S OF THROMBOLYTI C THERAP Y 292 III . THE ROL E OF PLATELET S AN D THROMBI N IN RESISTANC E 292 T O THERAP Y 292 1. THROMBI N 292 2. PLATELET S 295 D. ANTITHROMBOTI C THERAP Y 296 I. THROMBI N INHIBITIO N 296 1. HEPARI N 296 2. LOW-MOLECULAR-WEIGHT HEPARI N 300 3 . HIRUDI N 301 4. HIRULO G 304 5. ARGATROBA N 304 6. EFEGATRA N 305 II. ANTIPLATELE T AGENT S 305 1. ASPIRI N 305 2. GLYCOPROTEI N ILB/III A ANTAGONIST S 306 3. OTHE R DRUG S INHIBITIN G PLATELE T FUNCTIO N 308 4. PHYSICAL COUJUNCTIV E THERAP Y 309 E . OUTLOO K 309 LIST OF ABBREVIATION S 309 REFERENCE S 311 CONTENTS XIX THROMBOLYTIC TREATMENT OF OTHER CLINICAL THROMBOEMBOLIC CONDITIONS CHAPTE R 12 NEW CONCEPTS IN THROMBOLYSIS OF PULMONARY EMBOLISM A.A . SASAHARA AND G.V.R.K. SHARMA. WITH 5 FIGURES 325 A . INTRODUCTIO N 325 B. TREATMEN T WITH THROMBOLYTIC THERAP Y 327 C. ESTABLISHED CLINICAL EFFECT OF THROMBOLYTIC THERAPY 328 I. THROMBOLYTIC AGENT S HASTE N THROMBOEMBOLI C RESOLUTION 328 II. RESULTS OF PULMONARY ANGIOGRAPHY 328 III. RESULTS OF PERFUSION LUNG SCAN 328 IV. HEMODYNAMI C OBSERVATION S 329 V. THROMBOLYTIC THERAPY REMOVES PULMONARY THROMBOEMBOL I MORE COMPLETELY THAN HEPARI N THERAP Y 330 VI . THROMBOLYTIC AGENTS HASTE N DISSOLUTION OF THROMBI IN TH E VENOUS SYSTEM OF THE LEGS 332 VII . THROMBOLYTIC THERAPY CAN BE ADMINISTERE D SAFELY 332 D. POSSIBLE UNESTABLISHE D CLINICAL EFFECTS 334 I. THROMBOLYTIC AGENT S MAY DECREAS E MORTALITY FROM PULMONARY EMBOLISM 334 II. THROMBOLYTIC THERAP Y IMPROVE S LONG-TERM HEMODYNAMI C STATUS 335 E. NEW THROMBOLYTIC REGIMENS 336 F. SURGICAL THERAP Y 341 G. ADJUNCTIVE THERAP Y 343 LIST OF ABBREVIATION S 343 REFERENCES 344 CHAPTE R 13 DEE P VENOUS THROMBOSIS H. BOUNAMEAUX 349 A. INTRODUCTIO N 349 B. TREATMEN T REGIMENS 349 C. IMMEDIAT E EFFECTS OF THROMBOLYTIC THERAP Y OF DVT: THE DEFINITE RISK 350 D. LATE EFFECTS OF THROMBOLYTIC THERAPY OF DVT: THE POTENTIAL BENEFIT 352 E. THE BENEFIT-TO-RISK BALANCE 353 F. HOW T O REDUCE THE RISK AND IMPROVE THE BENEFIT? 354 I. REDUCING HCMORRHAGI C RISK 354 II. IMPROVING THROMBOLYTIC EFFICACY 355 G. MISCELLANEOUS VENOUS INDICATIONS 356 XX CONTENTS I. PHLEGMASI A CAERULE A DOLEN S 356 II . SUPERIO R O R INFERIOR VENA CAVA SYNDROM E 356 III . DEE P VENOU S THROMBOSI S OF TH E UPPE R LIMBS 356 IV. VENOUS THROMBOSI S OF UNUSUA L LOCALIZATIO N 356 V. THROMBOSI S OF CENTRA L VENOUS CATHETER S 357 H . LABORATOR Y MONITORIN G 357 I. TREATMEN T OF BLEEDIN G 358 J. CONCLUSIONS AN D PERSPECTIVE S 358 LIST OF ABBREVIATION S AN D ACRONYM S 359 REFERENCE S 359 CHAPTE R 14 PERIPHERAL ARTERIAL OCCLUSIONS D.C. BERRIDGE 363 A . INTRODUCTIO N 363 B. CURREN T INDICATION S 364 C. CONTRA-INDICATION S 366 D. DRUG S AVAILABLE 367 I. STREPTOKINAS E 367 II. APSAC , ANISTREPLAS E (ACYLATED-PLASMINOGEN - STREPTOKINASE-ACTIVATO R COMPLEX ) 367 III . UROKINAS E AN D PRO-UROKINAS E 368 IV. RECOMBINAN T TISSUE PLASMINOGE N ACTIVATO R (TPA ) 368 V. STAPHYLOKINAS E 368 E . TECHNIQUES USE D 368 I. SYSTEMIC ADMINISTRATIO N 368 II. LOCAL LOW-DOS E INTRA-THROMBOTI C ADMINISTRATIO N 369 III . HIGH-DOS E BOLU S 369 IV. PULSE-SPRA Y ADMINISTRATIO N 370 V. ENCLOSE D THROMBOLYSI S 371 VI . INTRA-OPERATIV E LYSIS 372 F. COMPARATIV E RESULT S 373 I. STREPTOKINAS E VS RECOMBINAN T TISSUE PLASMINOGE N ACTIVATO R 373 II . UK VS RECOMBINAN T TISSUE PLASMINOGE N ACTIVATO R 374 III . PRO-U K VS. UK 374 IV. SURGERY VS THROMBOLYSI S 374 G. LONG-TERM RESULT S 378 H. ADJUVAN T TREATMEN T 378 I. COMPLICATION S 379 I. MAJOR HEMORRHAG E 379 II. MINOR HEMORRHAG E 379 III . CEREBROVASCULA R ACCIDEN T 379 IV. DISTAL EMBOLIZATIO N 380 V. PERICATHETE R THROMBOSI S 380 CONTENTS XXI VI . ALLERGIC REACTION S 380 VII . OTHE R COMPLICATIONS 380 J. SUMMARY 381 LIST OF ABBREVIATION S AND ACRONYMS 381 REFERENCES 381 CHAPTE R 15 THROMBOTIC CEREBROVASCULAR DISEASE G.J. DEL ZOPPO 387 A . INTRODUCTIO N 387 B. FOCAL CEREBRA L ISCHEMIA 388 I. CONSIDERATION S FOR TISSUE SALVAGE 388 II. HEMORRHAGI C TRANSFORMATION 389 III . NEUROLOGICAL OUTCOM E 390 C. PLASMINOGEN ACTIVATOR S IN FOCAL CEREBROVASCULA R ISCHEMIA 392 I. COMPLETE D STROK E 393 II. ACUT E STROKE 394 1. CAROTID TERRITORY ISCHEMIA 394 A) ANGIOGRAPHY-CONTROLLE D TRIALS 394 A) INTRA-ARTERIA L LOCAL INFUSION 394 P) INTRAVENOU S (SYSTEMIC) INFUSION 397 Y) SINGLE PHOTON-EMISSION COMPUTE D TOMOGRAPHY (SPECT ) 400 B) SYMPTON-BASED (CLINICAL OUTCOME ) TRIALS 400 2. VERTEBROBASILA R TERRITORY ISCHEMIA 408 A) ANGIOGRAPHY-CONTROLLE D TRIALS 408 A) INTRA-ARTERIA L (LOCAL) INFUSION 408 P) INTRAVENOU S (SYSTEMIC) INFUSION 409 III. OTHE R CONDITIONS 409 1. RETINAL VASCULAR OCCLUSION 409 2. DURAL SINUS THROMBOSI S 410 D. ONGOING STROK E TRIALS WITH THROMBOLYTIC AGENT S 410 E. CONCLUSION 411 LIST OF ABBREVIATION S AND ACRONYMS 411 REFERENCES 412 THROMBOLYTIC AGENTS IN DEVELOPMENT, BIOCHEMISTRY, PHARMACOLOGY - EFFICACY IN ANIMAL EXPERIMENTS AND FIRST CLINICAL TRIALS CHAPTE R 16 STAPHYLOKINASE H.R. LIINEN AND D. CO N IN . WITH 3 FIGURES 425 A. INTRODUCTIO N 425 B. GEN E AND PROTEIN STRUCTURE OF STAPHYLOKINASE 426 XXII CONTENTS I. PRODUCTIO N OF STAPHYLOKINAS E 426 II . GEN E STRUCTUR E OF STAPHYLOKINAS E 427 III . PROTEI N STRUCTUR E OF STAPHYLOKINAS E 428 C. PLASMINOGE N ACTIVATIO N BY STAPHYLOKINAS E 429 I. INTERACTIO N WITH PLASMIN(OGEN ) 429 II . KINETICS OF PLASMINOGE N ACTIVATIO N 431 III . MECHANIS M OF PLASMINOGE N ACTIVATIO N 431 D. FIBRIN-SPECIFICITY OF STAPHYLOKINAS E 432 I. INHIBITIO N OF PLASMIN-STAPHYLOKINAS E COMPLE X BY A 2 -ANTIPLASMI N 432 II . EFFECT OF FIBRIN ON PLASMINOGE N ACTIVATIO N BY STAPHYLOKINAS E 433 III . MOLECULA R MECHANIS M OF FIBRIN-SPECIFICITY IN PLASMA 433 E . FIBRINOLYTIC PROPERTIE S OF STAPHYLOKINAS E IN PLASM A IN VITR O 435 I. FIBRINOLYTIC POTENCY AN D FIBRIN-SPECIFICITY 435 II . SPECIES-SPECIFICITY 437 F. THROMBOLYTI C PROPERTIE S OF STAPHYLOKINAS E IN ANIMA L MODEL S ... . 437 I. HAMSTER S WITH PULMONAR Y EMBOLIS M 437 II . RABBIT S WITH JUGULA R VEIN THROMBOSI S 438 III . RABBIT S WITH ARTERIA L THROMBOSI S 438 IV. RABBI T EMBOLI C STROK E MODE L 438 V. BABOON S WITH VENOU S AN D ARTERIA L THROMBOSI S 438 G. THROMBOLYTI C PROPERTIE S OF STAPHYLOKINAS E IN PATIENT S 439 I. ACUT E MYOCARDIA L INFARCTIO N 439 II . PERIPHERA L ARTERIA L OCCLUSION 440 H. PHARMACOKINETI C PROPERTIE S OF STAPHYLOKINAS E 441 I. IN ANIMA L MODEL S 441 II . IN PATIENT S 441 I. IMMUNOGENICIT Y OF STAPHYLOKINAS E 442 I. IN ANIMA L MODEL S 442 II. IN PATIENT S 442 III. ATTEMPT S T O REDUC E IMMUNOGENICIT Y 443 J. CONCLUSION S 443 LIST OF ABBREVIATION S AN D ACRONYM S 444 REFERENCE S 444 CHAPTE R 17 DESMODUS ROTUNDUS (COMMON VAMPIRE BAT) SALIVARY PLASMINOGEN ACTIVATOR W.-D. SCHLEUNING AN D P. DONNER . WITH 5 FIGURES 451 A. INTRODUCTIO N 451 B. NATURA L HISTOR Y OF VAMPIRE BATS 453 C. BIOCHEMISTRY 453 I. PURIFICATION 453 CONTENTS XXIII II . CLONING AND EXPRESSION 454 III . DSPA GEN E EXPRESSION IN HETEREOLOGOU S HOST CELLS 455 IV. THREE-DIMENSIONA L STRUCTUR E OF THE PROTEAS E DOMAIN 456 V. ENZYMOLOGY 456 D. PHARMACOLOGY 459 I. IN VITRO CLOT LYSIS 459 II . CAROTI D AND FEMORAL ARTER Y THROMBOSIS IN RABBITS 461 III . MYOCARDIAL INFARCTION IN DOGS 461 IV. EXPERIMENTA L PULMONARY EMBOLISMS IN RATS 462 V. BLEEDING MODELS 463 E. PHARMACOKINETICS 464 F. TOXICOLOGY 466 G. PHASE I CLINICAL STUDIES 466 H. PHASE IB CLINICAL STUDIES 467 I. CONCLUSIONS AND PERSPECTIVES 467 LIST OF ABBREVIATION S AND ACRONYM S 468 REFERENCE S 468 CHAPTE R 18 THROMBUS-TARGETING OF PLASMINOGEN ACTIVATORS C. BODE , K. PETER, M.S. RUNGE , AND E . HABER 473 A . INTRODUCTIO N 473 B. THE PRINCIPL E OF ANTIBOD Y TARGETIN G 474 I. ANTIFIBRIN ANTIBODIE S 474 II . ANTIPLATELE T ANTIBODIE S 474 III . CHEMICA L CONJUGATE S OR RECOMBINAN T FUSION PROTEIN S ... . 475 C. SYNTHESIS, PURIFICATION, AND CHARACTERIZATIO N OF CHEMICA L ANTIBODY-PLASMINOGE N ACTIVATO R CONJUGATE S 475 I. SYNTHESIS 475 II . PURIFICATION 476 III . CHARACTERIZATIO N 476 1. ANTIFIBRIN-U K CONJUGATE S 477 2. ANTIFIBRIN-TPA CONJUGATE S 477 3. ANTIFIBRIN-SCUPA CONJUGATE S 478 4. ANTIPLATELET-U K CONJUGATE S 478 5. ANTIPLATELET-SCUP A CONJUGATE S 478 D. TARGETIN G WITH BIFUNCTIONAL ANTIBODIE S 479 I. PRINCIPAL CONSIDERATION S 479 II. BISPECIFIC IGG (INTAC T ANTIBODIES ) 479 III. BISPECIFIC (FAB ) 2 480 IV. BISPECIFIC ANTIBODIE S BY HYBRID-HYBRIDOM A TECHNIQUE ... . 480 V. DOUBL E TARGETIN G 481 E. EXPRESSIO N AND CHARACTERIZATIO N OF RECOMBINAN T ANTITIBRIN - PLASMINOGEN ACTIVATO R FUSION PROTEIN S 481 XXIV CONTENTS I. ANTIFIBRIN-SK CONSTRUCTS 481 II. ANTIFIBRIN-TPA CONSTRUCTS 481 III. ANTIFIBRIN-SCUPA CONSTRUCTS 482 F. OTHER APPROACHES OF TARGETING PLASMINOGEN ACTIVATORS TO THROMBI 484 G. TARGETING THE THROMBIN INHIBITOR HIRUDIN TO FIBRIN 486 I. GENERAL CONSIDERATIONS 486 II. CHEMICAL CONJUGATES 486 III. RECOMBINANT FUSION PROTEIN 486 H. CONCLUSION AND OUTLOOK 487 LIST OF ABBREVIATIONS AND ACRONYMS 488 REFERENCES 488 CHAPTE R 19 THE HUNT FOR THE IDEAL THROMBOLYTIC AGENT: MUTANTS OF TPA AND UPA, CHIMERA OF BOTH MOLECULES, FIBROLASE M. VERSTRAETE. WITH 3 FIGURES 493 A. MUTANTS AND VARIANTS OF SINGLE-CHAIN UROKINASE-TYPE PLASMINOGEN ACTIVATOR 493 I. PLASMIN-RESISTANT MUTANTS OF SC-UPA 493 II. LOW-MOLECULAR-WEIGHT SC-UPA 493 III. MUTANT OF SC-UPA RESISTANT TO PAI-1 494 B. MUTANTS OF TISSUE-TYPE PLASMINOGEN ACTIVATOR (TPA) 494 I. MUTANTS WITH MODIFIED EPIDERMA L GROWTH FACTOR DOMAIN 494 II. MUTANTS WITH MODIFIED OR DELETED FINGER DOMAIN 495 III. DELETION OF THE FINGER AND EPIDERMAL GROWTH FACTOR DOMAINS 495 IV. DELETION OF THE EPIDERMAL GROWTH FACTOR AND FINGER DOMAINS AND OF GLYCOSYLATION SITES 496 V. MUTANTS CONSISTING OF KRINGLE 2 AND THE PROTEASE DOMAIN 496 VI. MUTANT CONSISTING OF KRINGLE 2 WITH POINT MUTATION IN LINKAGE TO PROTEASE LIGHT CHAIN 501 VII. MUTANT WITH MODIFICATIONS IN KRINGLE 1 503 VII. RECOMBINANT TNK-TPA 503 IX. UNGLYCOSYLATED PROTEASE DOMAINS OF TPA 510 C. CHIMERIC PLASMINOGEN ACTIVATORS 510 D. FIBROLASE 512 E. OTHE R FIBRINOLYTIC AGENTS 512 LIST OF ABBREVIATIONS AND ACRONYMS 512 REFERENCES 513 CONTENTS XXV CHAPTER 20 AGENTS WHICH INCREASE SYNTHESIS AND RELEASE OF TISSUE-TYPE PLASMINOGEN ACTIVATOR T. KOOISTRA AND J.J. EMEIS . WITH 3 FIGURES 521 A. INTRODUCTIO N 521 I. THE PLASMINOGEN/PLASMIN SYSTEM 521 II. INTRAVASCULAR FIBRINOLYSIS 521 III. TISSUE-TYPE PLASMINOGEN ACTIVATO R (TPA) IN THE CIRCULATION 522 IV. INVOLVEMENT OF THE ENDOTHELIU M IN PLASMA FIBRINOLYSIS ... . 523 B. REGULATION OF CONSTITUTIVE TPA SYNTHESIS 524 I. GENERA L 524 II. INTRACELLULA R SIGNALING AND ACTIVATION OF PROTEIN KINASE C 525 III. RETINOID S 526 IV. STEROI D HORMONE S 528 V. SODIUM BUTYRAT E AND OTHE R INHIBITOR S OF HISTONE DEACETYLASE 529 VI . TRIAZOLOBENZODIAZEPINES 530 C. REGULATE D SECRETION OF TPA 531 I. GENERA L 531 II. THE ENDOTHELIA L TPA STORAGE COMPARTMEN T AND THE CIRCULATORY REGULATION OF TPA 532 III. CELLULAR MECHANISMS INVOLVED IN REGULATED TPA SECRETION 535 IV. COMPOUND S AFFECTING REGULATED TPA SECRETION IN MAN ... . 536 1. THE OCCURRENCE OF REGULATED TPA SECRETION IN MAN. . . . 536 2. ADRENERGI C AGENT S 538 3. VASOPRESSIN 539 4. DDAV P 539 5. ACETYLCHOLINE AND METHACHOLINE 541 6. BRADYKININ AND SUBSTANCE P 541 7. COAGULATION ACTIVATION PRODUCTS 542 8. CAM P 542 9. MISCELLANEOUS COMPOUND S 542 10. ABNORMA L RELEASE OF TPA 543 D. INCREASE OF TPA ACTIVITY BY INHIBITION OF PAI-1 543 LIST OF ABBREVIATION S AND SYMBOLS 544 REFERENCES 544 XXVI CONTENTS AUTIFIBRINOLYTIC AGENTS CHAPTER 21 STRUCTURE, PHARMACOLOGY, AND CLINICAL USE OF ANTIFIBRINOLYTIC AGENTS CM . SAMAMA, W. DIETRICH, J. HORROW, O. TABY, AND M.M. SAMAMA. WITH 3 FIGURES 559 A. INTRODUCTION 559 B. PHARMACOLOGY AND CLINICAL USE OF EACA AND TA 559 I. E-AMINOCAPROIC ACID (EACA) 561 1. PHARMACOLOGY 561 2. NON-CARDIAC SURGERY 561 A) UROLOGIC SURGERY 561 B) ORAL SURGERY 561 C) LIVER TRANSPLANTATION 562 3. USE IN CARDIAC SURGERY 562 4. ADVERSE EFFECTS 562 II. TRANEXAMIC ACID 564 1. PHARMACOLOGY 564 2. NONSURGICAL APPLICATIONS 564 3. NONCARDIAC SURGERY 565 4. CARDIAC SURGERY 565 5. ADVERSE EFFECTS 565 C. PHARMACOLOGY OF APROTININ 567 I. STRUCTURE 567 II. PHARMACOLOGY 567 III. PHARMACOKINETICS 568 IV. CLINICAL USE 568 1. HISTORY 568 2. MODE OF ACTION OF APROTININ (CLINICAL POINT OF VIEW) 569 3. EFFICACY OF APROTININ TREATMENT 571 4. MISCELLANEOUS USES 572 A) ORTHOTOPIC LIVER TRANSPLANTATION (OLT) AND ELECTIVE LIVER RESECTION 572 B) ORTHOPEDIC SURGERY 574 5. SIDE EFFECTS OF APROTININ THERAPY 574 D. CONCLUSION 575 LIST OF ABBREVIATIONS AND ACRONYMS 576 REFERENCES 576 SUBJECT INDEX 587
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spellingShingle Fibrinolytics and antifibrinolytics [with 50 tables]
Handbook of experimental pharmacology
Fibrinolytic Agents cabt
Fibrinolytikum (DE-588)4017042-1 gnd
Pharmakologie (DE-588)4045687-0 gnd
Antifibrinolytikum (DE-588)4142667-8 gnd
subject_GND (DE-588)4017042-1
(DE-588)4045687-0
(DE-588)4142667-8
(DE-588)4143413-4
title Fibrinolytics and antifibrinolytics [with 50 tables]
title_auth Fibrinolytics and antifibrinolytics [with 50 tables]
title_exact_search Fibrinolytics and antifibrinolytics [with 50 tables]
title_full Fibrinolytics and antifibrinolytics [with 50 tables] contributors F. Bachmann ... Ed.: F. Bachmann
title_fullStr Fibrinolytics and antifibrinolytics [with 50 tables] contributors F. Bachmann ... Ed.: F. Bachmann
title_full_unstemmed Fibrinolytics and antifibrinolytics [with 50 tables] contributors F. Bachmann ... Ed.: F. Bachmann
title_short Fibrinolytics and antifibrinolytics
title_sort fibrinolytics and antifibrinolytics with 50 tables
title_sub [with 50 tables]
topic Fibrinolytic Agents cabt
Fibrinolytikum (DE-588)4017042-1 gnd
Pharmakologie (DE-588)4045687-0 gnd
Antifibrinolytikum (DE-588)4142667-8 gnd
topic_facet Fibrinolytic Agents
Fibrinolytikum
Pharmakologie
Antifibrinolytikum
Aufsatzsammlung
url http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009095375&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
volume_link (DE-604)BV002390716
work_keys_str_mv AT bachmannfedor fibrinolyticsandantifibrinolyticswith50tables