Washington University School of Medicine, Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, 660 South Euclid, Campus Box 8054, St Louis, MO 63110-1093, USA.
Expert Opin Biol Ther. 2010 Jul;10(7):1155-68. doi: 10.1517/14712598.2010.495713.
Antithrombin therapy (AT) has been tested in various medical applications. With advances in genetics and biotechnology, large-scale production of human recombinant antithrombin (rhAT) is now feasible. The prospect of administering a recombinant protein rather than a pooled blood component, has rekindled interest in antithrombin therapy. However, many known properties of human pooled antithrombin (hpAT) still need to be investigated and established for rhAT.
The manufacture and clinical pharmacology of antithrombin. The literature, evidence and our own views about the future of this drug and its potential clinical applications.
The reader will appreciate the biological rationale underpinning antithrombin administration in various clinical settings. The potential benefits and harms of the intervention are addressed. Novel future applications of recombinant antithrombin are broached.
rhAT has been approved for its use in congenital antithrombin deficiency. rhAT has also been used off-label to treat heparin-resistance in cardiac surgery and sepsis. It is a promising adjuvant for immunosuppression in organ transplantation, and may have role as an anti-angiogenic, anti-tumor and anti-viral agent. rhAT has clear safety advantages over phAT, such as the avoidance of infection transmission.
抗凝血酶治疗（AT）已在各种医学应用中进行了测试。随着遗传学和生物技术的进步，现在可以大规模生产人重组抗凝血酶（rhAT）。与使用混合血液成分相比，使用重组蛋白进行给药的前景重新激发了人们对抗凝血酶治疗的兴趣。然而，对于 rhAT，仍需要研究和确定人混合抗凝血酶（hpAT）的许多已知特性。
抗凝血酶的制造和临床药理学。关于这种药物的未来及其潜在临床应用的文献、证据和我们自己的观点。
读者将了解在各种临床环境中给予抗凝血酶的生物学基本原理。干预的潜在益处和危害得到了解决。探讨了重组抗凝血酶的新的未来应用。
rhAT 已获准用于先天性抗凝血酶缺乏症的治疗。rhAT 也已被超适应证用于心脏手术和败血症中的肝素抵抗治疗。它是器官移植中免疫抑制的一种很有前途的辅助药物，并且可能具有抗血管生成、抗肿瘤和抗病毒作用。rhAT 比 hpAT 具有明显的安全性优势，例如避免了感染的传播。
