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Exploring potential anticoagulant drug formulations using thrombin generation test.

作者信息

Zavyalova Elena, Kopylov Alexey

机构信息

Chemistry Department of Lomonosov Moscow State University, 'Apto-Pharm' LTD, Moscow, Russian Federation.

出版信息

Biochem Biophys Rep. 2015 Dec 1;5:111-119. doi: 10.1016/j.bbrep.2015.11.011. eCollection 2016 Mar.


DOI:10.1016/j.bbrep.2015.11.011
PMID:28955812
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5600416/
Abstract

Many anticoagulant drugs inhibiting proteins of the coagulation cascade have been developed. The main targets of anticoagulant drugs are thrombin and factor Xa; inhibiting these factors delays thrombus growth, thus preventing thrombosis while increasing bleeding risk. A balance between thrombosis and bleeding is ensured in the 'therapeutic window' of the anticoagulant drug concentration range. Novel anticoagulant drugs and combinations thereof are being developed. We rank coagulation factors as potential anticoagulant drug targets in combination with thrombin inhibitors, aptamer HD1 and bivalirudin, providing a background for several promising dual target treatment strategies. The thrombin generation test was used to assess the whole coagulation cascade in normal and factor-deficient human blood plasma. Potential therapeutic windows were estimated for coagulation factors, ranking them as targets for anticoagulant drugs. Thrombin and factor Xa have been revealed as the most promising targets, which fully agrees with the current drug development strategy. Inhibitors of factors Va and VIIa are expected to have narrow therapeutic windows. Inhibitors of factors VIIIa and IXa are expected to have a moderate anticoagulant effect. Factors XI and XII are poor targets for anticoagulant drugs. Compared with plasma that is deficient in factor II, the thrombin inhibitors bivalirudin and aptamer HD1 had increased activity. Both inhibitors were tested in deficient plasma providing a model of potential drug combination. The most promising combinations were anti-thrombin with anti-V/Va and also anti-thrombin with anti-IX/IXa. Each combination had an incremental dose-effect dependence that is promising from the standpoint of the therapeutic window.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/ad3492b5ef84/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/0c40baf1c23b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/dc1124b1f81d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/26b1000b7632/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/cbe212a1216f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/c5f3ff0e57e2/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/28a5e1e878d0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/ad3492b5ef84/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/0c40baf1c23b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/dc1124b1f81d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/26b1000b7632/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/cbe212a1216f/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/c5f3ff0e57e2/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/28a5e1e878d0/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abbf/5600416/ad3492b5ef84/gr7.jpg

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本文引用的文献

[1]
Thrombin generation induced by tissue factor plus ADP in human platelet rich plasma: A potential new measurement to assess the effect of the concomitant use of an oral factor Xa inhibitor edoxaban and P2Y12 receptor antagonists.

Thromb Res. 2015-5

[2]
Multiple inhibitory kinetics reveal an allosteric interplay among thrombin functional sites.

Thromb Res. 2015-1

[3]
Antiplatelet and anticoagulation agents in acute coronary syndromes: what is the current status and what does the future hold?

Am Heart J. 2014-6-26

[4]
Expanding use of new oral anticoagulants.

F1000Prime Rep. 2014-10-1

[5]
Efficacy versus safety: the dilemma of using novel platelet inhibitors for the treatment of patients with ischemic stroke and coronary artery disease.

Ther Clin Risk Manag. 2014-5-2

[6]
Platelets and allergic inflammation.

Clin Exp Allergy. 2014-7

[7]
New players in haemostasis and thrombosis.

Thromb Haemost. 2014-4-1

[8]
Combined anticoagulation and antiplatelet therapy for high-risk patients with atrial fibrillation: a systematic review.

Health Technol Assess. 2013-7

[9]
Investigational anticoagulants for hematological conditions: a new generation of therapies.

Expert Opin Investig Drugs. 2013-7-22

[10]
Antiplatelet and anticoagulant therapy for atherothrombotic disease: the role of current and emerging agents.

Am J Cardiovasc Drugs. 2013-8

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