Faqihi Fahimeh, Stoodley Marcus A, McRobb Lucinda S
Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
Biomedicines. 2021 Jul 4;9(7):776. doi: 10.3390/biomedicines9070776.
In cardiovascular and cerebrovascular biology, control of thrombosis and the coagulation cascade in ischemic stroke, myocardial infarction, and other coagulopathies is the focus of significant research around the world. Ischemic stroke remains one of the largest causes of death and disability in developed countries. Preventing thrombosis and protecting vessel patency is the primary goal. However, utilization of the body's natural coagulation cascades as an approach for targeted destruction of abnormal, disease-associated vessels and tissues has been increasing over the last 30 years. This vascular targeting approach, often termed "vascular infarction", describes the deliberate, targeted delivery of a thrombogenic effector to diseased blood vessels with the aim to induce localized activation of the coagulation cascade and stable thrombus formation, leading to vessel occlusion and ablation. As systemic delivery of pro-thrombotic agents may cause consternation amongst traditional stroke researchers, proponents of the approach must suitably establish both efficacy and safety to take this field forward. In this review, we describe the evolution of this field and, with a focus on thrombogenic effectors, summarize the current literature with respect to emerging trends in "coaguligand" development, in targeted tumor vessel destruction, and in expansion of the approach to the treatment of brain vascular malformations.
在心血管和脑血管生物学领域，控制血栓形成以及缺血性中风、心肌梗死和其他凝血病中的凝血级联反应是全球重大研究的焦点。缺血性中风仍是发达国家死亡和残疾的主要原因之一。预防血栓形成和保护血管通畅是首要目标。然而，在过去30年中，利用人体自然凝血级联反应作为一种靶向破坏异常的、与疾病相关的血管和组织的方法日益增多。这种血管靶向方法，通常称为“血管梗死”，是指将促血栓形成效应物特意靶向递送至患病血管，目的是诱导凝血级联反应的局部激活和稳定血栓形成，从而导致血管闭塞和消融。由于全身递送促血栓形成剂可能会引起传统中风研究人员的担忧，该方法的支持者必须适当地确立疗效和安全性，以推动这一领域的发展。在这篇综述中，我们描述了该领域的发展历程，并重点关注促血栓形成效应物，总结了当前关于“凝血配体”开发的新趋势、靶向肿瘤血管破坏以及该方法扩展至治疗脑血管畸形的文献。
