Pathophysiology of Haemostasis and Thrombosis
Therapy with Plasminogen Concentrates: Preliminary Results and Future Strategies
Review of Studies with Plasminogen Concentrates and Proposals for Further Therapeutic Strategies with Plasminogen ConcentratesAnderle K. · Fröhlich A.Immuno AG, Industriestraβe 72, A-1220 Vienna, Austria
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Article / Publication Details
Published online: February 16, 1988
Issue release date: 1988
Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0
ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)
For additional information: https://www.karger.com/PHT
Abstract
Since the introduction of thrombolytic treatment based on the activation of plasminogen (PLG) by streptokinase (SK) and urokinase (UK) the search for new and improved methods has been continuing. The pivotal issue is how to achieve clot-specific fibrinolysis without producing systemic fibrinogenolysis. One out of various approaches to enhance lysis rates has been the use of PLG either alone or in combination with UK or SK in the light of the fact that fibrinolytic treatment, particularly using SK, is accosiated with a consumption of PLG, and that thrombi contain relatively small amounts of native PLG, however, are capable of incorporating added PLG in vitro. PLG-concentrates from various manufactures have been administered intravenously for treatment of deep venous thrombosis, mainly in combination with SK, and of pulmonary embolism in combination with UK. Local intracoronary and intraarterial administration in combination with UK has been reported in patients with myocardial infarction, and peripheral arterial occlusions, respectively. Lysis rates obtained in these studies were in most cases superior to results obtained with SK or UK alone, without increasing the incidence of bleeding complications. In addition, excellent results in a larger group of patients with cerebral thrombosis were obtained with PLG alone. The encouraging results of these studies may be explained by the fact that all of the preparations used contained partially activated forms of PLG (commonly designated lys-PLG) to a greater or lesser extent. Lys-PLG has a higher affinity for fibrin than the native glu-PLG and is activated by UK or SK by a manyfold faster. These properties allow for a rapid formation of plasmin which – bound to fibrin – is also protected from the attack of neutralizing antiplasmin. The design and results of previous studies with lys-PLG concentrates will be reviewed and approaches to further improve fibrinolytic regimens with lys-PLG-concentrates discussed.
© 1988 S. Karger AG, Basel
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Article / Publication Details
Published online: February 16, 1988
Issue release date: 1988
Number of Print Pages: 11
Number of Figures: 0
Number of Tables: 0
ISSN: 1424-8832 (Print)
eISSN: 1424-8840 (Online)
For additional information: https://www.karger.com/PHT
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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