2014
DOI: 10.3892/mmr.2014.2025
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Direct thrombin inhibitors: Patents 2002–2012 (Review)

Abstract: Acute vascular diseases and other thromboses of the blood system constitute major health risks in developing countries. Thrombin plays a central role in blood coagulation, which is a crucial process involved in thrombosis. Direct thrombin inhibitors (DTIs) such as argatroban, dabigatran, dabigatran etexilate, lepirudin, desirudin and bivalirudin, which bind to thrombin and block its enzymatic activity, are widely and effectively used in the treatment of thromboembolic diseases. DTIs appear to overcome the disa… Show more

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Cited by 21 publications
(8 citation statements)
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“…Thrombin (T23) is predicted to be druggable both by Cheng et al 8 and by FTMap, and now has direct (i.e., not prodrug) oral inhibitors. 103,104 With 15 probe clusters, the penicillin binding protein (T22) is borderline druggable by FTMap, and ligand binding substantially strengthens the hot spot. This protein binds piperacillin, 105 an approved but not orally bioavailable drug (MW= 517.5 g/mol), with an IC 50 of 166 nM.…”
Section: Introductionmentioning
confidence: 99%
“…Thrombin (T23) is predicted to be druggable both by Cheng et al 8 and by FTMap, and now has direct (i.e., not prodrug) oral inhibitors. 103,104 With 15 probe clusters, the penicillin binding protein (T22) is borderline druggable by FTMap, and ligand binding substantially strengthens the hot spot. This protein binds piperacillin, 105 an approved but not orally bioavailable drug (MW= 517.5 g/mol), with an IC 50 of 166 nM.…”
Section: Introductionmentioning
confidence: 99%
“…Compared with heparins, DTIs do not require antithrombin as a cofactor and do not bind to plasma proteins; therefore, they produce a more predictable anticoagulant effect, and variability of patient response is low relative to other drug classes [ 9 ]. In reality, they still present limitations such as a narrow therapeutic window, and bleeding and anaphylaxis as side effects [ 10 ]. Therefore, alternative antithrombotic therapies are under extensive investigation, and many entities from natural products are being isolated and studied to counteract these side effects [ 11 ].…”
Section: Introductionmentioning
confidence: 99%
“…In 2002, Mollnes et al described an in vitro human whole blood model to study the role of the complement system in sepsis (14). The anticoagulant used in this model is lepirudin, a recombinant form of hirudin derived from leeches that acts on thrombin and does not affect complement system activity (15). This model allows for the analysis of the role of complement activation in the production of inflammatory cytokines and chemokines and in the expression of activation molecules by leukocytes (14, 16).…”
Section: Introductionmentioning
confidence: 99%