title: An objective perspective on recombinant hirudin: a new anticoagulant and antithrombotic agent.
abstract: Leeches have been in medical use for many years. Hirudin, the anticoagulant obtained from the medicinal leech has been purified, characterized and can now be produced by recombinant (r) technology. R-hirudin is a potent inhibitor of thrombin and is therefore a potentially valuable anticoagulant and antithrombotic drug. This article reviews the current status of r-hirudin in this role and compares the pharmacokinetics, mechanism of action and clinical efficacy of this agent with heparin. The methods available for laboratory assessment and clinical monitoring of r-hirudin and the possible ways of antagonizing its effects are also discussed. Finally, the potential clinical applications of r-hirudin are outlined, although further laboratory and clinical studies, together with a fall in the cost of this compound are required before r-hirudin can be more widely accepted as an anticoagulant and antithrombotic agent.
authors.affiliation: Department of Pathology, Loyola University Medical Center, Maywood, Illinois 60153.
authors.forename: J
authors.initials: J
authors.lastname: Fareed
authors.forename: J M
authors.initials: JM
authors.lastname: Walenga
authors.forename: L
authors.initials: L
authors.lastname: Iyer
authors.forename: D
authors.initials: D
authors.lastname: Hoppensteadt
authors.forename: R
authors.initials: R
authors.lastname: Pifarre
mesh_terms: D000595:Amino Acid Sequence; D000818:Animals; D001777:Blood Coagulation; D001792:Blood Platelets / Q000187:drug effects; D004341:Drug Evaluation; D005343:Fibrinolytic Agents / Q000032:analysis / Q000494:pharmacology / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000031:analogs & derivatives* / Q000032:analysis / Q000235:genetics / Q000494:pharmacology / Q000633:toxicity; D006801:Humans; D008969:Molecular Sequence Data; D011183:Postoperative Complications / Q000517:prevention & control; D011994:Recombinant Proteins / Q000032:analysis / Q000494:pharmacology / Q000627:therapeutic use / Q000633:toxicity; D013917:Thrombin / Q000037:antagonists & inhibitors; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D005343:Fibrinolytic Agents; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; D013917:Thrombin; C060225:desirudin