title: [Proteins influencing the blood coagulation].
abstract: This review describes some natural proteins, which can be employed, either as factor concentrates derived from human plasma or as recombinant drug, to modulate the coagulation system. I will address some biochemical characteristics and the physiological role of von Willebrand factor, the coagulation factors of the extrinsic and intrinsic pathways, and the physiological anticoagulant protein C. In addition, I will detail the pharmacological compounds, which are available for influencing or substituting the coagulation proteins: desmopressin (DDAVP), single coagulation factor concentrates, prothrombin complex concentrates, and protein C concentrate. In particular, I will address some treatment topics of general medical interest, such as the treatment of massive bleeding, the correction of the coagulopathy induced by vitamin K-antagonists in patients with cerebral haemorrhage, and of the coagulopathy of meningococcemia. Finally, I will describe some properties and practical clinical applications of the recombinant anticoagulans lepirudin and bivalirudin, which are derived from hirudin, the natural anticoagulant of the medical leech.
authors: Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor, Inselspital, Universitätsspital und Universität Bern. lorenzo.alberio@insel.ch
authors: Lorenzo
authors: L
authors: Alberio
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000097:blood / Q000188:drug therapy*; D001779:Blood Coagulation Factors / Q000009:adverse effects / Q000627:therapeutic use*; D001798:Blood Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy; D006470:Hemorrhage / Q000097:blood / Q000188:drug therapy; D006629:Hirudins / Q000009:adverse effects; D006801:Humans; D010446:Peptide Fragments / Q000009:adverse effects / Q000627:therapeutic use; D011486:Protein C / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014841:von Willebrand Factor / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D001798:Blood Proteins; D006629:Hirudins; D010446:Peptide Fragments; D011486:Protein C; D011994:Recombinant Proteins; D014841:von Willebrand Factor; D014812:Vitamin K; C074619:bivalirudin; C083544:lepirudin