title: 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 disadvantages of indirect thrombin inhibitors such as unfractionated heparins (UFH). Although these DTIs show specific advantages over indirect inhibitors, they still present limitations, such as a narrow therapeutic window, and bleeding and anaphylaxis as side-effects. Novel anticoagulant drugs need thus to be developed to overcome these limitations. In the search for additional candidate agents with improved efficacy, safety and high bioavailability in oral administration, a high number of compounds has been identified, such as those derived from the tripeptide template D-Phe-Pro-Arg, aptamers and peptides isolated from blood-sucking animals. These candidates may prove the new agents of choice for the treatment of cardiovascular diseases.
authors.affiliation: School of Life Science and Technology, China Pharmaceutical University, Nanjing, Jiangsu 210009, P.R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Kong
authors.affiliation: School of Life Science and Technology, China Pharmaceutical University, Nanjing, Jiangsu 210009, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Research Division of Clinical Pharmacology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China.
authors.forename: Yong-Qing
authors.initials: YQ
authors.lastname: Wang
authors.affiliation: Research Division of Clinical Pharmacology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Meng
authors.affiliation: Research Division of Clinical Pharmacology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China.
authors.forename: Ji-Fu
authors.initials: JF
authors.lastname: Wei
mesh_terms: D000818:Animals; D000991:Antithrombins / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D055808:Drug Discovery; D006801:Humans; D014652:Vascular Diseases / Q000188:drug therapy*
chemical_list: D000991:Antithrombins