title: Translation and Clinical Development of Antithrombotic Aptamers.
abstract: Thrombosis is a necessary physiological process to protect the body from uncontrolled bleeding. Pathological thrombus formation can lead to devastating clinical events including heart attack, stroke, deep vein thrombosis, pulmonary embolism, and disseminated intravascular coagulation. Numerous drugs have been developed to inhibit thrombosis. These have been targeted to coagulation factors along with proteins and receptors that activate platelets. While these drugs are effective at preventing blood clotting, their major side effect is inadvertent hemorrhage that can result in significant morbidity and mortality. There exists a need for anticoagulants that are not only effective at preventing thrombosis but can also be readily reversed. Aptamers offer a potential solution, representing a new class of drug agents that can be isolated to any protein and where antidote oligonucleotides can be designed based on the sequence of the aptamer. We present a summary of the anticoagulant and antithrombotic aptamers that have been identified and their stage of development and comment on the future of aptamer-based drug development to treat thrombosis.
authors.affiliation: 1 Department of Neurological Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.
authors.forename: Shahid M
authors.initials: SM
authors.lastname: Nimjee
authors.affiliation: 2 Duke Clinical Research Institute, Department of Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Povsic
authors.affiliation: 3 Department of Surgery, Duke University Medical Center , Durham, North Carolina.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Sullenger
authors.affiliation: 4 Department of Medicine, University of Cincinnati Medical Center , Cincinnati, Ohio.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Becker
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D052157:Aptamers, Nucleotide / Q000235:genetics / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000235:genetics; D001792:Blood Platelets / Q000187:drug effects; D006801:Humans; D010972:Platelet Activating Factor / Q000235:genetics / Q000627:therapeutic use*; D013927:Thrombosis / Q000235:genetics / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D052157:Aptamers, Nucleotide; D010972:Platelet Activating Factor