β Scribed by Umesh R. Desai
No coin nor oath required. For personal study only.
Clinically used anticoagulants are inhibitors of enzymes involved in the coagulation pathway, primarily thrombin and factor Xa. These agents can be either direct or indirect inhibitors of clotting enzymes. Heparinβbased anticoagulants are indirect inhibitors that enhance the proteinase inhibitory activity of a natural anticoagulant, antithrombin. Despite its phenomenal success, current anticoagulation therapy suffers from the risk of serious bleeding. The need for safer and more effective antithrombotic agents clearly exists. The past decade has seen enormous effort directed toward discovering and/or designing new molecules with anticoagulant activity. These new molecules can be classified into (a) antithrombin and its mutants, (b) natural polysaccharides, (c) synthetic modified heparins and heparinβmimics, (d) synthetic oligosaccharides, and (e) synthetic nonβsugar antithrombin activators. This review focuses on these efforts in designing or discovering new molecules that act through the antithrombin pathway of anticoagulation. Β© 2003 Wiley Periodicals, Inc. Med Res Rev, 24, No. 2, 151β181, 2004
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May soon replace heparin and warfarin