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Piechowski-Jozwiak B, Abidi E, El Nekidy WS, Bogousslavsky J. Clinical Pharmacokinetics and Pharmacodynamics of Desmoteplase. Eur J Drug Metab Pharmacokinet 2022; 47:165-176. [PMID: 34893967 PMCID: PMC8664670 DOI: 10.1007/s13318-021-00743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 11/20/2022]
Abstract
Desmoteplase is a bat (Desmodus rotundus) saliva-derived fibrinolytic enzyme resembling a urokinase and tissue plasminogen activator. It is highly dependent on fibrin and has some neuroprotective attributes. Intravenous administration of desmoteplase is safe and well tolerated in healthy subjects. Plasma fibrinolytic activity is linearly related to its blood concentration, its terminal elimination half-life ranges from 3.8 to 4.92 h (50 vs. 90 μg/kg dose). Administration of desmoteplase leads to transitory derangement of fibrinogen, D-dimer, alpha2-antiplasmin, and plasmin and antiplasmin complex which normalize within 4-12 h. It does not alter a prothrombin test, international normalized ratio, activated partial thromboplastin time, and prothrombin fragment 1.2. Desmoteplase was tested in myocardial infarction and pulmonary embolism and showed promising results versus alteplase. In ischemic stroke trials, desmoteplase was linked to increased rates of symptomatic intracranial hemorrhages and case fatality. However, data from "The desmoteplase in Acute Ischemic Stroke" Trials, DIAS-3 and DIAS-J, suggest that the drug is well tolerated and its safety profile is comparable to placebo. Desmoteplase is theoretically a superior thrombolytic because of high fibrin specificity, no activation of beta-amyloid, and lack of neurotoxicity. It was associated with better outcomes in patients with significant stenosis or occlusion of a proximal precerebral vessels. However, DIAS-4 was stopped as it might have not reached its primary endpoint. Due to its promising properties, desmoteplase may be added into treatment of ischemic stroke with extension of the time window and special emphasis on patients presenting outside the 4.5-h thrombolysis window, with wake-up strokes and strokes of unknown onset.
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Affiliation(s)
- Bartlomiej Piechowski-Jozwiak
- Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
- Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH, USA
- Department of Neurology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Emna Abidi
- Department of Pharmacy, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
| | - Wasim S El Nekidy
- Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH, USA
- Department of Pharmacy, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Julien Bogousslavsky
- Center for Brain and Nervous System Diseases (Neurocenter), Genolier Swiss Medical Network (Geneva, Lausanne, Glion, Genolier, Fribourg, Zurich), Clinique Valmont, 1823, Glion/Montreux, Switzerland
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Juenet M, Aid-Launais R, Li B, Berger A, Aerts J, Ollivier V, Nicoletti A, Letourneur D, Chauvierre C. Thrombolytic therapy based on fucoidan-functionalized polymer nanoparticles targeting P-selectin. Biomaterials 2017; 156:204-216. [PMID: 29216534 DOI: 10.1016/j.biomaterials.2017.11.047] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 12/19/2022]
Abstract
Injection of recombinant tissue plasminogen activator (rt-PA) is the standard drug treatment for thrombolysis. However, rt-PA shows risk of hemorrhages and limited efficiency even at high doses. Polysaccharide-poly(isobutylcyanoacrylate) nanoparticles functionalized with fucoidan and loaded with rt-PA were designed to accumulate on the thrombus. Fucoidan has a nanomolar affinity for the P-selectin expressed by activated platelets in the thrombus. Solid spherical fluorescent nanoparticles with a hydrodynamic diameter of 136 ± 4 nm were synthesized by redox radical emulsion polymerization. The clinical rt-PA formulation was successfully loaded by adsorption on aminated nanoparticles and able to be released in vitro. We validated the in vitro fibrinolytic activity and binding under flow to both recombinant P-selectin and activated platelet aggregates. The thrombolysis efficiency was demonstrated in a mouse model of venous thrombosis by monitoring the platelet density with intravital microscopy. This study supports the hypothesis that fucoidan-nanoparticles improve the rt-PA efficiency. This work establishes the proof-of-concept of fucoidan-based carriers for targeted thrombolysis.
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Affiliation(s)
- Maya Juenet
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Rachida Aid-Launais
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France; FRIM, INSERM UMS 034 Paris Diderot University, X. Bichat Hospital, 75018, Paris, France
| | - Bo Li
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Alice Berger
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Joël Aerts
- FRIM, INSERM UMS 034 Paris Diderot University, X. Bichat Hospital, 75018, Paris, France
| | - Véronique Ollivier
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Antonino Nicoletti
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Didier Letourneur
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France
| | - Cédric Chauvierre
- INSERM, U1148, Laboratory for Vascular Translational Science, X. Bichat Hospital, 46 rue Henri Huchard, 75018, Paris, France; Paris Diderot University, Paris 13 University, Sorbonne Paris Cité, Paris, France.
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Affiliation(s)
- Francesca L. Ware
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicester LE12 5RD, UK
| | - Martin R. Luck
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, Leicester LE12 5RD, UK
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Saadatirad A, Sardari S, Kazemali M, Zarei N, Davami F, Barkhordari F, Adeli A, Mahboudi F. Expression of a novel chimeric-truncated tPA in Pichia pastoris with improved biochemical properties. Mol Biotechnol 2016; 56:1143-50. [PMID: 25143123 DOI: 10.1007/s12033-014-9794-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thrombolytic therapy by plasminogen activators (PAs) has been a main goal in the treatment of acute myocardial infarction. Despite improved outcomes of currently available thrombolytic therapies, all these agents have different drawbacks that may result in less than optimal outcomes. In order to make tissue plasminogen activator (tPA) more potent, while being more resistant to plasminogen activator inhibitor-1 (PAI-1) and having a higher affinity to fibrin, a new chimeric-truncated form of tPA (CT tPA) was designed and expressed in Pichia pastoris. This novel variant consists of a finger domain of Desmoteplase, an epidermal growth factor (EGF) domain, a kringle 1 (K1) domain, a kringle 2 (K2) domain, in which the lysine binding site (LBS) was deleted, and a protease domain, where the four amino acids lysine 296, arginine 298, arginine 299, and arginine 304 were substituted by aspartic acid. The chimera CT tPA showed 14-fold increase in its activity in the presence of fibrin compared to the absence of fibrin. Furthermore, CT tPA showed about 10-fold more potency than commercially available full-length tPA (Actylase(®)) and provided 1.2-fold greater affinity to fibrin. A residual activity of only 68 % was observed after incubation of Actylase(®) with PAI-1, however, 91 % activity remained for CT tPA. These promising findings suggest that the novel CT tPA variant might be an acceptable PA with superior characteristics and properties.
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Affiliation(s)
- Amirhossein Saadatirad
- Biotechnology Research Center, Pasteur Institute of Iran (IPI), No. 69, Pasteur Avenue, Tehran, 1316943551, Iran
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