Cardiovascular drug highlight: hirudin
Research article published in Heart disease (Hagerstown, Md.) (1999)
Abstract
Hirudin is a polypeptide of 65 to 66 amino acids derived from the saliva of the medicinal leech Hirudo medicinalis. It is the most potent naturally occurring specific inhibitor of thrombin. Through genetic engineering, recombinant forms of hirudin (r-hirudin) have been made available in sufficient quantities for therapeutic use. Because hirudin is capable of inhibiting clot-bound thrombin and fluid-phase thrombin, it has great potential for management of patients with various types of thromboembolic complications. Clinical trials with hirudin have been conducted in patients with coronary artery disease, heparin-induced thrombocytopenia, and in patients undergoing orthopedic surgery. The results of selected clinical trials in each of these areas are reviewed here. At present, most clinical benefits of r-hirudin have been demonstrated in the management of patients with heparin-induced thrombocytopenia. For this reason, lepirudin (a form of r-hirudin) has recently been approved by the United States Food and Drug Administration (FDA) for anticoagulation in patients with heparin-induced thrombocytopenia and associated thromboembolic disease.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Hirudin is a polypeptide of 65 to 66 amino acids derived from the saliva of the medicinal leech Hirudo medicinalis. It is the most potent naturally occurring specific inhibitor of thrombin.
Why This Matters for Hirudotherapy
This review examines hirudin, a 65-66 amino acid polypeptide derived from the saliva of the medicinal leech Hirudo medicinalis, and surveys clinical trials of recombinant hirudin in coronary artery disease, heparin-induced thrombocytopenia, and orthopedic surgery. The abstract identifies hirudin as the most potent naturally occurring specific inhibitor of thrombin, capable of inhibiting both clot-bound and fluid-phase thrombin, and notes that lepirudin, a form of recombinant hirudin, received FDA approval for anticoagulation in patients with heparin-induced thrombocytopenia and associated thromboembolic disease. For ASH's domain, this article is directly relevant as it discusses one of the most clinically advanced therapeutics originating from leech saliva. As a review, it synthesizes existing clinical evidence rather than presenting new primary data; readers should consult the underlying trial reports for quantitative outcome details.
Citation
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