Direct thrombin inhibitors
Research article published in Nouvelle revue francaise d'hematologie (1992)
Abstract
Thrombin not only plays an important role in thrombosis and haemostasis but may also be involved in other pathological situations such as the progression of atherosclerotic plaque formation, inflammatory response and neurodegenerescence. It is therefore important to be able to control the action and/or the generation of this enzyme. With this aim in view, a great number of synthetic or recombinant direct thrombin inhibitors have recently been made. They block either the thrombin catalytic site or an anion-binding exosite which is a recognition site for some of its substrates (fibrinogen, thrombin receptor, thrombomodulin, heparin cofactor II) or act on both sites. Some of these inhibitors have revealed a number of advantages over heparin in experimental animal models of thrombosis and haemorrhagic risk. On-going clinical studies with some candidates will establish their real interest for patients.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed leech-derived compound and anticoagulant pharmacology relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This review surveys direct thrombin inhibitors, noting that thrombin drives not only thrombosis and hemostasis but also plaque progression, inflammation, and neurodegeneration, and that many synthetic and recombinant inhibitors had been developed that block thrombin's catalytic site, its anion-binding exosite, or both, with some showing advantages over heparin in animal thrombosis models and ongoing clinical study. This is directly germane to the medicinal-leech secretome story because hirudin, the leech's signature anticoagulant, is the prototypical direct thrombin inhibitor that bridges both the catalytic and exosite-binding mechanisms the review describes, situating leech-derived molecules within a broader pharmacologic class. As a narrative review it summarizes and interprets others' work rather than reporting original data, and it predates the clinical maturation of this drug class, so it should be read as historical context for thrombin-inhibitor pharmacology, not as outcome evidence for any specific agent or for hirudotherapy.
Citation
Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026