Американское общество гирудотерапии

Peptidomimetic thrombin inhibitors

Drug development review published in Pathophysiol Haemost Thromb (2005)

Последнее обновление: June 18, 2026Рецензент: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewРазработка лекарственных препаратовФармакология секрета слюнных желёзKikelj D · Pathophysiology of haemostasis and thrombosis, 2005

Abstract

The central position of thrombin in the coagulation cascade has made it a popular target for discovery of novel antithrombotic agents. Starting with hirudin, a natural peptide isolated from the medicinal leech, its shorter synthetic analogue hirulog, and argatroban,the first therapeutically used synthetic small-molecule thrombin active site inhibitor, hundreds of direct thrombin inhibitors have been discovered over the last 20 years. Most of them are peptidomimetic compounds,based on the amino acid sequence of fibrinogen which binds into the thrombin active site. Since elucidation of the crystal structure of human thrombin in 1989, the structure-based design of low-molecular-weight peptidomimetic thrombin inhibitors has been greatly aided by the use of x-ray crystallographic analysis of thrombin-inhibitor complexes. The ultimate goal of most research programmes and drug optimization strategies is to develop an orally bioavailable, small-molecule,direct thrombin inhibitor that would be suitable for once or twice daily dosing. An overview of the most advanced peptidomimetic direct thrombin inhibitors bivalirudin, argatroban, ximelagatran and dabigatran is presented.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsAntithrombinsHumansMolecular MimicryProdrugsThrombosis

Резюме

Reviews the development of direct thrombin inhibitors starting from leech-derived hirudin and its synthetic peptidomimetic descendants — hirulog, argatroban, bivalirudin, ximelagatran, dabigatran — culminating in orally bioavailable small-molecule scaffolds.

Почему это важно для гирудотерапии

This review surveys peptidomimetic direct thrombin inhibitors, tracing the field from hirudin, a natural peptide isolated from the medicinal leech, and related synthetic analogues such as hirulog, to small-molecule inhibitors including bivalirudin, argatroban, ximelagatran, and dabigatran. It emphasizes structure-based design informed by thrombin crystal structures and the goal of developing orally bioavailable direct thrombin inhibitors. This is relevant to ASH because it documents how a leech-derived molecule helped seed a major class of antithrombotic drug discovery. The caveat is that the article is a medicinal-chemistry review focused on synthetic inhibitors, not on leech therapy, the live leech secretome, or clinical hirudotherapy outcomes.

Цитирование

Peptidomimetic thrombin inhibitors.

Kikelj D · Pathophysiology of haemostasis and thrombosis, 2005

Связанный клинический контекст

Добавлено в библиотеку ASH: May 26, 2026 · Последнее обновление сайта: June 18, 2026

Этот сайт предоставляет образовательную информацию и не является медицинской консультацией, диагнозом или рекомендацией по лечению. Гирудотерапия сопряжена с клинически значимыми рисками и должна проводиться только квалифицированными клиницистами в рамках институционально утверждённых протоколов. Разрешение FDA 510(k) для медицинских пиявок ограничено определёнными показаниями; обсуждения исследовательского и нелицензионного применения отмечены соответствующим образом. Для индивидуальных медицинских рекомендаций обратитесь к квалифицированному медицинскому специалисту.