[The influence of taurolidine on physiological and pathological blood coagulation and implications for its use]

Taurolidine is an anti-infective agent with an unusually broad spectrum of effectivity against gram-positive and gram-negative bacteria, anaerobic organisms, and fungi. The effective principle is explained by the decomposition of the substance and the transfer of methylol groups to specific molecular structures of the cell walls of microbes. The acceptors are amino groups of the amino sugars and the lysine residues of glycoproteids. More recent investigations have shown that the effect of taurolidine is not limited to microorganisms, but can be detected in cells of the macrorganism as well. Here the influence of taurolidine on different blood clotting factors is described. The results can be explained by a transfer of methylol groups to residues of arginine and histidine in the active region, in analogy to the transfer to lysine residues in microorganisms. It is therefore to be expected that taurolidine will influence other vital systems of the macroorganism, dependently of concentration, as long as their biological function is connected to residues of arginine or histidine. Examples are the complement system and the fibrinolysis system. The implications of these observations have to do with new indications in connection with clotting phenomena in extracorporal circulatory systems or with thrombolysis, as well as with known indications in cases of shock and sepsis.