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Aprotinin: a pharmacologic overview.

Jerrold H Levy1, Edward Sypniewski

  • 1Department of Anesthesiology, Emory University School of Medicine, Cardiothoracic Anesthesiology and Critical Care, Emory Healthcare, Atlanta, Ga, USA.

Orthopedics
|July 9, 2004
PubMed
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Aprotinin, a serine protease inhibitor, demonstrates anti-inflammatory and hemostatic effects by targeting plasmin and kallikrein. It also protects platelets during surgery, suggesting broader clinical applications.

Area of Science:

  • Biochemistry
  • Pharmacology
  • Surgical Medicine

Background:

  • Aprotinin is a serine protease inhibitor impacting inflammatory, fibrinolytic, and hemostatic pathways.
  • It inhibits key enzymes like plasmin and kallikrein at specific concentrations.
  • Aprotinin is known to preserve platelet function during cardiopulmonary bypass.

Purpose of the Study:

  • To review the pharmacologic properties of aprotinin.
  • To explore its anti-inflammatory and hemostatic mechanisms.
  • To consider its potential use in surgeries beyond coronary artery bypass grafting.

Main Methods:

  • Literature review of aprotinin's mechanism of action.
  • Analysis of its effects on inflammatory mediators and platelet function.

Related Experiment Videos

  • Examination of its role in hemostasis and inflammation.

    • Main Results:

    • Aprotinin inhibits plasmin at 137 KIU/mL and kallikrein at >250 KIU/mL.
    • It prevents platelet glycoprotein loss (GpIb, GpIIb/IIIa), acting as a 'platelet-sparing' agent.
    • Aprotinin modulates neutrophil activity, reducing pro-inflammatory cytokines and tissue-damaging enzymes.

    Conclusions:

    • Aprotinin possesses direct anti-inflammatory and hemostatic properties.
    • Its platelet-sparing effect is beneficial in cardiopulmonary bypass.
    • Clinicians may consider aprotinin for broader surgical applications due to its pharmacologic profile.