[Pharmacologic principles of fibrinolytic therapy]

Increasing insight into the mechanisms of fibrinolysis, and particularly into the formation and release of plasminogen activator, has led to more effective thrombolytic therapy. The understanding of the mechanism of thrombolysis has provided the possibility to improve the therapeutic effects of the fibrinolytic agents streptokinase and urokinase. Further advances in thrombolytic therapy are expected by the use of the plasminogen activator from endothelium and pro-urokinase. Acylation of fibrinolytic enzymes will lead to beneficial effects (depot effect, protection from intrinsic inhibitors). Due to the extensive research into substances with fibrinolytic and thrombolytic effects a new generation of activators of fibrinolysis is expected that interferes with the biosynthesis and release of plasminogen activator of the vessel wall and that is suited for treatment of hypofibrinolytic states.