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Ferric Chloride-induced Murine Thrombosis Models
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A low bleeding risk thrombolytic agent: citPA5.

Shanli Chen1, Sudan Fang1, Yang Zhou1

  • 1College of Chemistry, Fuzhou University, No.2 Wulongjiang North Avenue, Fuzhou 350108, China.

Cardiovascular Research
|March 28, 2024
PubMed
Summary

A novel thrombolytic agent, citPA5, demonstrates potent clot-dissolving capabilities with a significantly reduced bleeding risk compared to alteplase. This enhanced safety profile allows for potential pre-hospital stroke treatment, improving patient outcomes.

Keywords:
Enhanced tPA potencyIschaemic strokeLow bleeding riskThrombolytic therapy

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Area of Science:

  • Biochemistry
  • Pharmacology
  • Cardiovascular Research

Background:

  • Alteplase is a standard thrombolytic for stroke but carries a bleeding risk, necessitating pre-treatment screening.
  • Current thrombolytic therapy requires differentiation between ischemic and hemorrhagic stroke before administration.

Purpose of the Study:

  • To develop and characterize a novel thrombolytic agent, citPA5, with an improved safety profile and reduced bleeding tendency.
  • To evaluate the efficacy and safety of citPA5 in preclinical stroke models.

Main Methods:

  • Engineered recombinant tissue plasminogen activator (rtPA) with point mutations to create citPA5, suppressing fibrin-independent activity.
  • Assessed fibrinolytic activity and resistance to plasminogen activator inhibitor-1 (PAI-1).
  • Conducted safety evaluations including thrombelastography, mice tail bleeding assay, and a murine intracerebral hemorrhage model. Evaluated efficacy in a carotid embolism-induced stroke model.

Main Results:

  • CitPA5 exhibited significantly enhanced fibrinolytic activity (15.8-fold increase in kcat/Km) and resistance to PAI-1.
  • Safety assessments showed citPA5 did not cause systemic bleeding or worsen intracerebral hemorrhage compared to alteplase.
  • CitPA5 effectively improved cerebral blood flow and reduced infarct volume in a stroke model.

Conclusions:

  • CitPA5 offers potent thrombolysis with a low bleeding risk, indicating potential for early stroke treatment in pre-hospital settings.
  • This novel agent could enable faster stroke intervention without the need for immediate stroke type classification.
  • The development strategy for citPA5 may pave the way for a new generation of safer and more specific fibrinolytic drugs.