F376A/M388A‐solulin, a new promising antifibrinolytic for severe haemophilia A

Haemophilia is a major bleeding disorder due to a deficiency of procoagulant factor VIII (type A) or IX (type B). The treatment is substitutive and based on infusion of factor concentrates. Main limitations of this therapy are cost, short factor half‐life and the development of inhibitors (up to 30% of severe HA patients). An important aggravating factor of haemophilia is due to a premature fibrinolysis, directing attention to the therapeutic potential of suitable antifibrinolytics. Thrombomodulin (TM) is a key player of the coagulation cascade by activating protein C (an inhibitor of thrombin generation, thus antagonizing coagulation) and of the fibrinolytic cascade by activating thrombin activatable fibrinolysis inhibitor TAFI (thus reducing fibrinolysis). Solulin is a soluble form of TM that shows both capabilities.

[1]  C. Kempton,et al.  Eradication of factor viii inhibitors in patients with mild and moderate hemophilia A , 2012, American journal of hematology.

[2]  D. Lillicrap,et al.  Solulin increases clot stability in whole blood from humans and dogs with hemophilia. , 2012, Blood.

[3]  B. Sørensen,et al.  Factor XIII in the treatment of hemophilia A. , 2012, The New England journal of medicine.

[4]  P. Cook,et al.  Kinetics of Activated Thrombin-activatable Fibrinolysis Inhibitor (TAFIa)-catalyzed Cleavage of C-terminal Lysine Residues of Fibrin Degradation Products and Removal of Plasminogen-binding Sites* , 2011, The Journal of Biological Chemistry.

[5]  J. Ingerslev,et al.  Factor XIII combined with recombinant factor VIIa: a new means of treating severe hemophilia A , 2011, Journal of thrombosis and haemostasis : JTH.

[6]  P. Giesen,et al.  Blood Coagulation , Fibrinolysis and Cellular Haemostasis Phase I study of Solulin , a novel recombinant soluble human thrombomodulin analogue , 2018 .

[7]  J. Foley,et al.  Soluble thrombomodulin partially corrects the premature lysis defect in FVIII‐deficient plasma by stimulating the activation of thrombin activatable fibrinolysis inhibitor , 2009, Journal of thrombosis and haemostasis : JTH.

[8]  J. Ingerslev,et al.  Tranexamic acid combined with recombinant factor VIII increases clot resistance to accelerated fibrinolysis in severe hemophilia A , 2007, Journal of thrombosis and haemostasis : JTH.

[9]  K. Hajjar,et al.  Molecular mechanisms of fibrinolysis , 2005, British journal of haematology.

[10]  M. Nesheim Thrombin and fibrinolysis. , 2003, Chest.

[11]  K. Mann,et al.  The dynamics of thrombin formation. , 2003, Arteriosclerosis, thrombosis, and vascular biology.

[12]  Weiqi Wang,et al.  Elements of the Primary Structure of Thrombomodulin Required for Efficient Thrombin-activable Fibrinolysis Inhibitor Activation* , 2000, The Journal of Biological Chemistry.

[13]  M. Betts,et al.  The interaction of thrombomodulin with Ca2+. , 1999, European journal of biochemistry.

[14]  K. Goa,et al.  Tranexamic acid: a review of its use in surgery and other indications. , 1999, Drugs.

[15]  M. Boffa,et al.  A Study of the Mechanism of Inhibition of Fibrinolysis by Activated Thrombin-activable Fibrinolysis Inhibitor* , 1998, The Journal of Biological Chemistry.

[16]  G. Broze,et al.  Coagulation-dependent inhibition of fibrinolysis: role of carboxypeptidase-U and the premature lysis of clots from hemophilic plasma. , 1996, Blood.

[17]  J. Morser,et al.  TAFI, or Plasma Procarboxypeptidase B, Couples the Coagulation and Fibrinolytic Cascades through the Thrombin-Thrombomodulin Complex* , 1996, The Journal of Biological Chemistry.

[18]  E. Blasko,et al.  The short loop between epidermal growth factor-like domains 4 and 5 is critical for human thrombomodulin function. , 1993, The Journal of biological chemistry.

[19]  J. Parkinson,et al.  Alanine-scanning mutagenesis of the epidermal growth factor-like domains of human thrombomodulin identifies critical residues for its cofactor activity. , 1993, The Journal of biological chemistry.

[20]  J. Lin,et al.  Oxidation of a specific methionine in thrombomodulin by activated neutrophil products blocks cofactor activity. A potential rapid mechanism for modulation of coagulation. , 1992, The Journal of clinical investigation.

[21]  W. Kreuz,et al.  Incidence of development of factor VIII and factor IX inhibitors in haemophiliacs , 1992, The Lancet.

[22]  Å. Ahlberg Haemophilia in Sweden. VII. Incidence, treatment and prophylaxis of arthropathy and other musculo-skeletal manifestations of haemophilia A and B. , 1965, Acta orthopaedica Scandinavica. Supplementum.