Thrombolytic and Haemorrhagic Effects of Bolus Doses of Tissue-Type Plasminogen Activator and a Hybrid Plasminogen Activator with Prolonged Plasma Half-Life (K2tu-PA: CGP 42935)

SummaryK2tu-PA is a hybrid plasminogen activator linking the kringle 2 domain of tissue-type plasminogen activator (t-PA) to the catalytic protease domain of single-chain urokinase-type plasminogen activator (scu-PA). K2tu-PA, as t-PA has high affinity for fibrin and is activated by fibrin but has a longer plasma half-life (over 30 min). The aim of this study was to compare the effects of bolus doses of recombinant t-PA (rt-PA) and K2tu-PA, on: 1) lysis of preformed thrombi (fibrinolysis), 2) accretion of new fibrin on pre-existing thrombi during fibrinolysis (thrombus growth), 3) thrombolysis as assessed by reduction of thrombus weight and 4) systemic plasma proteolysis and blood loss from a standard wound. A jugular vein thrombosis model and an ear bleeding model were adopted in rabbits. Saline produced 11 ± 2% fibrinolysis. rt-PA, 0.2 mg/kg, 0.4 mg and 0.8 mg/kg produced 35 ± 4%, 54 ± 4% and 78 ± 6% fibrinolysis, respectively. K2tu-PA, at the same doses, produced 39 ± 5%, 57 ± 6% and 83 ± 6% fibrinolysis, respectively. Thus, no differences in the fibrinolytic activity of rt-PA and K2tu-PA were observed. Injection of saline was followed by an accretion of 56.4 ± 5.9 μg of radioactive new fibrin on the thrombi. The injection of the three increasing doses of rt-PA was followed by an accretion of 54.9 ± 5.3 μg, 49.1 ± 6.1 μg and 47.2 ± 4.8 μg. The injection of three increasing doses of K2tu-PA was followed by an accretion of 38.1 ± 3.4 μg, 29.6 ± 2.5 μg and 17.1 ± 3.4 μg. At each of the three doses, K2tu-PA was more effective than rt-PA in reducing the accretion of new fibrin on the thrombi (p <0.01) and, as a consequence, in reducing thrombus weight (p <0.01). The two lower doses of rt-PA and K2tu-PA did not produce systemic proteolysis and bleeding. The highest dose of K2tu-PA produced a statistically significant more intense systemic proteolysis and bleeding than the highest dose of rt-PA.This study demonstrates that bolus doses of K2tu-PA and rt-PA produce a similar degree of fibrinolysis. Due to its longer half-life K2tu-PA is more efficient than rt-PA in inhibiting accretion of new fibrin on the thrombi during thrombolysis so that the thrombus size is more efficiently reduced. As a consequence the concomitant use of heparin might not be necessary. The potential increased risk of bleeding with bolus of high doses of K2tu-PA has to be seen in view of the advantage of avoiding the concomitant use of heparin.

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In Vitro Stability of a Tissue-Type Plasminogen Activator Mutant, BM 06.022, in Human Plasma

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648982 ◽

1994 ◽

Vol 72 (06) ◽

pp. 906-911 ◽

Cited By ~ 8

Author(s):

D C Rijken ◽

E Groeneveld ◽

M M Barrett-Bergshoeff

Keyword(s):

Plasminogen Activator ◽

Half Life ◽

Polyacrylamide Gel Electrophoresis ◽

Tissue Type ◽

Single Chain ◽

Tissue Type Plasminogen Activator ◽

Type Plasminogen Activator ◽

Sds Page ◽

Chain Form

SummaryBM 06.022 is a non-glycosylated mutant of human tissue-type plasminogen activator (t-PA) comprising only the kringle-2 and proteinase domains. The in vivo half-life of BM 06.022 antigen is 4- to 5-fold longer than that of t-PA antigen. The in vitro half-life of the activity of BM 06.022 at therapeutic concentrations in plasma is shorter than that of t-PA. In this study the inactivation of BM 06.022 in plasma was further investigated.Varying concentrations of BM 06.022 were incubated in plasma for 0-150 min. Activity assays on serial samples showed a dose-dependent decline of BM 06.022 activity with a half-life from 72 min at 0.3 μg/ml to 38 min at 10 μg/ml. SDS-polyacrylamide gel electrophoresis (SDS-PAGE) followed by fibrin autography showed the generation of several BM 06.022-complexes. These complexes could be completely precipitated with antibodies against Cl-inactivator, α2-antiplasmin and α1-antitrypsin.During the incubation of BM 06.022 in plasma, plasmin was generated dose-dependently as revealed by varying degrees of a2-anti-plasmin consumption and fibrinogen degradation. SDS-PAGE and immunoblotting showed that single-chain BM 06.022 was rapidly (i. e. within 45 min) converted into its two-chain form at concentrations of 5 μg/ml BM 06.022 and higher.In conclusion, BM 06.022 at therapeutic concentrations in plasma was inactivated by Cl-inactivator, a2-antiplasmin and a j-antitrypsin. The half-life of the activity decreased at increasing BM 06.022 concentrations, probably as a result of the generation of two-chain BM 06.022 which may be inactivated faster than the single-chain form.

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Potentiation by Heparin Fragments of Thrombolysis Induced with Human Tissue-Type Plasminogen Activator or Human Single-Chain Urokinase-Type Plasminogen Activator

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646021 ◽

1987 ◽

Vol 58 (03) ◽

pp. 947-950 ◽

Cited By ~ 30

Author(s):

J M Stassen ◽

I Juhan-Vague ◽

M C Alessi ◽

F De Cock ◽

D Collen

Keyword(s):

Plasminogen Activator ◽

San Francisco ◽

Human Tissue ◽

Factor Xa ◽

Tissue Type ◽

Single Chain ◽

Jugular Vein Thrombosis ◽

Tissue Type Plasminogen Activator ◽

Type Plasminogen Activator ◽

Urokinase Type Plasminogen Activator

SummaryThe effect of heparin and of two low molecular weight (low M r) fractions of heparin on thrombolysis with recombinant human tissue-type plasminogen activator (rt-PA, Genentech Inc., So. San Francisco, CA) or human single chain urokinase-type plasminogen activator (scu-PA, Sandoz AG, Basle, Switzerland) was measured in a rabbit jugular vein thrombosis model. Four bolus injections of 200 anti-Factor Xa units/kg body weight of heparin (Liquemine, Hoffmann-La Roche, Basle, Switzerland), of 90 units/kg of CY 216 (Choay, Paris, France) or of 90 units/kg of CY 222 (Choay, Paris, France) were given intravenously, immediately after the start of the infusion of rt-PA or scu-PA and at hourly intervals during their intravenous infusion over 4 hours. The bolus injections resulted in anti-Factor Xa levels in plasma of 5.7 ± 1.2 units/ml just before the repeat bolus injections of heparin with corresponding values of 3.9 ± 0.2 units/ml for CY 216 and 1.6 ± 0.2 units/ml for CY 222.Thrombolysis with 0.25 mg/kg rt-PA was 36 ± 1 percent (n = 9) in the absence of anticoagulant, 40 ± 1 percent (n = 7, p <0.05) in the presence of heparin, 49 ± 5 percent (n = 7, p <0.02) with CY 216 and 62 ± 5 percent (n = 7, p <0.01) with CY 222. Thrombolysis with 0.5 mg/kg scu-PA was 23 ± 1 percent (n = 4) without heparin, and increased to 24 ± 1 percent (n = 4, p >0.1) with heparin, to 32 ± 2 percent (n = 4, p <0.01) with CY 216 and to 33 ± 3 percent (n = 4, p <0.01) with CY 222.It is concluded that, at these high doses, the two low M r heparin fractions CY 216 and CY 222, potentiate thrombolysis by rt-PA and scu-PA in this animal model.

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Binding of 131I-Labeled Tissue-Type Plasminogen Activator on De-Endothelialized Lesions in Rabbits

Nuklearmedizin ◽

10.1055/s-0038-1628893 ◽

1987 ◽

Vol 26 (05) ◽

pp. 224-228 ◽

Cited By ~ 2

Author(s):

Y. Isaka ◽

H. Etani ◽

K. Kimura ◽

S. Yoneda ◽

T. Kamada ◽

...

Keyword(s):

Plasminogen Activator ◽

Abdominal Aorta ◽

Half Life ◽

Balloon Catheter ◽

Biochemical Properties ◽

Tissue Type ◽

Fibrin Deposition ◽

Tissue Type Plasminogen Activator ◽

High Affinity ◽

Type Plasminogen Activator

Tissue-type plasminogen activator (t-PA) which has a high affinity for fibrin in the clot, was labeled with 131I by the iodogen method, and its binding to de-endothelialized lesions in the rabbit was measured to assess the detectability of thrombi. The de-endothelialized lesion was induced in the abdominal aorta with a Fogarty 4F balloon catheter. Two hours after the de-endothelialization, 131I-labeled t-PA (125 ± 46 μCi) was injected intravenously. The initial half-life of the agent in blood (n = 12) was 2.9 ± 0.4 min. The degree of binding of 131I-labeled t-PA to the de-endothelialized lesion was evaluated at 15 min (n = 6) or at 30 min (n = 6) after injection of the agent. In spite of the retention of the biochemical properties of 131I-labeled t-PA and the presence of fibrin deposition at the de-endothelialized lesion, the binding of t-PA to the lesion was not sufficiently strong. Lesion-to-control ratios (cpm/g/cpm/g) were 1.65 ± 0.40 (at 15 min) and 1.39 ± 1.31 (at 30 min), and lesion-to-blood ratios were 1.39 ± 0.32 (at 15 min) and 1.36 ± 0.23 (at 30 min). These results suggest that radiolabeled t-PA may be inappropriate as a radiopharmaceutical for the scintigraphic detection of a pre-existing thrombotic lesion.

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Recombinant Variants of Tissue-Type Plasminogen Activator Containing Amino Acid Substitutions in the Finger Domain

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646342 ◽

1992 ◽

Vol 68 (06) ◽

pp. 672-677 ◽

Cited By ~ 4

Author(s):

Hitoshi Yahara ◽

Keiji Matsumoto ◽

Hiroyuki Maruyama ◽

Tetsuya Nagaoka ◽

Yasuhiro Ikenaka ◽

...

Keyword(s):

Amino Acid ◽

Plasminogen Activator ◽

Half Life ◽

Tissue Type ◽

Clot Lysis ◽

Amino Acid Substitutions ◽

Wild Type ◽

Plasma Clot ◽

Tissue Type Plasminogen Activator ◽

Type Plasminogen Activator

SummaryTissue-type plasminogen activator (t-PA) is a fibrin-specific agent which has been used to treat acute myocardial infarction. In an attempt to clarify the determinants for its rapid clearance in vivo and high affinity for fibrin clots, we produced five variants containing amino acid substitutions in the finger domain, at amino acid residues 7–9, 10–14, 15–19, 28–33, and 37–42. All the variants had a prolonged half-life and a decreased affinity for fibrin of various degrees. The 37–42 variant demonstrated about a 6-fold longer half-life with a lower affinity for fibrin. Human plasma clot lysis assay estimated the fibrinolytic activity of the 37–42 variant to be 1.4-fold less effective than that of the wild-type rt-PA. In a rabbit jugular vein clot lysis model, doses of 1.0 and 0.15 mg/kg were required for about 70% lysis in the wild-type and 37–42 variant, respectively. Fibrinogen was degraded only when the wild-type rt-PA was administered at a dose of 1.0 mg/kg. These findings suggest that the 37–42 variant can be employed at a lower dosage and that it is a more fibrin-specific thrombolytic agent than the wild-type rt-PA.

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Single-Chain and Two-Chain Tissue-Type Plasminogen Activator (t-PA) Bind Differently to Cultured Human Endothelial Cells

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646886 ◽

1989 ◽

Vol 62 (02) ◽

pp. 699-703 ◽

Cited By ~ 8

Author(s):

Rob J Aerts ◽

Karin Gillis ◽

Hans Pannekoek

Keyword(s):

Endothelial Cells ◽

Plasminogen Activator ◽

Binding Sites ◽

Umbilical Vein ◽

Tissue Type ◽

Single Chain ◽

Human Endothelial Cells ◽

Tissue Type Plasminogen Activator ◽

Type Plasminogen Activator ◽

Umbilical Vein Endothelial Cells

SummaryIt has recently been shown that the fibrinolytic components plasminogen and tissue-type plasminogen activator (t-PA) both bind to cultured human umbilical vein endothelial cells (HUVEC). After cleavage of t-PA by plasmin, “single-chain” t-PA (sct-PA) is converted into “two-chain” t-PA (tct-PA), which differs from the former in a number of respects. We compared binding of sct-PA and tct-PA to the surface of HUVEC. Removal of t-PA bound to HUVEC by a mild treatment with acid and a subsequent quantification of eluted t-PA both by activity- and immunoradiometric assays revealed that, at concentrations between 10 and 500 nM, HUVEC bind about 3-4 times more sct-PA than tct-PA. At these concentrations, both sct-PA and tct-PA remain active when bound to HUVEC. Mutual competition experiments showed that sct-PA and tct-PA can virtually fully inhibit binding of each other to HUVEC, but that an about twofold higher concentration of tct-PA is required to prevent halfmaximal binding of sct-PA than visa versa. These results demonstrate that sct-PA and tct-PA bind with different affinities to the same binding sites on HUVEC.

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Thrombolytic Treatment with Tissue-type Plasminogen Activator (t-PA) Containing Liposomes in Rabbits: a Comparison with Free t-PA

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653802 ◽

1995 ◽

Vol 73 (03) ◽

pp. 488-494 ◽

Cited By ~ 62

Author(s):

J L M Heeremans ◽

R Prevost ◽

M E A Bekkers ◽

P Los ◽

J J Emeis ◽

...

Keyword(s):

Plasminogen Activator ◽

Therapeutic Index ◽

Tissue Type ◽

Jugular Vein Thrombosis ◽

Thrombolytic Activity ◽

Tissue Type Plasminogen Activator ◽

Liposome Encapsulation ◽

Thrombosis Model ◽

Lysis Activity ◽

Type Plasminogen Activator

SummaryIn this study, we aimed at improving the therapeutic index of tissue- type Plasminogen Activator (t-PA) as thrombolytic agent in the treatment of myocardial infarction. Liposome-encapsulated t-PA was tested in a rabbit jugular vein thrombosis model: administration of free t-PA (t-PA) as a bolus injection in the ear vein was compared to a similar administration of liposomal t-PA (t-PA-lip), liposomal t-PA in plasminogen-coated liposomes (Plg-t-PA-lip), a mixture of free t-PA and empty liposomes (t-PA+empty lip) and a saline-blank (blank) in terms of thrombolytic activity and side effects.Liposomal t-PA (t-PA-lip/Plg-t-PA-lip) showed a significantly better thrombolysis efficiency than equimolar doses of free t-PA (t-PA/ t-PA+ empty lip): about 0.24 mg/kg of liposomal t-PA practically equalled the lysis-activity of a dose of free t-PA of 1.0 mg/kg (t-PAlmg/kg). On the other hand, liposome encapsulation did not affect the systemic activation of alpha2-antiplasmin and plasminogen by t-PA.We conclude that for this model an improvement in thrombolytic efficacy of t-PA is achieved by liposome encapsulation of t-PA. As t-PA-lip and Plg-t-PA-lip -treatment induced similar results, targeting of liposomal t-PA by coupled glu-Plg remains a topic to be optimized in future studies.

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Absence of Synergism Between Tissue-Type Plasminogen Activator (t-PA), Single-Chain UrokinaseType Plasminogen Activator (scu-PA) and Urokinase on Clot Lysis in a Plasma Milieu In Vitro

Thrombosis and Haemostasis ◽

10.1055/s-0038-1661598 ◽

1986 ◽

Vol 56 (01) ◽

pp. 035-039 ◽

Cited By ~ 42

Author(s):

D Collen ◽

F De Cock ◽

E Demarsin ◽

H R Lijnen ◽

D C Stump

Keyword(s):

Human Plasma ◽

Plasminogen Activator ◽

Dose Response ◽

Fibrinolytic System ◽

Tissue Type ◽

Clot Lysis ◽

Single Chain ◽

Tissue Type Plasminogen Activator ◽

Type Plasminogen Activator

SummaryA potential synergic effect of tissue-type plasminogen activator (t-PA), single-chain urokinase-type plasminogen activator (scuPA) or urokinase on clot lysis was investigated in a whole human plasma system in vitro. The system consisted of a human plasma clot labeled with 125I-fibrinogen, immersed in titrated whole human plasma, to which the thrombolytic agents were added. Clot lysis was quantitated by measurement of released 125I, and activation of the fibrinolytic system in the surrounding plasma by measurements of fibrinogen and α2-antiplasmin.t-PA, scu-PA and urokinase induced a dose-dependent and time-dependent clot lysis; 50 percent lysis after 2 h was obtained with 5 nM t-PA, 20 nM scu-PA and 12 nM urokinase. At these concentrations no significant activation of the fibrinolytic system in the plasma was observed with t-PA and scu-PA, whereas urokinase caused significant α2-antiplasmin consumption and concomitant fibrinogen degradation. The shape of the dose-response curves was different; t-PA and urokinase showed a log linear dose-response whereas that of scu-PA was sigmoidal.

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Pharmacokinetics and Pharmacodynamics of Lanoteplase (n-PA)

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615568 ◽

1999 ◽

Vol 82 (S 01) ◽

pp. 121-123 ◽

Cited By ~ 4

Author(s):

Martin Moser ◽

Benedikt Kohler ◽

Wolfgang Kübler ◽

Christoph Bode ◽

Thomas K. Nordt

Keyword(s):

Plasminogen Activator ◽

Tissue Type ◽

Bolus Administration ◽

Pharmacokinetics And Pharmacodynamics ◽

Therapeutic Principle ◽

Tissue Type Plasminogen Activator ◽

Promising Agent ◽

Type Plasminogen Activator ◽

Plasma Half Life ◽

Pharmacodynamic Data

SummaryIn acute myocardial infarction rapid, complete, and sustained reperfusion of the infarct-related coronary artery is the most important therapeutic principle. Lanoteplase or n-PA, a third-generation plasminogen activator consisting of a deletion and point mutant of tissue-type plasminogen activator (t-PA), is a promising agent to appraoch this therapeutic goal. The molecule exhibits an increased plasma half-life allowing single-bolus administration. In this article, after characterizing the n-PA molecule, the currently available pharmacokinetic and pharmacodynamic data including the results of the InTIME study are reviewed.

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