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Role of Streptokinase as a Thrombolytic Agent for Medical Applications
Published in Pankaj Bhatt, Industrial Applications of Microbial Enzymes, 2023
Hamza Rafeeq, Muhammad Anjum Zia, Asim Hussain, Ayesha Safdar, Muhammad Bilal, Hafiz M. N. Iqbal
Both the short- and long-term benefits have been demonstrated by these agents in many large-scale clinical trials to save lives (Locke et al., 2020). Early treatment is particularly important to gain maximum benefits of thrombolytic therapy conducted to restore blood flow, control the damage to heart muscles, and preserve heart functions (Dridi et al., 2020). Blood cells occluded by a fibrin matrix constrict the blood flow, forming a blood clot or thrombus. Thrombolysis or fibrinolysis is an enzyme-mediated suspension of the fibrin clot. The enzyme responsible for fibrinolysis in mammalian circulation is plasmin, which is a trypsin-like serine protease (Kojima et al., 2020). Inactive protein plasminogen forms fibrinolytically active plasmin, which is present in circulation. A limited proteolytic cleavage is involved in the conversion of the inactive plasminogen to fibrinolytic plasmin, and various plasminogen activators intercede this process. tPA and uPA are two plasminogen activators that occur naturally in the blood (Mei et al., 2020).
Austria
Published in Braithwaite Jeffrey, Mannion Russell, Matsuyama Yukihiro, Shekelle Paul, Whittaker Stuart, Al-Adawi Samir, Health Systems Improvement Across the Globe: Success Stories from 60 Countries, 2017
Maria M. Hofmarcher, Judit Simon, Gerald Haidinger
Currently, about 25,000 cases of stroke occur each year in Austria (population in 2014 was 8.5 million) (Gesundheit Österreich GmbH, 2016; Statistics Austria, 2016). Ischemic stroke represents around 85% of all cerebrovascular disease cases. Ischemic strokes occur when blood supply to a section of the brain is interrupted, leading to necrosis of the affected part. Treatment for ischemic stroke has advanced dramatically over the last decade. Clinical trials have demonstrated clear benefits of thrombolytic interventions (OECD, 2014a). While the recommended time window for thrombolytic therapy is 3 hours from symptom onset, recent data suggest that there are still treatment benefits even up to 4.5 hours after onset (Robinson et al., 2011). Beyond immediate healthcare issues, stroke impacts all dimensions of quality of life, including physical, psychological, and social functioning (Austrian Ministry of Health, 2015a).
Clinical Perspectives of Spectral Photon-Counting CT
Published in Katsuyuki Taguchi, Ira Blevis, Krzysztof Iniewski, Spectral, Photon Counting Computed Tomography, 2020
Salim Si-Mohamed, Loic Boussel, Philippe Douek
Ischemic stroke (IS) is the third leading cause of death and the second most common cause of death worldwide, with considerable disability among survivors. Rapid evaluation of acute stroke patients will increase as the population ages and acute therapies expand. Thrombolytic therapy has led to a higher proportion of patients presenting to hospital early, and this, with parallel developments in imaging technology, has greatly improved the understanding of acute stroke pathophysiology. The main challenge of stroke imaging is the distinction of hypoperfused tissue into three operational compartments; tissue that will inevitably die (core), tissue that will in principle survive (oligemia), and tissue that may either die or survive (the ischemic penumbra).
Comparison of conventional and extractive fermentation using aqueous two-phase system to extract fibrinolytic proteases produced by Bacillus stearothermophilus DPUA 1729
Published in Preparative Biochemistry & Biotechnology, 2021
Raimundo Felipe da Cruz Filho, Januário Gama dos Santos, Rosana Antunes Palheta, Valéria Carvalho Santos-Ebinuma, Daniela de Araújo Viana Marques, Maria Francisca Simas Teixeira
Thrombolytic drugs such as tissue plasminogen activator (t-PA), urokinase plasminogen activator (u-PA) and streptokinase are used in the treatment of cardiovascular diseases. In emergencies cases, activase® (serine protease), which is an activator of tissue plasminogen (t-PA) produced by recombinant DNA technology, is also used. All of these drugs have effective action in a short time but they are still expensive,[5,6] presented undesirable side effects, which include excessive bleeding, anaphylaxis and recurrence at the site of the residual thrombosis and have immunogenic effects.[7,8] In this way, alternative drugs and treatments are of great interest. In this sense, fibrinolytic enzymes, also known as nattokinase, which can reduce fibrinogen levels and degrade fibrin branched.[6,9] have gained attention due to their low cost of production and commercialization (three-time cheaper than conventional drugs), besides reduced side effects.[7,10] Fibrinolytic enzymes show the ability to dissolve the fibrin in blood clots represented by the fibrinolytic activity.[11]
Review of pulmonary emboli and techniques for their mechanical removal to inform device design
Published in Journal of Medical Engineering & Technology, 2020
Jessica Brand, Roger McGowan, Amit Nimunkar
As mentioned, thrombolytics are powerful clot dissolving medications that work more rapidly than anticoagulants. They have been proven to decrease mortality in patients with severe PEs [1]. However, thrombolytics have many contraindications and can increase the risk of major bleeding or intracranial haemorrhage [6,9]. Thrombolytics can be delivered systemically through an intravenous drip, or directly to the PAs through catheter-directed therapy (CDT) [9]. Systemic thrombolytic therapy is commonly the first recommended treatment for patients with massive PEs or PE patients who are hemodynamically compromised. CDT and surgical embolectomy are often only considered if systemic thrombolysis is ineffective, or if the patient is ineligible [9].
EkoSonic® endovascular system and other catheter-directed treatment reperfusion strategies for acute pulmonary embolism: overview of efficacy and safety outcomes
Published in Expert Review of Medical Devices, 2020
Lukas Hobohm, Karsten Keller, Thomas Münzel, Tommaso Gori, Stavros V. Konstantinides
Catheter-directed thrombolysis is increasingly attracting attention and gaining in popularity in the management of acute PE. Clinical application and ongoing research is focusing on patients with overt hemodynamic instability or those with signs of RV dysfunction and a risk of imminent decompensation (intermediate-high-risk PE). In general, recombinant tissue-type plasminogen activator (rtPA) is used as the thrombolytic agent.