Thromb Haemost 1996; 76(03): 384-392
DOI: 10.1055/s-0038-1650588
Original Article
Schattauer GmbH Stuttgart

Experimental Pharmacology of Hirunorm: a Novel Synthetic Peptide Thrombin Inhibitor

Rocco Cirillo
The Departments of Pharmacology of Laboratori Guidotti, Pisa, Italy
,
Annalisa Lippi
The Departments of Pharmacology of Laboratori Guidotti, Pisa, Italy
,
Alessandro Subissi
The Departments of Pharmacology of Laboratori Guidotti, Pisa, Italy
,
Giancarlo Agnelli
The institute of Internal and Vascular Medicine, University of Perugia, Italy
,
Marco Criscuoli
The Departments of Pharmacology of Laboratori Guidotti, Pisa, Italy
› Author Affiliations
Further Information

Publication History

Received 16 January 1996

Accepted after resubmission 24 May 1996

Publication Date:
10 July 2018 (online)

Summary

Enhanced thrombin activity has been associated with coronary thrombosis and with acute and long-term complications following coronary balloon angioplasty. Blocking thrombin activity with specific inhibitors is proposed as a promising antithrombotic therapy. We describe the anticoagulant and antithrombotic properties of hirunorm, a novel synthetic 26-aminoacid peptide thrombin inhibitor, in comparison with r-hirudin and hirulog-1. Hirunorm was equipotent to hirulog-1 and 1/30 as potent as r-hirudin in blocking a-thrombin amidolytic activity (IC50 = 10 ± 2,15 ± 1 and 0.3 ± 0.1 nM, respectively), but it did not affect trypsin, plasmin and t-PA activities at 10 μM. All the compounds inhibited clot-bound thrombin to clots prepared by thrombin hydrolysis of purified fibrinogen in buffer. Hirunorm and hirulog-1 showed similar species-dependent potency in doubling basal in vitro clotting times of human, rat and rabbit plasma (EC200 varied 70 to 200 nM for TT, 0.7 to 16 μM for aPTT and 0.8 to 17 μM for PT), while r-hirudin was always at least three times more active. When assayed by HPLC or by bioassay of the intact peptide, hirunorm was stable against a-thrombin and plasma hydrolases, but it was catabolized by rat liver and kidney enzymes. Venous thrombosis was produced in anaesthetized rats by vena cava ligation following a procoagulant serum injection. Intravenous and subcutaneous hirunorm inhibited venous thrombosis at doses (≤0.3 mg/kg) two-three times higher than those of r-hirudin. Hirulog-1 was as active as hirunorm only after i. v. infusion. Arterial thrombosis was obtained in the anaesthetized rat by chemical (FeCl2) stimulation of a common carotid and i.v. infused hirunorm (1-3 mg/kg/30 min) inhibited it dose-dependently; r-hirudin was partly active only at 3 mg/kg, but hirulog-1 was inactive at either dose. Full antithrombotic doses of hirunorm did not affect the bleeding time as measured from punctured mesenteric vessels, in anaesthetized rats. In conclusion, hirunorm is a potent peptide thrombin inhibitor endowed with antithrombotic activity in models of venous and arterial thrombosis.

 
  • References

  • 1 Cannon CP, McCabe CH, Henry TD, Schweiger MJ, Gibson RS, Mueller HS, Becker RC, Kleinian NS, Haugland JM, Anderson JL, Sharaf BL, Edwards SJ, Rogers WJ, Williams DO, Braunwald E. A pilot trial of recombinant desulfatohirudin compared with heparin in conjunction with tissue-type plasminogen activator and aspirin for acute myocardial infarction: results of the Thrombolysis In Myocardial Infarction (TIMI) 5 trial. J Am Coll Cardiol 1994; 23: 993-1003
  • 2 Eriksson BI, Kalebo P, Ekman S, Kerry R, Baur M. Effective prevention of thromboembolic complications after total hip replacement with three different doses of recombinant hirudin, CGP 39393 (Revasc®), Ciba, compared to unfractioned heparin. Circulation 1994; 90: 1-569 (abstract n° 3066)
  • 3 Ginsberg JS, Nurmohamed MT, Gent M, Mackinnon B, Sicurella J, Brilled-wards P, Levine MN, Panju AA, Powers P, Stevens P, Turpie AGG, Weitz J, Buller HR, Tencate JW, Neemeh J, Adelman B, Fox I, Maraganore J, Hirsh J. Use of hirulog in the prevention of venous thrombosis after major hip or knee surgery. Circulation 1994; 90: 2385-2389
  • 4 Topol EJ, Fuster V, Harrington RA, Califf RM, Kleiman NS, Kereiakes DJ, Cohen M, Chapekis A, Gold HK, Tannenbaum MA, Rao AK, Debowey D, Schwartz D, Henis M, Chesebro J. Recombinant hirudin for unstable angina pectoris. A multicenter, randomized angiographic trial. Circulation 1994; 89: 1557-1566
  • 5 Theroux P, Perez-Villa F, Waters D, Lesperance J, Shabani F, Bonan R. Randomized double-blind comparison of two doses of hirulog-1 with heparin as adjunctive therapy to streptokinase to promote early patency of the infarct-related artery in acute myocardial infarction. Circulation 1995; 91: 2132-2139
  • 6 Maraganore JM, Bourdon P, Jablonski J, Ramachandran KL, Fenton JW. Design and characterization of hirulog: a novel class of bivalent peptide inhibitors of thrombin. Biochemistry 1990; 29: 7095-7101
  • 7 Di Maio J, Gibbs B, Lefebvre J, Konishi Y, Munn D, Yi YueS. Synthesis of a homologous series of ketomethylene arginyl pseudodipeptides and application to low molecular weight hirudin-like thrombin inhibitors. J Med Chem 1992; 35: 3331-3341
  • 8 Thurieau C, Guyard C, Simonet S, Verbeuren TJ, Fauchere JL. Synthesis of a new bivalent hirudin analog (hirufos), which includes a stable 4’-phos-phono-L-phenylalanine mimic of (L-tyrosine 04-sulfate)-63. Helv Chim Acta 1994; 77: 679-684
  • 9 Fenton JW II, Ofosu FA, Moon DG, Maraganore JM. Thrombin structure and function: why thrombin is the primary target for antithrombotics. Blood Coagulation Fibrinolysis 1991; 2: 69-75
  • 10 Kaiser B, Hauptmann J. Pharmacology of synthetic thrombin inhibitors of the tripeptide type. Cardiovasc Drug Rev 1992; 10: 71-87
  • 11 Lefkovits J, Topol EJ. Direct thrombin inhibitors in cardiovascular medicine. Circulation 1994; 90: 1522-1536
  • 12 Markwardt F. Hirudin: the promising antithrombotic. Cardiovasc Drug Rev 1992; 10: 211-232
  • 13 Witting JI, Bourdon P, Brezniak DV, Maraganore JM, Fenton JW. Thrombin-specific inhibition by and slow cleavage of hirulog-1. Biochem J 1992; 283: 737-743
  • 14 Lidon R-M, Theroux P, Lesperance J, Adelman B, Bonan R, Duval D, Levesque J. A pilot, early angiographic patency study using a direct thrombin inhibitor as adjunctive therapy to streptokinase in acute myocardial infarction. Circulation 1994; 89: 1567-1572
  • 15 Bittl JA, Strony J, Brinker JA, Ahmed WH, Meckel CR, Chatman BR, Maraganore J, Deutsch E, Adelman B. Treatment with bivaluridin (hirulog) as compared with heparin during coronary angioplasty for unstable or postinfarction angina. N Engl J Med 1995; 333: 764-769
  • 16 Lombardi A, Nastri F, Galdiero S, Della MorteR, Staiano N, Pedone C, Pavone V. Rational design of enzymatically resistant, peptide based, multisite directed, α-thrombin inhibitors. American Peptide Symposium, Columbus (Ohio, USA), June 18-23 1995; abstract n° P930
  • 17 Rick W. Trypsin. In Methods in Enzymatic Analysis Bergmeyer HU. ed Academic Press; I edition 1963: 807-818
  • 18 Lowry OH, Rosebrough NJ, Farr AL, Randall LJ. Protein measurements with the Folin phenol reagent. J Biol Chem 1951; 193: 265-275
  • 19 Schumacher WA, Steinbacher TE, Heran CL, Seiler SM, Michel IM, Ogletree ML. Comparison of thrombin active site and exosite inhibitors and heparin in experimental models of arterial and venous thrombosis and bleeding. J Pharmacol Exp Ther 1993; 267: 1237-1242
  • 20 Kelly AB, Maraganore JM, Bourdon P, Hanson SR, Harker LA. Antithrombotic effects of synthetic peptides targeting various functional domains of thrombin. Proc Natl Acad Sci USA 1992; 89: 6040-6044
  • 21 Kline T, Hammond C, Bourdon P, Maraganore JM. Hirulog peptides with scissile bond replacements resistant to thrombin cleavage. Biochem Bio-phys Res Commun 1991; 177: 1049-1055
  • 22 Cappiello M, Vilardo PG, Lippi A, Criscuoli M, Del Corso A, Mura U. Kinetics of human thrombin inhibition by two novel peptide inhibitors (Hirunorm IV and Hirunorm V). Biochem Pharmacol. In press
  • 23 Bichler J, Baynes JW, Thorpe SR. Catabolism of hirudin and thrombin-hirudin complexes in the rat. Biochem J 1993; 296: 771-776
  • 24 Nowak G, Bucha E, Goock T, Thieler H, Markwardt F. Pharmacology of r-hirudin in renal impairment. Thromb Res 1992; 66: 707-715
  • 25 Antman EM. Hirudin in acute myocardial infarction. Safety report from the Thrombolysis and Thrombin Inhibition in Myocardial Infarction (TIMI) 9A trial. Circulation 1994; 90: 1624-1630
  • 26 Fox I, Dawson A, Loynds P, Eisner J, Findlen K, Levin E, Hanson D, Mant T, Wagner J, Maraganore J. Anticoagulant activity of hirulog™, a direct thrombin inhibitor, in humans. Thromb Haemost 1993; 69: 157-163
  • 27 Agnelli G, Renga C, Weitz JL, Nenci GG, Hirsh J. Sustained antithrombotic activity of hirudin after its plasma clearance: comparison with heparin. Blood 1992; 80: 960-965
  • 28 Romisch J, Stöhr H-A, Stauß H, Koschinsky R, Stüber W, Paques E-P. Inhibition of in vitro clot growth by r-hirudin is more effective and longer sustained than by an analogous peptide. Thromb Haemost 1994; 71: 320-324
  • 29 Maraganore JM. Hirudin and hirulog: advances in antithrombotic therapy. Perspectives in Drug Discovery and Design 1991; 1: 461-478
  • 30 Markwardt F. The development of hirudin as an antithrombotic drug. Thromb Res 1994; 74: 1-23
  • 31 Close P, Bichler J, Kerry R, Ekman S, Bueller HR, Kienast J, Marbet GA, Schramm W, Verstraete M. Weak allergenicity of recombinant hirudin CGP 39393 (™REVASC) in immunocompetent volunteers. Coronary Artery Disease 1994; 5: 943-949
  • 32 Klocking H-P. Toxicology of hirudin. Semin Thromb Haemost 1991; 17: 126-129