Hirudins are a group of highly homologous polypeptides from the medicinal leech, Hirudo medicinalis. They have an extremely high and specific affinity for thrombin and are consequently
potent anticoagulants. They inhibit platelet aggregation induced by thrombin and efficiently
inhibit thrombin when it is bound to a fibrin clot. Recombinant hirudins have now
been produced and have been used to show a wide range of effects on thrombosis in
animal models. They are particularly effective against venoustype thrombi and have
greater effects than heparins on the platelet-rich thrombi in arteries. Recombinant
hirudins are currently undergoing clinical trials in deep venous thrombosis and acute
coronary syndrome and as an adjunct to thrombolysis in myocardial infarction. Results
from pilot trials indicate promising advantages over the currently used antithrombotic
agents. Larger clinical trials have been initiated and we await with great interest
their imminent publication.
Hirudin - thrombin - venous thrombosis - acute coronary syndrome - myocardial infarction
