ThrombinIts Key Role in Thrombogenesis-Implications for Its Inhibition

This new multi-authored book reviews the current understanding of the role of thrombin in venous and arterial thrombosis and its inhibition in the clinical setting. Heparin, the most widely used antithrombotic, does not effectively regulate thrombin or its formation. Accumulating evidence suggests that other antithrombins are effective in some of the situations where heparin is not. Discussions include the current knowledge on antithrombotic prophylaxis and therapy, from the perspective of the role in thrombin in venous and arterial vascular disease, the limitations of the current anticoagulant therapies, and potential and limitations of newer antithrombins currently being tested in several experimental and clinical settings. Thrombin helps the clinician to better rationalize the use of specific antithrombins in the prevention and management of thrombotic disease and provides the basic scientist with a better understanding of the goals the clinician attempts to achieve with antithrombotic therapy.

Table of Contents:
Thrombin-Catalyzed Amplification and Inhibitory Reactions of Blood Coagulation, F.A. Ofosu, M.R. Buchanan, and S.J. Brister Introduction Acceleration of Blood Coagulation Summary The Structural Basis for Thrombin Inhibition by Hirudin and Serpins, M.T. Stubbs and W. Bode Introduction Thrombin Structure and Its Sites of Interaction Interaction with Fibrinogen Interaction with Hirudin Interaction with Serpins Summary Development and Rationale for the Use of Low Molecular Weight Heparins in the Prevention and Treatment of Venous Thrombosis, J.R. Leclerc Introduction Unfractionated Heparin Low Molecular Weight Heparins Mechanism of Action Advantages of Low Molecular Weight Heparin Clinical Studies Heparin Cofactor II and the Prevention and Treatment of Thrombosis, M.R. Buchanan, S.J. Brister, and F.A. Ofosu Introduction Why Target Thrombin for Inhibition? The Basis for Antithrombotic Therapy Inhibition of Surface-Bound Thrombin Thrombin HCII Inhibition Inhibition of Thrombin by Heparin Cofactor II: Effect on Thrombus Formation/Growth in the Experimental Setting Conclusion Future Directions Development and Rationale for the Use of Direct Thrombin Inhibitors in the Prevention and Treatment of Arterial and Venous Thrombosis, J.S. Ginsberg Introduction Clinical Studies of Direct Thrombin Inhibitors Development and Rationale for Use of Anti-Thrombins in Arterial Thrombosis, S.J. Brister, F.A. Ofosu, and M.R. Buchanan Introduction The Prothrombotic State Regulation of the Prothrombotic State Conclusion Pediatric Thromboembolism: Epidemiology, Prevention and Treatment, M. Andrew and M. David Introduction The Relationship Between Age and the Occurrence of DVT/PE Mechanisms Protecting Children from Thromboembolic Complications The Epidemiology of DVT/PE in Children Clinical Outcome Conclusion The Role of Thrombin Inhibition in Thrombolytic Therapy, M. Pr

About the Author :
Buchanan\, Michael R.; Ofosu\, Frederick A.; Brister\, Stephanie J.