A review of the therapeutic uses of thrombin

Roger L. Lundblad; Ralph A. Bradshaw; Don Gabriel; Thomas L. Ortel; Jeffrey Lawson; Kenneth G. Mann

doi:10.1160/TH03-12-0792

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 91(05): 851-860
DOI: 10.1160/TH03-12-0792

Review Article

Schattauer GmbH

A review of the therapeutic uses of thrombin

Roger L. Lundblad

¹Department of Pathology, University of North Carolina at Chapel Hill and Roger L. Lundblad, LLC, Chapel Hill, North Carolina, USA

,

Ralph A. Bradshaw

²Department of Physiology and Biophysics, University of California at Irvine, Irvine, California, USA

,

Don Gabriel

³Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

,

Thomas L. Ortel

⁴Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA

,

Jeffrey Lawson

⁵Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA

,

Kenneth G. Mann

⁶Department of Biochemistry, University of Vermont, Burlington, Vermont, USA

› Author Affiliations

Abstract

Summary

Thrombin is the product of the hemostatic response essential to the conversion of fibrinogen to fibrin. In addition, it is also responsible for the aggregation of blood platelets in the formation of the “platelet plug” as well as the activation of factor VIII, factor V, factor XI, factor XIII and protein C. The action of thrombin is not confined to the hemostatic response as it also has a critical function in the wound healing process by stimulating ‘mitogenic’ events through interaction with cell surface receptors. In this review, we consider the various biological activities of thrombin as they relate to current therapeutic use. While there has been considerable interest in the development of fibrin sealant products, there has been considerably less interest in documenting the continuing use of thrombin as a therapeutic. The use of thrombin for topical hemostasis and the treatment of pseudoaneurysms will be discussed in detail. It is concluded that the use of thrombin as a drug will not only continue but also will significantly increase. However, the availability of a safe human thrombin preparation will be critical for the continued use of thrombin as a therapeutic.

Keywords

Pseudoaneurysms - vascular surgery - thrombin - topical hemostatic agents - interventional radiology

Full Text

References

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