Haemostatic safety of a unique recombinant plasmin molecule lacking kringles 2-5

Thromb Haemost. 2010 Oct;104(4):780-7. doi: 10.1160/TH09-10-0742. Epub 2010 Aug 30.

Abstract

We previously demonstrated a significant margin of haemostatic safety for full-length plasmin in comparison with tissue plasminogen activator (t-PA). We now report studies that compare haemostatic safety of full-length plasmin with a novel recombinant plasmin derivative, (Δ K2-5) plasmin, consisting of kringle 1 linked to the serine protease domain of plasmin. Agent was administered intravenously in a randomised, blinded manner in a rabbit model of fibrinolytic haemorrhage. A dose-related decrease in α2-antiplasmin, factor VIII, and fibrinogen followed administration of 1.8, 2.7, 3.7 and 4.6 mg/kg of (Δ K2-5) plasmin, with nadir fibrinogen concentrations of 65%, 40%, 30%, and 0% of initial levels, respectively. Mean primary bleeding time was undisturbed at 1.8 mg/kg (2.2 ± 0.7 minutes), minimally prolonged at 2.7 or 3.7 mg/kg (5 ± 2.9 and 4.4 ± 2.2 minutes), and prolonged at the purposefully toxic 4.6 mg/kg dose (12.8 ± 18.8 minutes). Equimolar amounts of (Δ K2-5) plasmin and full-length plasmin had equal in vitro clot lysis efficacy, but in the bleeding model, (Δ K2-5) plasmin showed better haemostatic competency than full-length plasmin. This safety advantage may be explained by higher residual amounts of plasma fibrinogen in animals given (Δ K2-5) plasmin rather than full-length plasmin. We demonstrate that a unique recombinant plasmin mutant, (Δ K2-5) plasmin, possesses an advantage in hemostatic safety over an equimolar amount of full-length plasmin.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bleeding Time
  • Disease Models, Animal
  • Fibrinolysin / administration & dosage*
  • Fibrinolysin / adverse effects
  • Fibrinolysin / genetics
  • Fibrinolysin / metabolism
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control*
  • Humans
  • Kringles / genetics
  • Protein Interaction Domains and Motifs / genetics
  • Rabbits
  • Recombinant Proteins / administration & dosage*
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / genetics
  • Recombinant Proteins / metabolism
  • Sequence Deletion / genetics
  • Thrombolytic Therapy* / adverse effects
  • Thrombosis / complications
  • Thrombosis / drug therapy*
  • Thrombosis / physiopathology
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / adverse effects

Substances

  • Recombinant Proteins
  • Tissue Plasminogen Activator
  • Fibrinolysin