Textilinin-1, an alternative anti-bleeding agent to aprotinin: Importance of plasmin inhibition in controlling blood loss

Br J Haematol. 2009 Apr;145(2):207-11. doi: 10.1111/j.1365-2141.2009.07605.x. Epub 2009 Feb 22.

Abstract

Aprotinin has been used widely in surgery as an anti-bleeding agent but is associated with a number of side effects. We report that textilinin-1, a serine protease inhibitor from Pseudonaja textilis venom with sequence relatedness to aprotinin, is a potent but reversible plasmin inhibitor and has a narrower range of protease inhibition compared to aprotinin. Like aprotinin, textilinin-1 at 5 micromol/l gave almost complete inhibition of tissue plasminogen activator-induced fibrinolysis of whole blood clots. The activated partial thromboplastin time for plasma was markedly increased by aprotinin but unaffected by textilinin-1. In a mouse tail-vein bleeding model, intravenous textilinin-1 and aprotinin caused similar decreases in blood loss but time to haemostasis in the textilinin-treated animals was significantly shorter than in aprotinin-treated mice. Based on these data, textilinin-1 merits further investigation as a therapeutic alternative to aprotinin.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Aprotinin / therapeutic use*
  • Blood Loss, Surgical / prevention & control*
  • Elapid Venoms / therapeutic use*
  • Fibrinolysin / antagonists & inhibitors*
  • Fibrinolysis / drug effects
  • Hemostasis
  • Mice
  • Serine Proteinase Inhibitors / therapeutic use*
  • Time Factors

Substances

  • Elapid Venoms
  • Serine Proteinase Inhibitors
  • textilinin
  • Aprotinin
  • Fibrinolysin