摘要
血栓栓塞性疾病如深静脉血栓形成(DVT),肺栓塞(PE),心肌梗死(MI)和缺血性中风使人类发病率和死亡率增加,并已经严重影响到人们的世界各地的生活质量。据世界卫生组织统计,全球平均每年有1.7亿人死于血栓栓塞性疾病。因此,血栓栓塞性疾病的预防和治疗近年来受到广泛关注。基于血栓机制,抗血栓形成的药物主要分为抗凝药、抗血小板药和直接溶栓药物。抗凝剂如维生素K(vkas)、普通肝素 (UFH)和低分子量肝素 (LMWHs)成为治疗血栓栓塞性疾病的主要药物。然而,传统的抗凝药物起效慢、剂量调整的需求以及药物和药物、药物与食物之间的相互作用限制了该药物在临床治疗中疗效的提高。血栓栓塞性疾病的机制表明,凝血因子Xa(fXa)在凝血过程中起关键作用。因此,减少凝血酶的生成而不影响原有扩增凝血酶水平的FXa选择性抑制剂有着更好的抗血栓形成作用,从而减少原发性止血障碍。本文主要介绍了FXa抑制剂的研究进展,重点突出了其生物活性和构效关系(SAR)的信息,并特别强调了FXa抑制剂结构启示及其未来发展方向。
关键词: 抗凝药物,生物活性,F Xa,FXa抑制剂,凝血酶。
Current Drug Targets
Title:Advances in Inhibitors of FXa
Volume: 16 Issue: 11
Author(s): Liwei Guo and Shutao Ma
Affiliation:
关键词: 抗凝药物,生物活性,F Xa,FXa抑制剂,凝血酶。
摘要: Thromboembolic diseases such as deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI) and ischemic strokes are mainly responsible for people’s morbidity and mortality and have severely affected the people’s quality of life all over the world. According to WHO statistics, an average of 17 million people are killed by the thromboembolic diseases each year globally. Therefore, the prevention and treatment of thromboembolic diseases have received widespread attention in recent years. Based on thrombotic mechanism, anti-thrombotic drugs are mainly divided into anticoagulants, antiplatelet agents and direct thrombolytic drugs. In particular, anticoagulants such as vitamin K antagonists (VKAs), unfractionated heparin (UFH), and low-molecular-weight heparins (LMWHs) have become the main therapies for pre-treatment of thromboembolic disorders. However, the limitations of traditional anticoagulants such as slow onset of action, dose-adjusted requirement, drug-drug and drug-food interactions have restricted their improvement in the clinical treatment. The mechanism of the thromboembolic disorders has indicated that coagulation factor Xa (fXa) plays a pivotal role in the blood coagulation cascade. Thus, selective inhibition of fXa by diminishing the amplified generation of thrombin without affecting the pre-existing thrombin levels can provide better antithrombotic effect, thereby causing less impairment of primary hemostasis. In this paper, we mainly introduce the recent advances of fXa inhibitors, with focus on their biological activity and structure-activity relationship (SAR) information. In particular, the inspirations from the structures of the fXa inhibitors and their future direction are highlighted.
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Cite this article as:
Liwei Guo and Shutao Ma , Advances in Inhibitors of FXa, Current Drug Targets 2015; 16 (11) . https://dx.doi.org/10.2174/1389450116666150518095533
DOI https://dx.doi.org/10.2174/1389450116666150518095533 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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