ANTITHROMBIN-III AND HEPARIN
ANTITHROMBIN-III AND HEPARIN
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DOI：
10.1093/oxfordjournals.bmb.a071484
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发表时间：
1978-01-01
影响因子：
6.7
通讯作者：
THOMAS, D
中科院分区：
文献类型：
--
作者：
BARROWCLIFFE, TW;JOHNSON, EA;THOMAS, D
肝素是1916年由一名医学生发现的（McLean, 1959），作为抗凝血剂在临床使用已有40多年。肝素不仅是仍在使用的最古老的抗血栓药物，也是最广泛使用的即时抗凝剂。近年来，人们对肝素的化学和作用方式产生了相当大的兴趣，并且已经有专门讨论肝素的专题讨论会（如Bradshaw & Wessler, 1973; Kakkar & Thomas, 1976）。认识到肝素和抗凝血酶III （Atm）之间相互作用的重要性是最近才开始的，这导致了对肝素如何起作用的更好理解。遗传性AtHI缺乏是极少数可以从生物化学角度明确定义血栓倾向的情况之一；此外，At HI和肝素之间的相互关系在我们理解血栓栓塞性疾病的发病机制和治疗中起着关键作用。本文将回顾该领域的最新进展，特别强调生物化学的发展。尽管最近取得了进展，但仍然可以说促进凝血的因素比抑制凝血的因素更有特点。很明显，存在强大的机制来中和活化的凝血因子，特别是凝血酶。当血液在体外凝结时，所有的凝血原通常都转化为凝血酶，如果它没有被中和，10ml血液形成的凝血酶将足以凝结体内所有的纤维蛋白原。抗凝血酶n^ iflnism的有效性可以通过一个简单的例子来证明
Heparin, discovered by a medical student in 1916 (McLean, 1959), has been in clinical use as an anticoagulant for over 40 years. Not only is heparin the oldest antithrombotic drug still in use, it also remains the most widely used agent for immediate anticoagulation. In recent years, there has been a considerable upsurge of interest in its chemistry and mode of action, and there have been symposia devoted solely to heparin (eg Bradshaw & Wessler, 1973; Kakkar & Thomas, 1976). Recognition of the importance of the interaction between heparin and antithrombin III (Atm) is of more recent origin, and this has led to a better understanding of how heparin works. An inherited deficiency of AtHI is one of the very few conditions in which a tendency to thrombosis can be clearly defined biochemically; furthermore, the interrelationship between At HI and heparin plays a key role in our understanding of the pathogenesis and management of thrombo-embolic disease. In this paper, recent advances in the field will be reviewed, with particular emphasis on biochemical developments.Despite recent progress, it is still true to say that the factors that promote coagulation are better characterized than those that inhibit it. It is clear that powerful mechanisms exist for neutralizing activated clotting factors, particularly thrombin. When blood dots in vitro, all the prothrombm is normally converted into thrombin and, were it not neutralized, the thrombin formed from 10ml of blood would be sufficient to clot all the fibrinogen in the body. The efficiency of the antithrombin" n^ iflnism can be demonstrated by a simple