Thrombin and antithrombotics

From injury through healing, thrombin has several important functions in bl ood clotting, subsequent clot lysis, and tissue repair. These include edema , inflammation, cell recruitment, cellular releases, transformations, mitog enesis, and angiogenesis. Thrombin also participates in disease states, suc h as venous thrombosis, coronary thrombosis, stroke, and pulmonary emboli, among others and is implicated in atherosclerosis, the growth and metastasi s of certain cancers, Alzheimer's disease, and perhaps other conditions. Thrombin must be continually generated to sustain normal and pathogenic pro cesses. This is because of a variety of consumptive mechanisms. Unlike othe r activated factors in thrombotic and fibrinolytic pathways, and because th rombin promotes its own generation (feedback and cellular activation), thro mbin is a primary target for therapeutics. Besides recombinant hirudins, Ar gatroban (Novastan(R)) and Bivalirudin (Hirulog(R)) are promising thrombin- directed inhibitors for antithrombotic intervention.