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Yin Q, Zhang X, Liao S, Huang X, Wan CC, Wang Y. Potential anticoagulant of traditional chinese medicine and novel targets for anticoagulant drugs. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 116:154880. [PMID: 37267694 DOI: 10.1016/j.phymed.2023.154880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Anticoagulants are the main drugs used for the prevention and treatment of thrombosis. Currently, anticoagulant drugs are primarily multitarget heparin drugs, single-target FXa inhibitors and FIIa inhibitors. In addition, some traditional Chinese drugs also have anticoagulant effects, but they are not the main direction of treatment at present. But the anticoagulant drugs mentioned above, all have a common side effect is bleeding. Many other anticoagulation targets are under investigation. With further exploration of coagulation mechanism, how to further determine new anticoagulant targets and how to make traditional Chinese medicine play anticoagulant role have become a new field of exploration. PURPOSE The purpose of the study was to summarize the recent research progress on coagulation mechanisms, new anticoagulant targets and traditional Chinese medicine. METHODS A comprehensive literature search was conducted using four electronic databases, including PubMed, Embase, CNKI, Wanfang database and ClinicalTrials.gov, from the inception of the study to 28 Feb 2023. Key words used in the literature search were "anticoagulation", "anticoagulant targets", "new targets", "coagulation mechanisms", "potential anticoagulant", "herb medicine", "botanical medicine", "Chinese medicine", "traditional Chinese medicine", "blood coagulation factor", keywords are linked with AND/OR. Recent findings on coagulation mechanisms, potential anticoagulant targets and traditional Chinese medicine were studied. RESULTS The active components extracted from the Chinese medicinal herbs, Salvia miltiorrhiza, Chuanxiong rhizoma, safflower and Panax notoginseng have obvious anticoagulant effects and can be used as potential anticoagulant drugs, but the risk of bleeding is unclear. TF/FVIIa, FVIII, FIX, FXI, FXII, and FXIII have all been evaluated as targets in animal studies or clinical trials. FIX and FXI are the most studied anticoagulant targets, but FXI inhibitors have shown stronger advantages. CONCLUSION This review of potential anticoagulants provides a comprehensive resource. Literature analysis suggests that FXI inhibitors can be used as potential anticoagulant candidates. In addition, we should not ignore the anticoagulant effect of traditional Chinese medicine, and look forward to more research and the emergence of new drugs.
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Affiliation(s)
- Qinan Yin
- Department of Pharmacy, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China; Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China
| | - Xiaoqin Zhang
- Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China
| | - Suqing Liao
- Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China
| | - Xiaobo Huang
- Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China
| | - Chunpeng Craig Wan
- College of Agronomy, Jiangxi Agricultural University, Jiangxi Key Laboratory for Post-Harvest Technology and Nondestructive Testing of Fruits & Vegetables, Nanchang 330045, PR. China.
| | - Yi Wang
- Department of Critical Care Medicine, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, PR. China.
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Cimmino G, Cirillo P. Tissue factor: newer concepts in thrombosis and its role beyond thrombosis and hemostasis. Cardiovasc Diagn Ther 2018; 8:581-593. [PMID: 30498683 DOI: 10.21037/cdt.2018.10.14] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
For many years, the attention on tissue factor (TF) in human pathophysiology has been limited to its role as initiator of extrinsic coagulation pathway. Moreover, it was described as a glycoprotein located in several tissue including vascular wall and atherosclerotic plaque. However, in the last two decades, the discovery that TF circulates in the blood as cell-associated protein, microparticles (MPs) bound and as soluble form, is changing this old vessel-wall TF dogma. Moreover, it has been reported that TF is expressed by different cell types, even T lymphocytes and platelets, and different pathological conditions, such as acute and chronic inflammatory status, and cancer, may enhance its expression and activity. Thus, recent advances in the biology of TF have clearly indicated that beyond its known effects on blood coagulation, it is a "true surface receptor" involved in many intracellular signaling, cell-survival, gene and protein expression, proliferation, angiogenesis and tumor metastasis. Finally, therapeutic modulation of TF expression and/or activity has been tested with controversial results. This report, starting from the old point of view about TF as initiator of extrinsic coagulation pathway, briefly illustrates the more recent concepts about TF and thrombosis and finally gives an overview about its role beyond thrombosis and haemostasis focusing on the different intracellular mechanisms triggered by its activation and potentially involved in atherosclerosis.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Science, Division of Cardiology, University of Campania "Luigi Vanvitelli" Naples, Italy
| | - Plinio Cirillo
- Department of Advance Biomedical Science, Division of Cardiology, University of Naples "Federico II", Naples, Italy
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Muhsin-Sharafaldine MR, McLellan AD. Apoptotic vesicles: deathly players in cancer-associated coagulation. Immunol Cell Biol 2018; 96:723-732. [PMID: 29738615 DOI: 10.1111/imcb.12162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/01/2018] [Accepted: 05/02/2018] [Indexed: 12/27/2022]
Abstract
Although cancer is associated with coagulation disorders, it is still unclear how the combination of tumor cell and host factors enhance the hypercoagulable state of cancer patients. Emerging evidence points to a central role for tumor endosomal and plasma membrane-derived vesicular components in the pathogenesis of cancer-related thrombosis. In particular, tumor cell membranes and extracellular vesicles (EV) harbor lipids and proteinaceous coagulation factors able to initiate multiple points within the coagulation matrix. The impact of chemotherapy upon a host already burdened with a hypercoagulable state increases the risk of pathological coagulation. We argue that chemotherapy-induced EV harbor the most active components for cancer related thrombosis and discuss how membrane components of the host and tumor act to initiate coagulation to enhance thrombotic risk in cancer patients.
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Fischer PM. Design of Small-Molecule Active-Site Inhibitors of the S1A Family Proteases as Procoagulant and Anticoagulant Drugs. J Med Chem 2017; 61:3799-3822. [DOI: 10.1021/acs.jmedchem.7b00772] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Peter M. Fischer
- School of Pharmacy and Centre for Biomolecular Sciences, University of Nottingham, Nottingham NG7 2RD, U.K
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Neutral macrocyclic factor VIIa inhibitors. Bioorg Med Chem Lett 2017; 27:2650-2654. [DOI: 10.1016/j.bmcl.2017.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/28/2017] [Accepted: 04/01/2017] [Indexed: 11/21/2022]
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Richter JM, Cheney DL, Bates JA, Wei A, Luettgen JM, Rendina AR, Harper TM, Narayanan R, Wong PC, Seiffert D, Wexler RR, Priestley ES. Design and Synthesis of Novel Meta-Linked Phenylglycine Macrocyclic FVIIa Inhibitors. ACS Med Chem Lett 2017; 8:67-72. [PMID: 28105277 DOI: 10.1021/acsmedchemlett.6b00375] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/01/2016] [Indexed: 12/28/2022] Open
Abstract
Two novel series of meta-linked phenylglycine-based macrocyclic FVIIa inhibitors have been designed to improve the rodent metabolic stability and PK observed with the precursor para-linked phenylglycine macrocycles. Through iterative structure-based design and optimization, the TF/FVIIa Ki was improved to subnanomolar levels with good clotting activity, metabolic stability, and permeability.
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Affiliation(s)
- Jeremy M. Richter
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Daniel L. Cheney
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - J. Alex Bates
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Anzhi Wei
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Joseph M. Luettgen
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Alan R. Rendina
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Timothy M. Harper
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Rangaraj Narayanan
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Pancras C. Wong
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Dietmar Seiffert
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - Ruth R. Wexler
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
| | - E. Scott Priestley
- Research & Development, Bristol-Myers Squibb, Hopewell, New Jersey 08534, United States
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Wurtz NR, Parkhurst BL, Jiang W, DeLucca I, Zhang X, Ladziata V, Cheney DL, Bozarth JR, Rendina AR, Wei A, Luettgen JM, Wu Y, Wong PC, Seiffert DA, Wexler RR, Priestley ES. Discovery of Phenylglycine Lactams as Potent Neutral Factor VIIa Inhibitors. ACS Med Chem Lett 2016; 7:1077-1081. [PMID: 27994741 DOI: 10.1021/acsmedchemlett.6b00282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 09/16/2016] [Indexed: 11/29/2022] Open
Abstract
Inhibitors of Factor VIIa (FVIIa), a serine protease in the clotting cascade, have shown strong antithrombotic efficacy in preclinical thrombosis models with minimal bleeding liabilities. Discovery of potent, orally active FVIIa inhibitors has been largely unsuccessful because known chemotypes have required a highly basic group in the S1 binding pocket for high affinity. A recently reported fragment screening effort resulted in the discovery of a neutral heterocycle, 7-chloro-3,4-dihydroisoquinolin-1(2H)-one, that binds in the S1 pocket of FVIIa and can be incorporated into a phenylglycine FVIIa inhibitor. Optimization of this P1 binding group led to the first series of neutral, permeable FVIIa inhibitors with low nanomolar potency.
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Affiliation(s)
- Nicholas R. Wurtz
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Brandon L. Parkhurst
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Wen Jiang
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Indawati DeLucca
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Xiaojun Zhang
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Vladimir Ladziata
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Daniel L. Cheney
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - Jeffrey R. Bozarth
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Alan R. Rendina
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Anzhi Wei
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Joseph M. Luettgen
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Yiming Wu
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Pancras C. Wong
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Dietmar A. Seiffert
- Bristol-Myers Squibb R&D, 311 Pennington Rocky Hill Road, Pennington, New Jersey 08534, United States
| | - Ruth R. Wexler
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
| | - E. Scott Priestley
- Bristol-Myers Squibb R&D, 350 Carter Road, Hopewell Township, New Jersey 08540, United States
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Ladziata V(U, Glunz PW, Zou Y, Zhang X, Jiang W, Jacutin-Porte S, Cheney DL, Wei A, Luettgen JM, Harper TM, Wong PC, Seiffert D, Wexler RR, Priestley ES. Synthesis and P1′ SAR exploration of potent macrocyclic tissue factor-factor VIIa inhibitors. Bioorg Med Chem Lett 2016; 26:5051-5057. [DOI: 10.1016/j.bmcl.2016.08.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 10/21/2022]
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Zhang X, Glunz PW, Johnson JA, Jiang W, Jacutin-Porte S, Ladziata V, Zou Y, Phillips MS, Wurtz NR, Parkhurst B, Rendina AR, Harper TM, Cheney DL, Luettgen JM, Wong PC, Seiffert D, Wexler RR, Priestley ES. Discovery of a Highly Potent, Selective, and Orally Bioavailable Macrocyclic Inhibitor of Blood Coagulation Factor VIIa-Tissue Factor Complex. J Med Chem 2016; 59:7125-37. [PMID: 27455395 DOI: 10.1021/acs.jmedchem.6b00469] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Inhibitors of the tissue factor (TF)/factor VIIa complex (TF-FVIIa) are promising novel anticoagulants which show excellent efficacy and minimal bleeding in preclinical models. Starting with an aminoisoquinoline P1-based macrocyclic inhibitor, optimization of the P' groups led to a series of highly potent and selective TF-FVIIa inhibitors which displayed poor permeability. Fluorination of the aminoisoquinoline reduced the basicity of the P1 group and significantly improved permeability. The resulting lead compound was highly potent, selective, and achieved good pharmacokinetics in dogs with oral dosing. Moreover, it demonstrated robust antithrombotic activity in a rabbit model of arterial thrombosis.
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Affiliation(s)
- Xiaojun Zhang
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Peter W Glunz
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - James A Johnson
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Wen Jiang
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Swanee Jacutin-Porte
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Vladimir Ladziata
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Yan Zou
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Monique S Phillips
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Nicholas R Wurtz
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Brandon Parkhurst
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Alan R Rendina
- Bristol-Myers Squibb R&D , 311 Pennington-Rocky Hill Road, Pennington, New Jersey 08534-2130, United States
| | - Timothy M Harper
- Bristol-Myers Squibb R&D , 311 Pennington-Rocky Hill Road, Pennington, New Jersey 08534-2130, United States
| | - Daniel L Cheney
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - Joseph M Luettgen
- Bristol-Myers Squibb R&D , 311 Pennington-Rocky Hill Road, Pennington, New Jersey 08534-2130, United States
| | - Pancras C Wong
- Bristol-Myers Squibb R&D , 311 Pennington-Rocky Hill Road, Pennington, New Jersey 08534-2130, United States
| | - Dietmar Seiffert
- Bristol-Myers Squibb R&D , 311 Pennington-Rocky Hill Road, Pennington, New Jersey 08534-2130, United States
| | - Ruth R Wexler
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
| | - E Scott Priestley
- Bristol-Myers Squibb R&D , 350 Carter Road, Hopewell, New Jersey 08540, United States
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Priestley ES, Cheney DL, DeLucca I, Wei A, Luettgen JM, Rendina AR, Wong PC, Wexler RR. Structure-Based Design of Macrocyclic Coagulation Factor VIIa Inhibitors. J Med Chem 2015; 58:6225-36. [PMID: 26151189 DOI: 10.1021/acs.jmedchem.5b00788] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
On the basis of a crystal structure of a phenylpyrrolidine lead and subsequent molecular modeling results, we designed and synthesized a novel series of macrocyclic FVIIa inhibitors. The optimal 16-membered macrocycle was 60-fold more potent than an acyclic analog. Further potency optimization by incorporation of P1' alkyl sulfone and P2 methyl groups provided a macrocycle with TF/FVIIa Ki = 1.6 nM, excellent selectivity against a panel of seven serine proteases, and FVII-deficient prothrombin time EC2x = 1.2 μM. Discovery of this potent, selective macrocyclic scaffold opens new possibilities for the development of orally bioavailable FVIIa inhibitors.
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11
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Design and synthesis of potent, selective phenylimidazole-based FVIIa inhibitors. Bioorg Med Chem Lett 2015; 25:2169-73. [DOI: 10.1016/j.bmcl.2015.03.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 03/19/2015] [Accepted: 03/23/2015] [Indexed: 11/17/2022]
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