The first generation is non-specific plasminogen activators such as Streptokinase and Urokinase; the second generation is represented by t-PA such as Alteplase and Prourokinase
; the third generation includes Reteplase, Tenecteplase, Nateplase, Recombinant Human Urokinase, etc.
for acute ischemic stroke.
Currently available thrombolytic agents include Alteplase (t-PA or Activase), Reteplase (r-PA or Retavaseurokinase (Abbokinase), prourokinase
, Anisoylated Purified Streptokinase Activator Complex (APSAC) and streptokinase 2 are of human origin, which are very expensive.
In conjunction, the human body's fibrinolytic, clot dissolving, system uses two natural enzymes, tissue plasminogen activator (tPA) and prourokinase
(proUK), rather than only one of them.
Siadaty, "Therapeutic or preventive procedures associated with prourokinase
," BioMedLib Review, vol.
was characterized and subsequently produced by recombinant technology using Escherichia coli (nonglycosylated) or mammalian cells (fully glycosylated).
plasminogen activator induces the transformation of plasminogen into active plasmin.
For example, the Prolyse in Acute Cerebral Thromboembolism Trials (PROACT I and II) were randomized, controlled trials that used recombinant prourokinase
to treat middle cerebral artery occlusion experienced for a time period of not greater than 6 hours.
Due to frequent hemorrhagic complications streptokinase, urokinase (UK) and prourokinase
(r-proUK) are not preferred (Multicentre Acute Stroke Trial--Italy (Mast-I) Group, 1995; Multicentre Acute Stroke Trial--Europe Study Group, 1996; Yasak, Chambers, Davis, and Donnan, 1998).
A Cochrane review on thrombolysis for acute ischaemic stroke included 26 trials with data on 7 152 patients testing urokinase, streptokinase, tPA, recombinant prourokinase
or desmoteplase with 56% of all data that came from trials testing tPA--11 trials, 3 977 patients.
Expression of prourokinase
in different mammalian cells.