What is the mechanism of action for prourokinase in thrombolytic therapy?

Updated: Aug 04, 2021
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Prourokinase is a newer fibrinolytic agent that is currently undergoing clinical trials for a variety of indications. It is a relatively inactive precursor that must be converted to urokinase before it becomes active in vivo. The need for such conversion has handicapped therapeutic exploitation of the fibrin-specific physiologic properties of prourokinase.

The relative fibrin-specificity of prourokinase is explained by preferential activation of fibrin-bound plasminogen found in a thrombus over the free plasminogen in flowing blood. This agent has been studied in the settings of AMI, AIS, and peripheral arterial occlusion. Researchers have developed a mutant of prourokinase (M5) that has even greater plasma stability and causes faster plasminogen activation and greater fibrin-specific clot lysis than wild-form prourokinase. [11]

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