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streptokinase (Indikinase)

✓ Approved

Unichem · PLG · 重组蛋白

什么是 streptokinase？

streptokinase 是一种重组蛋白，由Unichem研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intravenous (IV)。

药物档案

商品名Indikinase
公司Unichem
药物类别重组蛋白
分子靶点PLG
给药途径Injectable (Others), Intravenous (IV)
状态Approved
来源： ClinicalTrials.gov, Unichem

作用机制

分子靶点

streptokinase 作用于 1 个分子靶点：

PLGplasminogen (HAE4)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

streptokinase 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Cardiac disordersMyocardial infarction✓ Approved

相关研究文献

PubMedJournal of thrombosis and haemostasis : JTH2026-09-08

Mapping the Mutational Landscape for Streptokinase Binding to Plasminogen.

Baid Srishti S, Holding Matthew L ML, Laurin Taylor T, Siemieniak David D et al.

Group A Streptococcus (GAS) expresses streptokinase (SK), a critical virulence factor that non-enzymatically activates the host's plasminogen (PLG), to an active form (PLGSK) via a conformational change. PLGSK subsequently activates PLG to plasmin, resulting in fibrinolysis and facilitating bacterial dissemination. As a potent thrombolytic, SK has been used as a therapeutic agent. GAS SK is highly specific for human PLG, and sequence variation between SK from different GAS strains has been linked to differences in PLG binding and disease severity. The contributions of individual amino acids to these differences are poorly understood. We employed phage display and deep mutational scanning (DMS) to map the effects of amino acid substitutions within SK from Group C Streptococcus (GCS), which shares high sequence homology with GAS, on its ability to bind human PLG. We demonstrate that SK expressed as a fusion protein to the p3 coat protein of M13 filamentous phage retains its capacity to bind human PLG. DMS mapped 71% of all possible single amino acid substitutions within SK, identifying specific regions in which amino acid substitutions are likely to increase or decrease SK's affinity for PLG. Our findings suggest a complex protein-protein interaction in which long-range protein dynamics influence the conformational activation of PLG to PLGSK. These data lay the foundation for linking SK variation between GCS strains to differences in virulence, mapping the determinants of GCS SK's human specificity, and potentially contributing to the development of improved therapeutics for heart attack and stroke.

PMID 42710811
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PubMedJACC. Case reports2026-09-03

Diffuse Alveolar Hemorrhage After Streptokinase Thrombolysis in ST-Segment Elevation Myocardial Infarction: A 2-Patient Case Series.

Toshniwal Saket Satyasham SS, Toshniwal Satyasham S, Agrawal Shashank S, Singh Shashank S et al.

Diffuse alveolar hemorrhage is a rare and serious complication of thrombolytic therapy. We describe 2 patients with ST-segment elevation myocardial infarction who received streptokinase, developed diffuse alveolar hemorrhage, and survived. The first patient was a 46-year-old man with an inferior infarction. He later needed bypass grafting for triple-vessel disease. After receiving streptokinase, he experienced hemoptysis, decreasing hemoglobin, and bilateral ground-glass opacities on computed tomography. The second patient was a 52-year-old woman with anterior infarction. She experienced cardiac arrest during thrombolysis and underwent rescue angioplasty for failed thrombolysis. While on strong dual antiplatelet therapy for her stent, she developed a similar pulmonary syndrome, which was identified as blood-tinged endotracheal secretions during ventilation. Both patients received corticosteroids, temporary changes in their antithrombotic therapy, and supportive care. They achieved full recovery while their coronary disease was treated further. These cases highlight the careful diagnosis and treatment needed when hemorrhagic and ischemic processes occur together.

PMID 42684239
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PubMedBiotechnology and applied biochemistry2026-08-31

Synthesis and Analysis of Biochemical and Pharmaceutical Properties of Polysialylated Recombinant Streptokinase Enzyme.

Shahbazmohammadi Hamid H, Omidinia Eskandar E

Streptokinase (SK) is an enzyme drug and is used in medicine for dissolving clots in conditions such as heart attacks, lung artery emboli, vein thrombosis, and occlusions of arteries. Despite the impressive use of SK, its immunogenicity and short half-life are major challenges that limit its efficacy in clinical settings. In this communication, we studied the polysialylation of SK with the aim of improving the pharmacokinetics of this thrombolytic drug. Recombinant SK was covalently conjugated to polysialic acid (PSA; also referred to as colominic acid [CA]) via reductive amination. Native and polysialylated variants were compared in terms of structural properties, enzyme kinetics, stability, immunization, and biological half-life. The best molecular weight of PSA, optimum molar ratio, incubation time, and temperature for the conjugation reaction were determined to be 10.0 kDa, 200:1, 24 h, and 25°C, respectively. The exact molecular weight of SK-10.0 kDa PSA was determined to be 56.5 kDa by MALDI-TOF mass spectrometry, which matches the calculated value by SDS-PAGE. The intrinsic fluorescence intensity of polysialylated SK increased compared to the native version, meaning that the stability of SK was increased by immobilization on the PSA polymer. Km of polysialylated SK was slightly higher than that of native SK, which showed that the attached PSA molecules to the enzyme did not significantly reduce the substrate specificity. Polysialylated SK elicited nearly 63.0% lower antibody production compared to the native variant. Native and polysialylated SKs exhibited plasma half-lives of 0.5 and 2.21 h, respectively, implying that the modified variant has a 4.42-fold longer residence time in the body. Briefly, comparative studies with native and PSA-conjugated enzymes show that polysialylation can be useful in enhancing the therapeutic efficacy of SK. It is worth emphasizing that this is the first report describing the use of polysialylation technology to improve the pharmaceutical properties of SK.

PMID 42675018
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PubMedIndian pediatrics2026-08-19

Comparative Efficacy, Safety, and Cost of Different Intrapleural Fibrinolytic Agents for the Management of Empyema Thoracis in Children: A Systematic Review.

Malik Meenakshi M, Bhatt Sonia S, Gupta Sarika S, Kaur Hardeep H et al.

Pediatric empyema thoracis is a serious complication of bacterial pneumonia, and poses management challenges due to the absence of evidence-based guidelines on optimal treatment approaches. Intrapleural fibrinolytic agents are frequently used to enhance pleural drainage and avoid surgical intervention in pediatric empyema thoracis; however, the comparative efficacy, safety, and cost-effectiveness of different fibrinolytic agents remain uncertain. To systematically evaluate and compare the efficacy, safety, and cost of different intrapleural fibrinolytic agents in children with empyema thoracis, to develop evidence-based recommendations for informing clinical decision-making. A systematic search of PubMed, EMBASE, the Cochrane Library, Scopus, Web of Science, ProQuest, OpenGrey, and four clinical trial registries was done, from their inception. Studies were eligible for inclusion in the systematic review if they were randomized controlled trials (RCT) including children under 18 years old with empyema thoracis (defined by any standard definition), comparing different fibrinolytic agents such as streptokinase, urokinase, and tissue plasminogen activator. The main outcomes included treatment failure, need for surgery, serious adverse events, and short-term clinical outcomes. Other outcomes were length of hospital stay, symptom duration, and cost. A total of 3110 records was identified; after de-duplication, 2022 unique citations were screened. A three-step screening process identified no RCT meeting the eligibility criteria. The available studies had other study designs, or lacked pediatric data. Current evidence is insufficient to determine the most effective and safe fibrinolytic agent for pediatric empyema thoracis. There is an urgent need for well-designed, comparative pediatric trials to support evidence-based treatment guidelines.

PMID 42616246
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PubMedChemistry & biodiversity2026-07-30

The Phytochemical Investigation, Thrombolytic, and Antioxidant Activity of Clerodendrum thomsoniae Balf.

Surana Ajaykumar Rikhabchand AR, Patil Prathamesh Shyam PS, Jadhav Ankita Mulchand AM, Narkhede Harsha Iccharm HI et al.

Clerodendrum thomsoniae Balf. f. (Lamiaceae) is commonly known as the bleeding-heart vine or glory tree and traditionally used for treating blood-related disorders. This research investigated the phytochemical constituents, antioxidant capacity, and thrombolytic potential of leaf extracts. Among the extracts, the ethanol extract exhibited the highest total phenolic content, which correlated with its strong antioxidant activity demonstrated through multiple assays including DPPH, hydrogen peroxide, nitric oxide (NO) scavenging, and ferrous ion chelation. The petroleum ether extract showed notable thrombolytic activity by effectively lysing blood clots, achieving 34.52% clot lysis, which was significantly higher than the negative control (7.89%) but lower than the standard drug streptokinase (60.23%). Through GC-MS analysis, identified several bioactive compounds including sterols and fatty acids, which likely contribute these health benefits. These results suggest that C. thomsoniae leaves are a promising natural alternative for managing cardiovascular disorder and oxidative stress. Further in vivo studies and isolation of active compounds are essential.

PMID 42531223
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PubMedBasic research in cardiology2026-07-18

Historical account of reperfusion therapy and the development of cardioprotection beyond reperfusion.

Heusch Gerd G, Kleinbongard Petra P, Gersh Bernard J BJ

The only way to salvage myocardium from infarction is timely reperfusion of the occluded coronary artery. Timely reperfusion reduces infarct size and mortality. The history of reperfusion therapy from the first clinical use of intravenous streptokinase in patients with acute myocardial infarction by Sherry et al. in the late 1950s, over seminal experimental dog studies by Ross Jr. et al., demonstrating infarct size reduction by timely reperfusion in the early 1970s, to a more systematic use of initially streptokinase and a later tissue plasminogen activator in clinical trials (GISSI, TIMI), the addition of platelet inhibition (ISIS) and ultimately mechanical recanalization by percutaneous coronary intervention with stenting, is reviewed in detail. Cardioprotection beyond timely reperfusion was first demonstrated in the seminal experimental dog studies of ischemic conditioning by Murry, Reimer, and Jennings in the 1980s and initiated a tsunami of experimental studies in various experimental models to identify the underlying signal transduction, but has not yet been established in clinical practice. Clinical trials on various forms of ischemic conditioning, potentially cardioprotective drugs and transcutaneous vagal nerve stimulation, are still underway.

PMID 42469452
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