Study on the Thrombolytic Effect of Platelet Membrane Coated Recombinant Staphylokinase on Human Arterial Thrombus

NCT ID: NCT05978791

Last Updated: 2023-10-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Total Enrollment

24 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-10-11

Study Completion Date

2024-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Recombinant staphylokinase (r-SAK) is a third-generation thrombolytic agent produced by genetic engineering technology in 1985, which has better thrombolytic effect than streptokinase (SK) and urokinase (UK). It has similar biological properties to natural SAK, is highly selective to fibrin, does not activate systemic fibrinolysis, and can dissolve clots in a short period of time without significantly increasing the risk of bleeding, especially for platelet-rich arterial clots. Previous studies have shown that the thrombolytic revascularization rate of r-SAK is significantly better than that of r-SK and UK at the same dose in the rabbit model of acute femoral artery occlusive thrombosis. The revascularization rate of coronary artery at 90 minutes after thrombolysis was significantly higher with r-SAK than r-tPA. The combination of thrombolytic drugs and nanocarriers may provide a new solution for the existing thrombolytic therapy. Inspired by the natural affinity of platelets (PLT) in hemostasis and pathological thrombosis, we have developed a thrombus targeting nanocarrier, which is a platelet membrane cloaked r-SAK(PLT-SAK)and compare the thrombolytic effect of PLT-SAK with different doses of free r-SAK on human arterial thrombus, aiming to further improve the thrombolytic effectiveness of r-SAK.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Currently, the most important treatment for thrombus and related cardiovascular diseases is prevention, but in the case of long-term thrombosis, the main treatment options include balloon catheters, surgical removal of embolus, thrombolytic therapy, and other related operations. Considering the cost of surgical treatment and its damage to the body, thrombolytic therapy has become one of the most effective ways to achieve rapid thrombus clearance and recanalization of blocked blood vessels in thrombotic diseases.

Recombinant staphylokinase (r-SAK) is a third-generation thrombolytic agent produced by genetic engineering technology in 1985, which has better thrombolytic effect than streptokinase (SK) and urokinase (UK). It has similar biological properties to natural SAK, is highly selective to fibrin, does not activate systemic fibrinolysis, and can dissolve clots in a short period of time without significantly increasing the risk of bleeding, especially for platelet-rich arterial clots. Previous studies have shown that the thrombolytic revascularization rate of r-SAK is significantly better than that of r-SK and UK at the same dose in the rabbit model of acute femoral artery occlusive thrombosis. The revascularization rate of coronary artery at 90 minutes after thrombolysis was significantly higher with r-SAK than r-tPA. The combination of thrombolytic drugs and nanocarriers may provide a new solution for the existing thrombolytic therapy. Inspired by the natural affinity of platelets (PLT) in hemostasis and pathological thrombosis, we have developed a thrombus targeting nanocarrier, which is a platelet membrane cloaked r-SAK(PLT-SAK)and compare the thrombolytic effect of PLT-SAK with different doses of free r-SAK on human arterial thrombus, aiming to further improve the thrombolytic effectiveness of r-SAK.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Arterial Thrombosis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Hospitalized patients with suspected coronary artery disease

Take aspirin and ticagrelor maintenance dose ≥3 days, or loading dose of aspirin (300mg) and ticagrelor (180mg) ≥12 hours

collection of venous blood or arterial blood

Intervention Type PROCEDURE

1. Partial CAD patients were collected 20 mL arterial blood samples 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor. The blood samples were divided into 2 mL centrifuge tubes, with each containing 1.0 mL (for preparation of blood clots).
2. Partial CAD patients were collected 40 mL blood samples into sodium citrate anticoagulant tubes 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor (for preparation of platelet-poor plasma, PPP).
3. Healthy volunteer (group 1) collected 40 mL blood samples into sodium citrate anticoagulant tubes (for preparation of PPP).
4. Healthy volunteer (group 2) collected 9 mL venous blood samples (for platelet aggregation assay).

healthy volunteers

Age 18-75 years old, body weight ≥45kg, regardless of gender;

collection of venous blood or arterial blood

Intervention Type PROCEDURE

1. Partial CAD patients were collected 20 mL arterial blood samples 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor. The blood samples were divided into 2 mL centrifuge tubes, with each containing 1.0 mL (for preparation of blood clots).
2. Partial CAD patients were collected 40 mL blood samples into sodium citrate anticoagulant tubes 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor (for preparation of platelet-poor plasma, PPP).
3. Healthy volunteer (group 1) collected 40 mL blood samples into sodium citrate anticoagulant tubes (for preparation of PPP).
4. Healthy volunteer (group 2) collected 9 mL venous blood samples (for platelet aggregation assay).

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

collection of venous blood or arterial blood

1. Partial CAD patients were collected 20 mL arterial blood samples 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor. The blood samples were divided into 2 mL centrifuge tubes, with each containing 1.0 mL (for preparation of blood clots).
2. Partial CAD patients were collected 40 mL blood samples into sodium citrate anticoagulant tubes 12 hours after the last intake of 100mg aspirin and 2 hours after intake of 90mg ticagrelor (for preparation of platelet-poor plasma, PPP).
3. Healthy volunteer (group 1) collected 40 mL blood samples into sodium citrate anticoagulant tubes (for preparation of PPP).
4. Healthy volunteer (group 2) collected 9 mL venous blood samples (for platelet aggregation assay).

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age 18-75 years old, body weight ≥45kg, regardless of gender;
2. Patients with suspected coronary artery disease scheduled for coronary angiography or interventional therapy.
3. Take aspirin and ticagrelor maintenance dose ≥3 days, or loading dose of aspirin (300mg) and ticagrelor (180mg) ≥12 hours;


1\. Age 18-75 years old, body weight ≥45kg, regardless of gender;

Exclusion Criteria

1. Previous thrombolytic therapy with r-SAK;
2. A previous diagnosis of Staphylococcus aureus infection;
3. Those who are enrolled in other clinical trials;
4. Those who were deemed ineligible by other investigators.

For healthy volunteer:


1. Currently taking any medication that may affect platelet function, such as antiplatelet drugs or nonsteroidal anti-inflammatory drugs.
2. Individuals with blood disorders, active bleeding or a tendency to bleed, including platelet count \<100×10\^9/L, hemoglobin \<100g/L, or recent bleeding in the digestive system or urinary tract within one month.
3. Individuals with impaired liver or kidney function, including alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels above the upper limit of normal reference range, and estimated glomerular filtration rate (eGFR) \<90 mL/min/1.73m\^2 (calculated based on the CKD-EPI equation).
4. Recent (within one month) severe trauma, surgery, or head injury.
5. Pregnant or lactating women.
6. Diabetes.
7. Smokers.
8. Those who are enrolled in other clinical trials;
9. Those who were deemed ineligible by other investigators.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Chunjian Li

Director of Cardiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

The First Affiliated Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

China

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Chunjian Li, PhD

Role: CONTACT

+86 13701465229

Rui Hua, MBBS

Role: CONTACT

+86 13196825735

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Chunjian Li, PHD

Role: primary

+86 13701465229

Rui Hua, MBBS

Role: backup

+86 13196825735

References

Explore related publications, articles, or registry entries linked to this study.

Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL; American Heart Association Stroke Council. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018 Mar;49(3):e46-e110. doi: 10.1161/STR.0000000000000158. Epub 2018 Jan 24.

Reference Type BACKGROUND
PMID: 29367334 (View on PubMed)

Tillett WS, Garner RL. THE FIBRINOLYTIC ACTIVITY OF HEMOLYTIC STREPTOCOCCI. J Exp Med. 1933 Sep 30;58(4):485-502. doi: 10.1084/jem.58.4.485.

Reference Type BACKGROUND
PMID: 19870210 (View on PubMed)

MACFARLANE RG, PILLING J. Fibrinolytic activity of normal urine. Nature. 1947 Jun 7;159(4049):779. doi: 10.1038/159779a0. No abstract available.

Reference Type BACKGROUND
PMID: 20241608 (View on PubMed)

Rijken DC, Collen D. Purification and characterization of the plasminogen activator secreted by human melanoma cells in culture. J Biol Chem. 1981 Jul 10;256(13):7035-41.

Reference Type BACKGROUND
PMID: 6787058 (View on PubMed)

Noble S, McTavish D. Reteplase. A review of its pharmacological properties and clinical efficacy in the management of acute myocardial infarction. Drugs. 1996 Oct;52(4):589-605. doi: 10.2165/00003495-199652040-00012.

Reference Type BACKGROUND
PMID: 8891469 (View on PubMed)

Simpson D, Siddiqui MA, Scott LJ, Hilleman DE. Reteplase: a review of its use in the management of thrombotic occlusive disorders. Am J Cardiovasc Drugs. 2006;6(4):265-85. doi: 10.2165/00129784-200606040-00007.

Reference Type BACKGROUND
PMID: 16913828 (View on PubMed)

Nordt TK, Bode C. Thrombolysis: newer thrombolytic agents and their role in clinical medicine. Heart. 2003 Nov;89(11):1358-62. doi: 10.1136/heart.89.11.1358. No abstract available.

Reference Type BACKGROUND
PMID: 14594904 (View on PubMed)

Ross AM, Gao R, Coyne KS, Chen J, Yao K, Yang Y, Qin X, Qiao S, Yao M; TUCC Investigators. A randomized trial confirming the efficacy of reduced dose recombinant tissue plasminogen activator in a Chinese myocardial infarction population and demonstrating superiority to usual dose urokinase: the TUCC trial. Am Heart J. 2001 Aug;142(2):244-7. doi: 10.1067/mhj.2001.116963.

Reference Type BACKGROUND
PMID: 11479462 (View on PubMed)

Gao RL, Han YL, Yang XC, Mao JM, Fang WY, Wang L, Shen WF, Li ZQ, Jia GL, Lu SZ, Wei M, Zeng DY, Chen JL, Qin XW, Xu B, DU CH; Collaborative Research Group of Reperfusion Therapy in Acute Myocardial Infarction (RESTART). Thorombolytic therapy with rescue percutaneous coronary intervention versus primary percutaneous coronary intervention in patients with acute myocardial infarction: a multicenter randomized clinical trial. Chin Med J (Engl). 2010 Jun;123(11):1365-72.

Reference Type BACKGROUND
PMID: 20819587 (View on PubMed)

Nedaeinia R, Faraji H, Javanmard SH, Ferns GA, Ghayour-Mobarhan M, Goli M, Mashkani B, Nedaeinia M, Haghighi MHH, Ranjbar M. Bacterial staphylokinase as a promising third-generation drug in the treatment for vascular occlusion. Mol Biol Rep. 2020 Jan;47(1):819-841. doi: 10.1007/s11033-019-05167-x. Epub 2019 Nov 1.

Reference Type BACKGROUND
PMID: 31677034 (View on PubMed)

Toombs CF. New directions in thrombolytic therapy. Curr Opin Pharmacol. 2001 Apr;1(2):164-8. doi: 10.1016/s1471-4892(01)00030-3.

Reference Type BACKGROUND
PMID: 11714091 (View on PubMed)

Szemraj J, Stankiewicz A, Rozmyslowicz-Szerminska W, Mogielnicki A, Gromotowicz A, Buczko W, Oszajca K, Bartkowiak J, Chabielska E. A new recombinant thrombolytic and antithrombotic agent with higher fibrin affinity - a staphylokinase variant. An in-vivo study. Thromb Haemost. 2007 Jun;97(6):1037-45. doi: 10.1160/th06-10-0562.

Reference Type BACKGROUND
PMID: 17549308 (View on PubMed)

Li CJ, Huang J, Yang ZJ, Cao KJ. Thrombolytic efficacy of native recombinant staphylokinase on femoral artery thrombus of rabbits. Acta Pharmacol Sin. 2007 Jan;28(1):58-65. doi: 10.1111/j.1745-7254.2007.00455.x.

Reference Type BACKGROUND
PMID: 17184583 (View on PubMed)

Vanderschueren S, Barrios L, Kerdsinchai P, Van den Heuvel P, Hermans L, Vrolix M, De Man F, Benit E, Muyldermans L, Collen D, et al. A randomized trial of recombinant staphylokinase versus alteplase for coronary artery patency in acute myocardial infarction. The STAR Trial Group. Circulation. 1995 Oct 15;92(8):2044-9. doi: 10.1161/01.cir.92.8.2044.

Reference Type BACKGROUND
PMID: 7554180 (View on PubMed)

Kamaly N, Yameen B, Wu J, Farokhzad OC. Degradable Controlled-Release Polymers and Polymeric Nanoparticles: Mechanisms of Controlling Drug Release. Chem Rev. 2016 Feb 24;116(4):2602-63. doi: 10.1021/acs.chemrev.5b00346. Epub 2016 Feb 8.

Reference Type BACKGROUND
PMID: 26854975 (View on PubMed)

Shen S, Wu Y, Liu Y, Wu D. High drug-loading nanomedicines: progress, current status, and prospects. Int J Nanomedicine. 2017 May 31;12:4085-4109. doi: 10.2147/IJN.S132780. eCollection 2017.

Reference Type BACKGROUND
PMID: 28615938 (View on PubMed)

Tan YF, Lao LL, Xiong GM, Venkatraman S. Controlled-release nanotherapeutics: State of translation. J Control Release. 2018 Aug 28;284:39-48. doi: 10.1016/j.jconrel.2018.06.014. Epub 2018 Jun 15.

Reference Type BACKGROUND
PMID: 29902484 (View on PubMed)

Tietjen GT, Bracaglia LG, Saltzman WM, Pober JS. Focus on Fundamentals: Achieving Effective Nanoparticle Targeting. Trends Mol Med. 2018 Jul;24(7):598-606. doi: 10.1016/j.molmed.2018.05.003. Epub 2018 Jun 5.

Reference Type BACKGROUND
PMID: 29884540 (View on PubMed)

Falati S, Gross P, Merrill-Skoloff G, Furie BC, Furie B. Real-time in vivo imaging of platelets, tissue factor and fibrin during arterial thrombus formation in the mouse. Nat Med. 2002 Oct;8(10):1175-81. doi: 10.1038/nm782. Epub 2002 Sep 16.

Reference Type BACKGROUND
PMID: 12244306 (View on PubMed)

Lippi G, Franchini M, Targher G. Arterial thrombus formation in cardiovascular disease. Nat Rev Cardiol. 2011 Jul 5;8(9):502-12. doi: 10.1038/nrcardio.2011.91.

Reference Type BACKGROUND
PMID: 21727917 (View on PubMed)

Hu CM, Fang RH, Wang KC, Luk BT, Thamphiwatana S, Dehaini D, Nguyen P, Angsantikul P, Wen CH, Kroll AV, Carpenter C, Ramesh M, Qu V, Patel SH, Zhu J, Shi W, Hofman FM, Chen TC, Gao W, Zhang K, Chien S, Zhang L. Nanoparticle biointerfacing by platelet membrane cloaking. Nature. 2015 Oct 1;526(7571):118-21. doi: 10.1038/nature15373. Epub 2015 Sep 16.

Reference Type BACKGROUND
PMID: 26374997 (View on PubMed)

Cheng JW, Zhang XJ, Cheng LS, Li GY, Zhang LJ, Ji KX, Zhao Q, Bai Y. Low-Dose Tissue Plasminogen Activator in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis. 2018 Feb;27(2):381-390. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.014. Epub 2017 Oct 27.

Reference Type BACKGROUND
PMID: 29111341 (View on PubMed)

Zamanlu M, Farhoudi M, Eskandani M, Mahmoudi J, Barar J, Rafi M, Omidi Y. Recent advances in targeted delivery of tissue plasminogen activator for enhanced thrombolysis in ischaemic stroke. J Drug Target. 2018 Feb;26(2):95-109. doi: 10.1080/1061186X.2017.1365874. Epub 2017 Aug 25.

Reference Type BACKGROUND
PMID: 28796540 (View on PubMed)

Ma YH, Liu CH, Liang Y, Chen JP, Wu T. Targeted Delivery of Plasminogen Activators for Thrombolytic Therapy: An Integrative Evaluation. Molecules. 2019 Sep 19;24(18):3407. doi: 10.3390/molecules24183407.

Reference Type BACKGROUND
PMID: 31546842 (View on PubMed)

Hassanpour S, Kim HJ, Saadati A, Tebon P, Xue C, van den Dolder FW, Thakor J, Baradaran B, Mosafer J, Baghbanzadeh A, de Barros NR, Hashemzaei M, Lee KJ, Lee J, Zhang S, Sun W, Cho HJ, Ahadian S, Ashammakhi N, Dokmeci MR, Mokhtarzadeh A, Khademhosseini A. Thrombolytic Agents: Nanocarriers in Controlled Release. Small. 2020 Oct;16(40):e2001647. doi: 10.1002/smll.202001647. Epub 2020 Aug 12.

Reference Type BACKGROUND
PMID: 32790000 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

021

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.