(Circulation. 1997;95:463-472.)
© 1997 American Heart Association, Inc.
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the Center for Molecular and Vascular Biology (D.C., S.V.), the Department of Radiology (L.S.), and the Department of Vascular Surgery (H.L., R.S.), University of Leuven, and the Center for Transgene Technology and Gene Therapy (D.C.), Flanders Interuniversity Institute for Biotechnology, Leuven, Belgium.
Correspondence to D. Collen, MD, PhD, Center for Molecular and Vascular Biology, University of Leuven, Campus Gasthuisberg O & N, Herestr 49, B-3000 Leuven, Belgium. E-mail desire.collen{at}med.kuleuven.ac.be
Background The thrombolytic potency and antibody induction of selected variants of recombinant staphylokinase (SakSTAR), including SakSTAR(K74) with Lys74, SakSTAR(E75) with Glu75, SakSTAR(EER) with Glu38, Glu75, and Arg77, and SakSTAR(K74ER) with Lys74, Glu75, and Arg77 replaced by Ala, were studied.
Methods and Results In rabbits, SakSTAR(K74) and SakSTAR(EER) elicited significantly less circulating neutralizing activity than SakSTAR and SakSTAR(E75) (P=.005 and P=.0002 versus SakSTAR, respectively). In baboons, SakSTAR(K74) induced significantly fewer antibodies than wild-type SakSTAR (P<.05). Intra-arterial administration in patients with peripheral arterial occlusion of SakSTAR(K74) (n=11) or SakSTAR(K74ER) (n=6) induced significantly fewer circulating neutralizing antibodies [median values and interquartile ranges, 20 (3.8 to 26) and 2.4 (0.2 to 59) µg compound neutralized/mL plasma after 3 to 4 weeks (P=.01 and P=.035 versus SakSTAR, respectively)] than SakSTAR (n=9) [median value and interquartile range, 93 (24 to 110) µg compound neutralized/mL plasma]. Overt neutralizing antibody induction (>10 µg compound neutralized/mL plasma) occurred in all 9 patients given wild-type SakSTAR, in 6 of the 11 SakSTAR(K74) patients (P=.038 versus SakSTAR), and in 2 of the 6 SakSTAR(K74ER) patients (P=.011 versus SakSTAR).
Conclusions SakSTAR(K74), a variant of recombinant staphylokinase with a single substitution of Lys74 with Ala, and SakSTAR(K74ER), with Lys74, Glu75, and Arg77 substituted with Ala, have intact thrombolytic potencies but induce significantly less antibody formation in patients.
Key Words: thrombolysis infarction plasminogen activators
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