A new anticoagulant with no risk of bleeding

Originally published by Université de Génevé, Medias, on 30 April 2024

A UNIGE team, in collaboration with the University of Sydney, has developed a new type of anticoagulant whose action can be rapidly stopped.

 The image illustrates the combined action of two molecules cooperating to inhibit thrombin. The antidote dissociates the two molecules, preventing the cooperativity. The association and dissociation of the two molecules is controlled by hybridization of oligonucleotides. © Millicent Dockerill / Nicolas Winssinger

Anticoagulant treatments are crucial for managing many conditions, such as heart disease, stroke, and venous thrombosis. Current options, however, carry an inherent risk of serious bleeding due to trauma or unforeseen events. A team from the University of Geneva (UNIGE) and the University of Sydney has developed a new anticoagulant, designed to have an on-demand reversible activity, with a fast-acting ‘‘antidote’’. This approach could revolutionize the use of anticoagulants in surgery or other applications. The mechanism of activation and deactivation of the active principle could also be used in immunotherapy. These results are published in Nature Biotechnology.

Anticoagulant therapies are essential for managing many conditions, such as heart disease, stroke, and venous thrombosis. However, current treatment options, such as heparin and warfarin, have major drawbacks, including the need for regular monitoring of blood coagulation and the risk of serious bleeding in the event of overdose or trauma. Around 15% of emergency hospital visits for adverse drug effect are attributable to complication with anticoagulant treatments (an estimated 235 000 case/year in the US), emphasizing the importance of developing new, safer, and more effective therapeutic options.

This breakthrough goes beyond the development of a new anticoagulant and its associated antidote. It can be easily adapted to other therapeutic targets.

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