aprotinin / Generic mfg. - LARVOL DELTA

Blood Product Transfusion and Antifibrinolytic Choice Are Not Associated with Higher Rates of Intraluminal Thrombus Following Non-Emergency Aortic Arch Replacement Surgery. (PubMed, J Clin Med) - "We hypothesized that there may be an association between (i) intra- and postoperative blood product transfusion volumes and the development of ILT and (ii) whether the use of either aprotinin or tranexamic acid is associated with postoperative ILT formation. However, the small number of ILT events (n = 10) limits statistical power, and a clinically meaningful association cannot be excluded. These findings provide preliminary reassurance that correction of intra- and postoperative coagulopathy may not increase ILT risk, though larger multicentre studies with adjustment for confounding variables including postoperative anticoagulation practices are warranted."

Journal • Anesthesia • Cardiovascular • Critical care • Hematological Disorders • Thrombosis

Comparison of aprotinin and tranexamic acid in the prevention of perioperative bleeding in non-elective cardiac procedures involving the ascending aorta. (PubMed, J Thorac Dis) - "In this retrospective monocentric study, aprotinin was associated with reduced perioperative bleeding severity compared with tranexamic acid in urgent cardiac interventions involving the ascending aorta. Further investigations are warranted to validate the efficacy and safety of aprotinin in contemporary aortic surgery with high-risk of bleeding."

Journal • Cardiovascular

Obituary: Professor Kenneth MacDonald "Ken" Taylor MB ChB MD FRCS FRCSE FESC FETCS FSA British heart foundation Professor of cardiac surgery, imperial College London. (PubMed, Perfusion) - No abstract available

Journal • Cardiovascular

Clinical Trial With Aprotinin in the Acute Respiratory Distress Syndrome Treatment (clinicaltrials.gov) - P3 | N=156 | Recruiting | Sponsor: Fundacion del Hospital Nacional de Paraplejicos para la Investigacion y la Integracion | Not yet recruiting ➔ Recruiting | Initiation date: Mar 2026 ➔ Jun 2026

Enrollment open • Trial initiation date • Acute Respiratory Distress Syndrome • Pulmonary Disease • Respiratory Diseases

Efficacy and safety of haemostatic agents for patients receiving antiplatelet therapy before coronary artery bypass grafting: a protocol for a systematic review and network meta-analysis of randomised controlled trials. (PubMed, BMJ Open) - "Tranexamic acid, aminocaproic acid, aprotinin and desmopressin are commonly employed to reduce such risk; however, robust direct head-to-head comparative evidence remains limited in this specific population. Findings will be submitted to a peer-reviewed journal and disseminated to support clinical decision-making. CRD420251235248."

Journal • Retrospective data • Acute Kidney Injury • Anesthesia • Cardiovascular • Hematological Disorders • Nephrology

Optimizing hemostasis to prevent bleeding and reduce transfusion requirements in neonatal and infant cardiac surgery with cardiopulmonary bypass: a systematic review and network meta-analysis. (PubMed, Front Pediatr) - "Aprotinin (APR) was identified as the optimal hemostatic strategy for reducing 24-hour blood loss (SUCRA=99.15%), platelet (PLT) (SUCRA=82.19%) and fresh frozen plasma (FFP) (SUCRA=84.82%) transfusion requirements, re-sternotomy for hemostasis (SUCRA=72.85%), and risks of thrombosis (SUCRA=79.13%) and renal dysfunction (SUCRA=72.61%)...Tranexamic acid (TXA) emerged as the optimal intervention for reducing mortality (SUCRA=84.77%)...However, because the relevant comparisons were largely against active comparators rather than placebo or no hemostatic intervention, the efficacy of blood component therapies relative to no blood component therapy remains uncertain. Future large-scale RCTs are needed to further validate these findings."

Journal • Retrospective data • Review • Cardiovascular • Hematological Disorders • Nephrology • Renal Disease • Thrombosis

A novel biosensor for measuring plasmin activity. (PubMed, Res Pract Thromb Haemost) - "FPS can measure plasmin generation in clotting plasma, which was increased by an inhibitory antibody against α2-antiplasmin and attenuated by aprotinin, tranexamic acid, and fibrin absence. Lastly, plasmin generation measured using FPS is relatively consistent in plasma from healthy volunteers, with only a 2-fold variation in peak plasmin, peak time, and endogenous plasmin potential. FPS may improve the evaluation of fibrinolysis in preclinical and clinical settings, thereby enhancing our understanding of fibrinolytic disorders."

Journal • A2M

Use of Aprotinin in a Patient With a Renal Transplant for Redo Coronary Artery Bypass Graft Surgery. (PubMed, Cureus) - "In this case, aprotinin infusion was utilised intraoperatively to manage perioperative bleeding. We focused on evaluating the effects of aprotinin on renal function and postoperative renal indices."

Journal • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Hematological Malignancies • Hepatology • Ischemic stroke • Metabolic Disorders • Monoclonal Gammopathy • Myocardial Infarction • Nephrology • Transplantation • Type 1 Diabetes Mellitus

Pathogenic citrullination of serine proteases in Rheumatoid Arthritis (EULAR 2026) - "PAD2-citrullinated trypsin also displayed resistance to Aprotinin, a specific inhibitor of trypsin (Fig1F)...Image(s), graphic(s), or table(s) Figure 1: Citrullination enhances the activity and stability of trypsin through conformational changes that enhances binding to the active site. Figure 2: Citrullinated neutrophil serine proteases degrade joint cartilage, generate autoantibodies and induce proinflammatory changes in synovial fibroblasts."

Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • Targeted Protein Degradation • ACAN • CTSG • ELANE • IL1B • IL6 • PRSS1

A scoping review of factors affecting activated clotting time measurement results. (PubMed, Thromb J) - "This scoping review comprehensively analyzed factors influencing ACT and emphasized ACT measurement variability across devices. Despite its widespread use as a point-of-care test for anticoagulation monitoring, ACT's limitations and device discrepancies highlight the need for cautious interpretation in clinical settings."

Journal • Review

Proteomic insights into aprotinin's immunomodulatory effects in attenuating renal fibrosis in a unilateral ureteral obstruction model. (PubMed, Front Immunol) - "Its effects are associated with suppression of CTSS, inhibition of ERK signaling, and modulation of CD4+ T-cell subsets, and reduced immune cell infiltration. These findings indicate that aprotinin attenuates renal fibrosis through immunomodulatory mechanisms and support further investigation of serine protease inhibitors in immune-mediated kidney injury."

Journal • Chronic Kidney Disease • Fibrosis • Immunology • Inflammation • Nephrology • Renal Disease • CD4 • CTSS

An era of precision: Emerging, research, and adjunct radiotracers for nuclear imaging of cardiac amyloidosis. (PubMed, J Nucl Cardiol) - "Herein, we summarize 1) Emerging radiotracers primed for clinical availability, including the pan-amyloid peptide tracers, [124I]evuzamitide and [99mTc]p5+14, the stilbene-based small molecule [18F]florbetaben, and the protein-based radiotracer, [99mTc]aprotinin; 2) Research-focused, Aβ amyloid radiotracers and their performance in CA ([11C]PiB; [18F]florbetapir, [18F]flutemetamol; and newer [18F]florbetazine); and 3) Adjunct radiotracers for exploring myocardial microenvironment ([68Ga]FAPI, and others), emphasizing rationale for use, opportunities, synergies, strengths, limitations, and regulatory status. Finally, we outline future research and molecular targets to elucidate the pathology and the impact of novel amyloid therapeutics as they become available."

Journal • Review • Amyloidosis • Cardiac Amyloidosis • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Inflammation

Protocol for fibrin-based endothelial-cardiomyocyte co-culture in a microfluidic device. (PubMed, STAR Protoc) - "Here, we present a protocol for building a vascularized heart-on-a-chip by co-encapsulating human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes and endothelial cells in vascular endothelial growth factor (VEGF)- and aprotinin-supplemented fibrin. We describe steps for cell preparation, fibrin formulation, chip loading, optional droplet-based pilot or high-throughput setups, and imaging. We then detail procedures for immunofluorescence staining and routine quantitative analysis of vascular and contractile features during culture for up to three weeks."

Journal

Shrinking pharmacological options in modern anaesthesia. (PubMed, Br J Anaesth) - "Although standardisation improves reliability, excessive pharmacological contraction can reduce clinical resilience, erode training competence with alternative agents, and increase vulnerability to shortages or context-specific contraindications. Stimulated by recent commentary that desflurane abandonment is only one component of a comprehensive sustainability strategy in anaesthesia, we argue that pharmacological diversity represents a form of preparedness: maintaining second-line and context-specific options is not inefficiency but a safeguard for patient-centred, adaptable care."

Journal • Anesthesia

An in vitro collagen gel contraction assay to assess the relaxing effect of potential pharmacological alternatives to oxytetracycline on foals' tendons. (PubMed, Sci Rep) - "Myofibroblasts were isolated from forelimb SDFTs and inferior check ligaments from foals euthanised for reasons unrelated to this study, and seeded in collagen gels containing oxytetracycline, MMP-inhibitors incyclinide, ilomastat, aprotinin, and pentoxifylline, β-aminopropionitrile fumarate (BAPN), and control medium. Consequently, the inhibitory capacity of BAPN and incyclinide on myofibroblast-mediated collagen gel contraction, which demonstrates their effect on tractional structuring of collagen, makes them promising candidates as potential substitutes for oxytetracycline. Further investigations into their side effects, pharmacodynamics, pharmacokinetics, and application methods in juvenile equine patients are needed."

Journal • Preclinical

Microfluidics-assisted Aprotinin-based nano-carrier for Valproic acid delivery. (PubMed, J Control Release) - "Therefore, plasma profile of VPA and Apr-VPA nanoconjugates by LC-MS/MS and serum enzymatic markers were assessed in wild-type balb/c mice, depicting significantly enhanced availability of drug when conjugated with a carrier. These findings highlight the feasibility of using aprotinin as a scalable protein-based nanocarrier for tumor-preferential therapeutic response in tested cancer models and support its future development in advanced nanomedicine applications."

Journal • Oncology

PROTEOMIC CHARACTERIZATION OF APROTININ'S IMMUNE-MODULATING ROLE IN RENAL FIBROSIS FOLLOWING UUO (ISN-WCN 2026) - "These findings underscore the therapeutic potential of serine protease inhibitors in immune-driven kidney disease and highlight CTSS as a promising molecular target.Download: Download high-res image (295KB)Download: Download full-size imageA schematic summarizes aprotinin's immunomodulatory effects in UUO, highlighting CTSS downregulation and restoration of CD4+ T cell balance.I have potential conflict of interest to disclose.This study was supported by the Yunnan Fundamental Research Projects (202501AU070020), the Ten Thousand Talent Plan for Medical Expert of Yunnan Province (YNWR-MY-2018-019), and the National Natural Science Foundation of China (82460150).I used generative AI and AI-assisted technologies in the writing process.During the preparation of this work, the authors used ChatGPT (OpenAI) in order to improve the language clarity and readability. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for..."

Acute Kidney Injury • Chronic Kidney Disease • Fibrosis • Immunology • Inflammation • Nephrology • Renal Disease • CD4 • CTSS

Protease inhibitor regulation of proteins involved in heat-induced leaf senescence in creeping bentgrass. (PubMed, Ann Bot) - "The protease inhibitor regulated various proteins that could be involved in mitigating heat-induced leaf senescence. Identification of upstream molecular factors for the specific protease inhibitor-responsive proteins will provide further insight into mechanisms of controlling leaf senescence."

Journal • Targeted Protein Degradation

ICI24/00011: CLINICAL TRIAL WITH APROTININ IN THE ACUTE RESPIRATORY DISTRESS SYNDROME TREATMENT (clinicaltrialsregister.eu) - P2/3 | N=156 | Not yet recruiting | Sponsor: Fundacion Del Hospital Nacional De Paraplejicos Para La Investigacion Y La Integracion

New P2/3 trial • Acute Respiratory Distress Syndrome • Pulmonary Disease • Respiratory Diseases

Trends and Variations in the Use of Procoagulants in Pediatric Cardiac Surgery: An STS-CHSD Analysis (STS 2026) - "Methods The STS-CHSD was queried for index cardiac operations performed with the use of cardiopulmonary bypass in patients (<18y) from 2014–2023 to identify the intra-operative use of procoagulants (Activated Factor-VIIa, 3 and 4-Factor Prothrombin Complex Concentrates, 4-Factor-Prothrombin Complex Concentrates with Activated Factor-VIIa, Fibrinogen concentrate, Desmopressin, Humate-P, Antithrombin-3) and anti-fibrinolytics (Aminocaproic acid, Tranexamic acid, Aprotinin). Further studies are needed to develop evidence-based protocols for hemostatic agent use in pediatric cardiac surgery and to evaluate their associations with bleeding and resource utilization. Table Image"

Clinical • Late-breaking abstract • Surgery • Cardiovascular • Hematological Disorders • Pediatrics • STAT5

Coc-SEPP1B: Expression of Protein Tyrosine Phosphatase 1B (PTP1B) and Body Composition Modification in Patients With Septic Shock (clinicaltrials.gov) - P=N/A | N=52 | Completed | Sponsor: University Hospital, Rouen | Unknown status ➔ Completed

Trial completion • Septic Shock

Isolation and Characterization of a Biocontrol Serine Protease from Pseudomonas aeruginosa FZM498 Involved in Antagonistic Activity Against Blastocystis sp. Parasite. (PubMed, Biomolecules) - "Inhibition by PMSF, TLCK, aprotinin, benzamidine, and SBTI protease reagents suggests a serine protease family...This could be a promising, eco-friendly, natural alternative as an anti-Blastocystis agent. The objective of this study was to isolate, purify, and biochemically characterize an extracellular serine protease produced by gut-associated bacteria, as well as to assess its in vitro anti-Blastocystis efficacy as a potential natural and ecologically friendly antiparasitic therapy."

Journal • Gastrointestinal Disorder

HSP90α and KLK6 Coregulate Stress-Induced Prostate Cancer Cell Motility. (PubMed, Cells) - "Screening for protease inhibitors that would rescue stress-induced decreases in MMP-2 activity identified a single serine protease inhibitor: aprotinin...In conclusion, we identify a novel stress-induced extracellular network that regulates MMP-2 activity and cell motility. We identified KLK6 as a stress-induced extracellular protease leading to decreased MMP-2 activity and cellular invasion, while eHSP90α is required for the rescue of MMP-2 activity once KLK6 is neutralized."

Journal • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • CDC37 • HSP90AA1 • KLK6 • MMP2

Effectiveness and safety of antifibrinolytic agents in off-pump coronary artery bypass grafting: a systematic review and meta-analysis. (PubMed, Braz J Anesthesiol) - "In off-pump CABG, antifibrinolytics reduced the need for blood transfusion while reducing thromboembolic events and overall mortality in RCT subgroups, while pooled analyses combining RCTs and observational studies did not demonstrate significant reductions. PROSPERO LINK: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545640."

Journal • Retrospective data • Review • Cardiovascular • Critical care

Human CELA1 has pancreatic elastase-like activity. (PubMed, Biochimie) - "We show that pro-hCELA1 cleavage by trypsin is blocked by aprotinin. We have determined the enzyme kinetics of the active fraction of recombinant hCELA1 and show that it follows steady-state kinetics with a higher substrate affinity than commercial porcine pancreatic elastase."

Journal • ELANE