aprotinin / Generic mfg. - LARVOL DELTA

Innovative strategies in coagulation management for cardiothoracic surgery: a narrative review of pharmacological and nonpharmacological approaches. (PubMed, J Cardiothorac Surg) - "The use of pharmacological interventions such as tranexamic acid, heparin, and aprotinin minimizes bleeding but increases the associated risks of renal impairment and seizures. Recent advancements in this context include novel hemostatic agents, prothrombin complex concentrates, and direct oral anticoagulants. Future research should not only explore the combined use of pharmacological and nonpharmacological strategies but also evaluate the long-term effects and cost-effectiveness of integrated approaches during cardiothoracic surgery, particularly in high-risk populations."

Journal • Review • CNS Disorders • Epilepsy • Hematological Disorders • Metabolic Disorders • Pediatrics • Renal Disease

Blood collection tubes with protease inhibitors to prevent falsely high renin concentrations due to cryoactivation. (PubMed, Clin Chim Acta) - "Our study shows more cryoactivation of renin in plasma aliquots stored at -20 °C compared to storage at + 4 °C. Cryoactivation of prorenin in trypsin inhibitor and protease inhibitor cocktail tubes was reversed by a 2-hours incubation at 37 °C, which may be an alternative procedure for laboratories that are not able to store renin samples in -80 °C freezers."

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Variability in Oxytocin Blood Levels in Rats: A Review and Experimental Insights. (PubMed, Clin Psychopharmacol Neurosci) - "Furthermore, we investigated the effects of two anesthetic protocols (inhaled isoflurane and a combination of three anesthetics) and the proteinase inhibitor aprotinin on plasma oxytocin levels in adult male rats. Our findings revealed that neither the anesthetics nor aprotinin significantly affected plasma oxytocin levels. We also discussed potential factors contributing to the marked differences in reported rat blood oxytocin levels."

Journal • Preclinical • Anesthesia

A Comparative Study of the Efficacy and Safety Profile of Topical Application of Tranexamic Acid in the Form of Mist to Reduce Postoperative Bleeding in on-Pump CABG Procedures. (PubMed, Ann Card Anaesth) - "The topical application of TXA in mist form significantly reduced postoperative bleeding, the necessity for blood transfusion, and the duration of mechanical ventilation in on-pump CABG procedures."

Clinical • Journal • Cardiovascular

Rapid Clotting Assay for Tissue Factor Pathway inhibitor (TFPI) (ISTH 2025) - "A low amount of TF, cephalin, aprotinin and calcium trigger clotting, thus making the clotting time dependent on TFPI activity in the sample...Several samples from patients with thrombosis or a positive family history, and no abnormal results in other coagulation tests, showed abnormal TFPI activity. Ten out of 13 samples from patients with miscarriages, pregnancy thrombosis, or familiar thrombosis showed abnormal low TFPI activity, the remaining 3 had < 50% TFPI."

Cardiovascular • Hematological Disorders • Hemophilia • Hemophilia A • Rare Diseases • Thrombosis

Intraoperative Hemostatic Agents in Thoracic Aortic Surgery-A Scoping Review. (PubMed, J Clin Med) - "Two small RCTs-one on TXA, one on aprotinin-suggest reduced transfusions and blood loss. Small studies suggest potential for the routine use of antifibrinolytics, FEIBA, and fibrinogen supplementation-but only in bleeding patients with hypofibrinogenemia. High-quality RCTs focused on thoracic aortic procedures are needed to determine optimal coagulation management."

Journal • Review • Cardiovascular

The Effect of Prophylactic Use of Antifibrinolytics During Pediatric Non-Cardiac Surgeries on Bleeding and Transfusions: A Systematic Review and Meta-Analysis. (PubMed, Paediatr Anaesth) - "In craniofacial, scoliosis, and tonsillectomy/adenoidectomy surgery, prophylactic administration of tranexamic acid results in lower estimated blood loss. Tranexamic acid and aprotinin are effective for reducing transfusion in craniofacial surgery. For scoliosis surgery, tranexamic acid is more efficacious than aminocaproic acid. More literature is needed to assess the efficacy of tranexamic acid in VRDO/VRO and hip reconstruction surgery and the efficacy of different dosing regimens."

Journal • Retrospective data • Review • Cardiovascular • Pediatrics

Anaphylaxis associated with Tisseel fibrin sealant during re-resection of a craniopharyngioma: illustrative case. (PubMed, J Neurosurg Case Lessons) - "This case and the accompanied literature can aid in recognizing patients at risk for an anaphylactic reaction against aprotinin. It also serves to remind us that medicine used locally in the surgical field can also cause anaphylaxis. https://thejns.org/doi/10.3171/CASE2517."

Journal • Allergy • Brain Cancer • CNS Tumor • Dermatology • Hypotension • Immunology • Urticaria

Pharmacological alternatives to oxytetracycline as potential treatment of flexural limb deformities in foals: a preliminary in vitro cell viability and proliferation study. (PubMed, Sci Rep) - "The myofibroblasts were incubated with oxytetracycline, the MMP-inhibitors incyclinide, ilomastat, aprotinin, pentoxifylline, the lathyrogenic agent β-aminopropionitrile fumarate and Dulbecco's modified eagle medium as control. The morphology and immunohistochemistry profile of the cultured cells was consistent with tendon and ligament myofibroblasts. All test substances were biocompatible, shown by the absence of significant differences with cells incubated with medium, demonstrating the absence of cytotoxic or anti-proliferative effect on juvenile myofibroblasts in the tested concentrations in this preliminary study."

Journal • Preclinical

Neuroprotective Strategies in Coronary Artery Disease Interventions. (PubMed, J Cardiovasc Dev Dis) - "Pharmacological neuroprotection includes agents such as barbiturates, volatile anesthetics, lidocaine, NMDA receptor antagonists, magnesium, nimodipine, corticosteroids, and aprotinin. Postoperatively, timely antiplatelet administration, glucose control, hemodynamic stabilization, and cognitive monitoring are critical. Comprehensive neuroprotective approaches, spanning pre- to postoperative phases, aim to reduce neurological complications and enhance outcomes in coronary interventions."

Journal • Review • Anesthesia • Atherosclerosis • Cardiovascular • CNS Disorders • Coronary Artery Disease • Diabetes • Epilepsy • Hypertension • Ischemic stroke • Metabolic Disorders

ACCURACY OF C-PEPTIDE MEASUREMENTS IS DEPENDENT ON THE ASSAY METHOD, THE APPROPRIATE BLOOD COLLECTION TECHNIQUE AND ADDITION OF STABILIZING AGENTS FOR MANIPULATION AND STORAGE (ATTD 2025) - "The plasma samples collected in aprotinin pretreated EDTA tubes, validated for the liquid chromatography–mass spectrometry method, produced more accurate, lower C-peptide values...Immediate testing and storing plasma at -70 degree Celsius improve accuracy. Standardizing C-peptide measurement to a reference method can increase comparability between laboratories."

Diabetes • Hypoglycemia • Metabolic Disorders • Solid Tumor • Type 2 Diabetes Mellitus

Dendrimer-Mediated Molecular Sieving on Avidin. (PubMed, Biomacromolecules) - "Dissociation constants of high-generation biotin-dendrons (G5 and G6) with higher-generation avidin-dendron conjugates (Av-G6) increased from ∼10-15 M (for the native structures) to ∼10-6 M, and binding was found to be weaker than that of the Avidin-HABA complex. Avidin-G5 and Avidin-G6 were highly size-selective for biotinylated ligands; both prevented the binding of aprotinin (6.9 kDa), bovine serum albumin (BSA), and PEG3400 while forming fractional complexes with smaller biotinylated dendrons."

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ROLE OF ISCHEMIC PRECONDITIONING TO PREVENT ACUTE KIDNEY INJURY IN POST CABG SURGERIES (ISN-WCN 2025) - "The intraoperative factors are comprised of the hemodynamic effects of cardiopulmonary bypass (CPB) pump, cytokine and chemokine expression, inflammatory mechanisms, microscopic and macroscopic emboli, effects of aprotinin, and effects of the on-pump technique...Drug therapy with sulfonamide or nicorandil (preconditioning-blocking and preconditioning-mimetic medication, respectively)...In addition , we also conclude that RIPC performed with total duration of ischemia < 20minutes renders the best benefit. However , due to the major limitations of the small sample size and variations of the surgical procedures and basal characteristics of the participants in this study , our conslusions need to be further corroborated in future larger studies."

IO biomarker • Surgery • Acute Kidney Injury • Addiction (Opioid and Alcohol) • Anemia • Anesthesia • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Coronary Artery Disease • Heart Failure • Hematological Disorders • Infectious Disease • Inflammation • Myocardial Infarction • Nephrology • Peripheral Arterial Disease • Renal Disease • Reperfusion Injury • Septic Shock • HMGB1 • IGFBP7 • TIMP2

AM fungus plant colonization rather than an Epichloë endophyte attracts fall armyworm feeding. (PubMed, Mycorrhiza) - "The interactions of the AM fungus and Epichloë endophyte increased the jasmonic acid concentrations by 24.29% and decreased trasylol activity by 11.75% in the host plants under FAW attack. Neither the AM fungus nor Epichloë endophyte influenced the relative growth rate (RGR) of FAW. Overall, the AM fungus had a greater positive effect on plant growth than the Epichloë endophyte, regardless of FAW larvae infestation."

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Risks and Harms to Physicians Reporting Hematologic Adverse Drug Reactions (ADRs) to Health Authorities (ASH 2024) - "ADR findings resulted in drug removal (n = 7; Vioxx, Avandia, Bextra, Celebrex, Trasylol, Phenyl propanolamine, Hydroxy-ethyl starch), revised indications (n = 2) (Procrit, Aranesp 2007, 2008, 2010)) or 10-year delay in FDA-approval (n = 1) (Fereprox)...Pharmaceutical companies paid $600,000 (Fereprox) to $5.8 billion (Vioxx) in fines and settlements.Discussion : Twelve physicians experienced severe threats and/or harms after reporting hematologic-associated ADRs to Health Authorities and/or in major publications. We suggest physicians not sign secrecy agreements that might jeopardize public safety (as currently established by almost all US medical universities) and should partner with independent drug safety monitoring boards (DSMBs) on ADR evaluations to monitor safety concerns of drugs and medical devices."

Adverse drug reaction • Hematological Disorders • Oncology • Solid Tumor

Platelet-sparing properties of aprotinin: A scoping review on mechanisms and clinical effects. (PubMed, Eur J Anaesthesiol) - "This review elucidated current knowledge on how aprotinin influences platelets and exerts its platelet-sparing effect, while highlighting gaps in the existing literature."

Journal • Review • Cardiovascular • Hematological Disorders • Targeted Protein Degradation

Fibrin Glue After ESD for High Risk Patients of Bleeding (clinicaltrials.gov) - P=N/A | N=134 | Completed | Sponsor: Seoul National University Hospital | Recruiting ➔ Completed | N=254 ➔ 134

Enrollment change • Trial completion • Gastric Cancer • Oncology • Solid Tumor

Dual optical elastography detects -induced alterations in the biomechanical properties of skin scaffolds. (PubMed, J Biomed Opt) - "Skin scaffold samples, grouped into three categories (control, -treated, and + galunisertib-treated), were prepared in two distinct culture media-one with aprotinin (AP) and another without. Moreover, the + galunisertib-treated group exhibited lower wave speed without and with AP and reduced Brillouin frequency shift than the -treated group without AP, further strengthening the potential role of in regulating the mechanical properties of the samples. These findings offer valuable insights into -induced biomechanical alterations in bio-engineered skin scaffolds, highlighting the potential of OCE and Brillouin microscopy in the development of targeted therapies in conditions involving abnormal tissue remodeling and fibrosis."

Journal • Fibrosis • Immunology

A surface-functionalized whole blood-based dielectric microsensor for assessment of clot firmness in a fibrinolytic environment. (PubMed, Biosens Bioelectron) - "We also show that surface coating with aprotinin and manual addition of aprotinin yield similar results in inhibiting tissue plasminogen activator (tPA)-induced upregulated fibrinolysis in human whole blood samples. Validated through a clinically relevant, complementary assay - rotational thromboelastometry for clot viscoelasticity - we finally establish that a microsensor dual-coated with both TF and aprotinin detects the hemostatic rescue in the tPA-induced hyperfibrinolytic profile of whole blood and the hemostatic dysfunction due to concurrent platelet depletion in the blood sample, thus featuring enhanced ability in evaluating complex, combinatorial coagulopathies."

Journal • Hematological Disorders • Thrombocytopenia

Liposome-encapsulated aprotinin biodistribution in mice: Side-by-side comparison with free drug formulation. (PubMed, Biochem Biophys Res Commun) - "This suggests that the liposomal formulation exhibits a longer residence time in the target organ and, thus, has the potential for a longer therapeutic effect. The results reveal the great potential of the aprotinin-loaded liposomes for the treatment of respiratory system injuries and heart- and kidney-related complications of viral infections."

Journal • Preclinical • Infectious Disease • Influenza • Novel Coronavirus Disease • Respiratory Diseases • Respiratory Syncytial Virus Infections

Optimizing Renal Transporter Immunodetection: Consequences of Freeze-Thaw during Sample Preparation. (PubMed, Am J Physiol Renal Physiol) - "In female Sprague Dawley rat kidneys homogenized with: aprotinin, Na2EDTA, PMSF, and phosphatase inhibitors, immunodetection signals were ~50% lower in Frozen versus Fresh samples for most transporters...Thus, kidney sample preparation variables, including freeze-thaw and protease inhibition, have substantial transporter-specific effects on quantification of renal transporter abundance by immunoblot. These findings underscore the critical importance of assessing and reporting the impact of sample preparation protocols on transporter recovery to ensure robust rigor and reproducibility."

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Stability of adrenocorticotropic hormone in whole blood samples: effects of storage conditions. (PubMed, Biochem Med (Zagreb)) - "Aprotinin does not appear to give ACTH greater stability but can be used without exceeding 4 hours at 4 °C. Refrigerated pouch transport also seems to be more appropriate for ACTH in whole blood."

Journal • Hematological Disorders

Optimization of Vascularized Intestinal Organoid Model. (PubMed, Adv Healthc Mater) - "This study explores how varying the ratio of Matrigel in fibrin-Matrigel co-gel affects vascular network formation and intestinal organoid growth. A fine-tuned hydrogel is developed by adding aprotinin and 15% Matrigel in fibrin...By incorporating engineered thick collagen fiber bundles into the system, vascular network formation is guided by bundle architectures, enhancing interactions between vascular networks and organoids. The results demonstrate an optimized system that advances tissue and organoid vascularization by combining fiber bundles with fine-tuned hydrogel and modified medium."

Journal • FGF

Cost analysis study comparing the impact of treatment with aprotinin versus tranexamic acid in cardiac surgery under cardiopulmonary bypass. (PubMed, Ann Pharm Fr) - "The additional cost of aprotinin at the time of purchase is offset by the additional costs of blood products in the tranexamic acid group."

Cost-analysis • HEOR • Journal • Surgery • Cardiovascular

Aprotinin (I): Understanding the Role of Host Proteases in COVID-19 and the Importance of Pharmacologically Regulating Their Function. (PubMed, Int J Mol Sci) - "We aim to elucidate the pathophysiological bases of COVID-19 in the context of the imbalance between the action of proteases and anti-proteases to understand the mechanism of aprotinin action (a panprotease inhibitor). In a second-part review, titled "Aprotinin (II): Inhalational Administration for the Treatment of COVID-19 and Other Viral Conditions", we explain in depth the pharmacodynamics, pharmacokinetics, toxicity, and use of aprotinin as an antiviral drug."

Journal • Review • Cardiovascular • Hematological Disorders • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • Targeted Protein Degradation • Thrombosis