Urokinase
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| Clinical data |
| AHFS/Drugs.com |
monograph |
| Pregnancy cat. |
? |
| Legal status |
? |
| Identifiers |
| CAS number |
9039-53-6 Y |
| ATC code |
B01AD04 |
| DrugBank |
BTD00030 |
| UNII |
83G67E21XI N |
| KEGG |
D03341 Y |
| ChEMBL |
CHEMBL1201420 N |
| Chemical data |
| Formula |
C1376H2145N383O406S18 |
| Mol. mass |
31126.5 g/mol |
N(what is this?) (verify)
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plasminogen activator, urokinase
| Identifiers |
| Symbol |
PLAU |
| Entrez |
5328 |
| HUGO |
9052 |
| OMIM |
191840 |
| RefSeq |
NM_002658 |
| UniProt |
P00749 |
| Other data |
| EC number |
3.4.21.31 |
| Locus |
Chr. 10 q24 |
Urokinase (trade name Abbokinase), also called urokinase-type plasminogen activator (uPA), is a serine protease (EC 3.4.21.73). Urokinase was originally isolated from human urine, but is present in several physiological locations, such as blood stream and the extracellular matrix. The primary physiological substrate is plasminogen, which is an inactive zymogen form of the serine protease plasmin. Activation of plasmin triggers a proteolysis cascade that, depending on the physiological environment, participates in thrombolysis or extracellular matrix degradation. This links urokinase to vascular diseases and cancer.
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Contents
- 1 Molecular characteristics
- 2 Interaction partners
- 3 Urokinase and cancer
- 4 Clinical applications
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Molecular characteristics
Urokinase is a 411-residue protein, consisting of three domains: the serine protease domain, the kringle domain, and the growth factor domain. Urokinase is synthesized as a zymogen form (prourokinase or single-chain urokinase), and is activated by proteolytic cleavage between L158 and I159. The two resulting chains are kept together by a disulfide bond.
Interaction partners
The most important inhibitors of urokinase are the serpins plasminogen activator inhibitor-1 (PAI-1) and plasminogen activator inhibitor-2 (PAI-2), which inhibit the protease activity irreversibly. In the extracellular matrix, urokinase is tethered to the cell membrane by its interaction to the urokinase receptor.
Fibrinolysis (simplified). Blue arrows denote stimulation, and red arrows inhibition.
Urokinase and cancer
Elevated expression levels of urokinase and several other components of the plasminogen activation system are found to be correlated with tumor malignancy. It is believed that the tissue degradation following plasminogen activation facilitates tissue invasion and, thus, contributes to metastasis. This makes urokinase an attractive drug target, and, so, inhibitors have been sought to be used as anticancer agents. However, incompatibilities between the human and murine systems hamper clinical evaluation of these agents. Through its interaction with the urokinase receptor, urokinase affects several other aspects of cancer biology such as cells adhesion, migration, and cellular mitotic pathways.
Clinical applications
Urokinase is used clinically as a thrombolytic agent in the treatment of severe or massive deep venous thrombosis, pulmonary embolism, myocardial infarction, and occluded intravenous or dialysis cannulas. It is also administered intrapleurally to improve the drainage of complicated pleural effusions and empyemas. Urokinase is presently marketed as KinlyticTM, and competes with AlteplaseTM as a thrombolytic drug in infarctation.
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Proteins: coagulation
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| Coagulation factors |
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Primary hemostasis
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vWF
platelet membrane glycoproteins: Ib (A, B, IX) · IIb/IIIa (IIb, IIIa) · VI
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Intrinsic pathway
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HMWK/Bradykinin · Prekallikrein/Kallikrein · XII "Hageman"
XI · IX · VIII
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Extrinsic pathway
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III "Tissue factor" · VII
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Common pathway
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X · V · II "(Pro)thrombin" · I "Fibrin" · Fibrinogen (FGA, FGG)
XIII
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| Coagulation inhibitors |
Antithrombin (inhibits II, IX, X, XI, XII) · Protein C (inhibits V, VIII)/Protein S (cofactor for protein C) · Protein Z (inhibits X) · ZPI (inhibits X, XI) · TFPI (inhibits III)
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| Thrombolysis/fibrinolysis |
Plasmin · tPA/urokinase · PAI-1/2 · α2-AP · α2-macroglobulin · TAFI
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cell/phys (coag, heme, immu, gran), csfs
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rbmg/mogr/tumr/hist, sysi/epon, btst
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drug (B1/2/3+5+6), btst, trns
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Endopeptidases: serine proteases/serine endopeptidases (EC 3.4.21)
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| Digestive enzymes |
Enteropeptidase · Trypsin · Chymotrypsin · Elastase (Neutrophil, Pancreatic)
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| Coagulation |
factors: Thrombin · Factor VIIa · Factor IXa · Factor Xa · Factor XIa · Factor XIIa · Kallikrein (PSA, KLK1, KLK2, KLK3, KLK4, KLK5, KLK6, KLK7, KLK8, KLK9, KLK10, KLK11, KLK12, KLK13, KLK14, KLK15)
fibrinolysis: Plasmin · Plasminogen activator (Tissue plasminogen activator · Urinary plasminogen activator)
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| Complement system |
Factor B · Factor D · Factor I · MASP (MASP1, MASP2) · C3-convertase
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| Other immune system |
Chymase · Granzyme · Tryptase · Proteinase 3/Myeloblastin
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| Venombin |
Ancrod · Batroxobin
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| Other |
Acrosin · Prolyl endopeptidase · Pronase · Proprotein convertases (1, 2) · Reelin · Subtilisin/Furin · Streptokinase · S1P · Cathepsin (A, G)
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B enzm: 1.1/2/3/4/5/6/7/8/10/11/13/14/15-18, 2.1/2/3/4/5/6/7/8, 2.7.10, 2.7.11-12, 3.1/2/3/4/5/6/7, 3.1.3.48, 3.4.21/22/23/24, 4.1/2/3/4/5/6, 5.1/2/3/4/99, 6.1-3/4/5-6
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Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)
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| Antiplatelet drugs |
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Glycoprotein IIb/IIIa inhibitors
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Abciximab • Eptifibatide • Tirofiban
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ADP receptor/P2Y12 inhibitors
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thienopyridines (Clopidogrel, Prasugrel, Ticlopidine) • nucleotide/nucleoside analogs (Cangrelor, Elinogrel, Ticagrelor)
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Prostaglandin analogue (PGI2)
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Beraprost • Prostacyclin • Iloprost • Treprostinil
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COX inhibitors
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Acetylsalicylic acid/Aspirin# • Aloxiprin • Carbasalate calcium • Indobufen • Triflusal
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Thromboxane inhibitors
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thromboxane synthase inhibitors (Dipyridamole, Picotamide) • receptor antagonist (Terutroban†)
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Phosphodiesterase inhibitors
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Cilostazol • Dipyridamole • Triflusal
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Other
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Cloricromen • Ditazole
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| Anticoagulants |
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Vitamin K antagonists
(inhibit II, VII, IX, X)
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coumarins: Acenocoumarol • Coumatetralyl • Dicoumarol • Ethyl biscoumacetate • Phenprocoumon • Warfarin#
1,3-Indandiones: Clorindione • Diphenadione • Phenindione
other: Tioclomarol
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Factor Xa inhibitors
(with some II inhibition)
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Heparin group/
glycosaminoglycans/
(bind antithrombin)
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low-molecular-weight heparin (Bemiparin, Certoparin, Dalteparin, Enoxaparin, Nadroparin, Parnaparin, Reviparin, Tinzaparin)
oligosaccharides (Fondaparinux, Idraparinux)
heparinoid (Danaparoid, Sulodexide, Dermatan sulfate)
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Direct Xa inhibitors
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xabans (Apixaban, Betrixaban, Edoxaban, Otamixaban, Rivaroxaban)
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Direct thrombin (II) inhibitors
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bivalent: Hirudin (Bivalirudin, Lepirudin, Desirudin)
univalent: Argatroban • Dabigatran • Melagatran ‡ • Ximelagatran ‡
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Other
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REG1 • Defibrotide • Ramatroban • Antithrombin III • Protein C (Drotrecogin alfa)
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Thrombolytic drugs/
fibrinolytics |
plasminogen activators: r-tPA (Alteplase, Reteplase, Tenecteplase) • UPA (Urokinase, Saruplase) • Streptokinase# • Anistreplase • Monteplase
other serine endopeptidases: Ancrod • Fibrinolysin
Brinase
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| Non-medicinal |
Citrate • EDTA • Oxalate
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- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
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cell/phys (coag, heme, immu, gran), csfs
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rbmg/mogr/tumr/hist, sysi/epon, btst
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drug (B1/2/3+5+6), btst, trns
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