Streptokinase for Treatment of Thrombotic Disorders: The End? Or the End of the Beginning?

Thrombotic disorders, such as myocardial infarction, ischemic stroke, peripheral arterial disease, deep venous thrombosis, pulmonary embolism, or other embolic diseases that are responsible for worldwide mortality and morbidity, are manifestations of the formed thrombi by blood clots during a pathologic blood coagulation process. Once thrombi are formed, the only way to resolve the blood clot is treatment with specific thrombolytic agents, so called plasminogen activators (PAs), such as tissue-PAs (tPAs), urokinase, and streptokinase (SK). PAs convert the endogenous human plasminogen (HPG: the inactive proenzyme) to plasmin (HPM: the active enzyme), which cleaves the fibrin network of the blood clot, a process known as fibrinolysis (Fig. 1)...