ArticleMolecular therapy. Nucleic acids2022
Aptamer-based factor IXa inhibition preserves hemostasis and prevents thrombosis in a piglet model of ECMO.
Article in Molecular therapy. Nucleic acids, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Extravascular factor IX: a semicentennial narrative review.Research and practice in thrombosis and haemostasis · 2026Review
- A Snail Galactosed Glycosaminoglycan Inhibits Thrombosis without Affecting Hemostasis via Disrupting FIXa-FVIIIa Complex Generation.ACS central science · 2026Article
- Recent Advances in Aptamer-Based Applications in Cardiology.International journal of molecular sciences · 2026Review
- From Selection to Use: Aptamers as Targeting Reagents in Hematology.Biomedicines · 2026Review
- Emerging role of nucleic acid aptamers in sepsis-induced coagulopathy: Future perspectives in diagnostics and therapeutics.Annals of intensive care · 2026Review
- ECMO-induced coagulopathy: strategic initiatives for research and clinical practice (a workshop report of the NHLBI).Blood vessels, thrombosis & hemostasis · 2025Review
- RNA aptamer-mediated RNA nanotechnology for potential treatment of cardiopulmonary diseases.Pharmacological research · 2025Review
- An RNA aptamer exploits exosite-dependent allostery to achieve specific inhibition of coagulation factor IXa.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Applications and future of aptamers that achieve rapid-onset anticoagulation.RNA (New York, N.Y.) · 2023Article
- Aptamers Regulating the Hemostasis System.Molecules (Basel, Switzerland) · 2022Review
- Coagulation and Transfusion Updates From 2021.Journal of cardiothoracic and vascular anesthesia · 2022Review
- Article
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
Extracorporeal membrane oxygenation (ECMO) requires anticoagulation to prevent clotting when the patient's blood contacts the circuit. Unfractionated heparin (UFH) usually prevents clotting but can cause life-threatening bleeding. An anticoagulant that selectively inhibits the contact activation (intrinsic) pathway while sparing the tissue factor (extrinsic) pathway of coagulation might prevent clotting triggered by the circuit while permitting physiologic coagulation at surgical sites. DTRI-178 is an RNA anticoagulant aptamer conjugated to polyethylene glycol that increases its half-life in circulation. This aptamer is based on a previously described molecule (9.3t) that inhibits intrinsic tenase activity by binding to factor IXa on an exosite. Using a piglet model of pediatric venoarterial (VA) ECMO, we compared thromboprevention and blood loss using a single dose of DTRI-178 versus UFH. In each of five experiments, we subjected two litter-matched piglets, one anticoagulated with DTRI-178 and the other with UFH, to simultaneous 12-h periods of VA ECMO. Both anticoagulants achieved satisfactory and comparable thromboprotection. However, UFH piglets had increased surgical site bleeding and required significantly greater blood transfusion volumes than piglets anticoagulated with DTRI-178. Our results indicate that DTRI-178, an aptamer against factor IXa, may be feasible, safer, and result in fewer transfusions and clinical bleeding events in ECMO.
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Registered trials
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