Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.21.7 (plasmin)
 9,023 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Enzymatic vitreous disruption refers to cleaving the vitreoretinal junction by enzymatic means, thereby inducing posterior vitreous detachment (PVD) and liquefaction of the vitreous gel. Several enzymes have been proposed in this respect, including chondroitinase, hyaluronidase, dispase, and plasmin. In an experimental setting, chondroitinase induced PVD and was helpful in removing epiretinal membranes but no further data have been reported yet. Hyaluronidase liquefies the vitreous as demonstrated in a phase III trial in diabetic patients with vitreous haemorrhage. Dispase induces PVD but also causes inner retinal damage and is now used as an animal model of proliferative vitreoretinopathy. Plasmin has the capability of both PVD induction and liquefaction. However, plasmin is highly unstable and not available for clinical use. Microplasmin (ThromboGenics Ltd, Dublin, Ireland) is a truncated form of human plasmin sharing the same catalytic activity like plasmin. Recombinant microplasmin is under clinical investigation in patients with vitreomacular traction. This review article reports on the current knowledge of enzymatic vitreous disruption and discusses details of the enzyme candidates in basic and clinical research terms.
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PMID:Enzymatic vitreous disruption. 1829 84

Various pharmacologic vitreolysis agents, including hyaluronidase, urea, plasmin, dispase, tissue plasminogen activator and chondroitinase have been tested. Pharmacologic vitreolysis can avoid the complications of surgery such as cataract, endophthalmitis, retinal hemorrhage, tear or detachment, and anesthesia related complications. Hyaluronan is a major macromolecule of vitreous. It is a long, unbranched polymer of repeating disaccharide (glucuronic acid beta (1,3)-N-acetylglucosamine) moieties linked by beta 1-4 bonds. Hyaluronan is covalently linked to a protein core, to form a proteoglycan. It plays a pivotal role in stabilizing the vitreous gel. Hyaluronidase cleaves glycosidic bonds of hyaluronic acid and, to a variable degree, other acid mucopolysaccharides of the connective tissue. Dissolution of the hyaluronic acid and collagen complex results in decreased viscosity of the extracellular matrix. This in turn increases the diffusion rate of erythrocytes and exudates along with phagocytes through the vitreous and facilitates red blood cell lysis and phagocytosis.
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PMID:Hyaluronidase for pharmacologic vitreolysis. 1949 48