ABSTRACT
Soluble thrombomodulin, a soluble form of human thrombomodulin isolated from urine or
produced by recombinant techniques, binds thrombin, inhibits its procoagulant activity, and
promotes activation of protein C. Activated protein C inhibits thrombin generation by inactivat-
ing factors Va and VIIIa in the presence of protein S. Thus, soluble thrombomodulin attenuates
thrombus growth by inhibiting thrombin generation. Intravenous soluble thrombomodulin is
effective in animal models of venous thrombosis, disseminated intravascular coagulation (DIC),
and arteriovenous shunt thrombosis, and it has a wider safety margin than conventional
anticoagulants. The plasma half-life of soluble thrombomodulin is long, especially after
subcutaneous injection. In phase II trials, soluble thrombomodulin was well tolerated in patients
with DIC. Studies in venous thrombosis are planned. Thus, soluble thrombomodulin is a
promising antithrombotic drug.
