Abstract
Failure of hemostasis and the formation of blood clots in the arteries are the main reasons that provoke the onset of cardiovascular diseases (CVDs) such as myocardial infarction and ischemic stroke. Cardiovascular diseases have become the primary cause of deaths and disabilities across the globe. Therefore, this problem needs to be addressed with urgency. The disintegration of blood clots requires fibrinolytic agents, which are involved in thrombolysis. Streptokinase and urokinase are fibrinolytic enzymes; the former is primarily produced from microbial sources and the latter is isolated from urine, respectively. Streptokinase and urokinase have been in use for a long time to treat cardiovascular diseases. This review explains in detail the comparison of employing streptokinase and urokinase for the said purpose in a cost-effective manner. The recombinant production of both the agents has been discussed in detail. Furthermore, the efficacy of both the agents has been compared based upon their side effects and retention time in the body. A thorough study has been made to compare the influence of using both the agents on the health of cardiovascular patients in the last decade.
Highlights
Cardiovascular diseases (CVDs) account for almost 17.9 million deaths every year and have been reported to be the leading cause of death by the World Health Organization. Medical complications such as myocardial infarction, ischemic stroke, peripheral arterial thrombosis, pulmonary embolism, and deep vein thrombosis (Ruscica, Corsini, Ferri, Banach, & Sirtori, 2020), which are majorly caused by atherosclerosis, are all included in the set of cardiovascular diseases (CVDs)
Streptokinase and urokinase are widely used across the globe as fibrinolytic agents
Streptokinase possesses specific side effects due its bacterial origin, but they can be overcome through recombinant techniques
Summary
Mc Farlane and Pilling (Mahmood et al, 2018) first isolated urokinase in 1947; after which in 1972, UPA was first licensed for use in France (Kunamneni, Ogaugwu, & Goli, 2018) It is a serine protease which functions as a thrombolytic agent by hydrolyzing the peptide link in plasminogen, transforming it into plasmin that can, in turn, hydrolyze the fibrin mesh in the blood clots (Figure 3) (Tan et al, 2017). Urokinase is favored over streptokinase essentially because it is a human indigenous protein and can be administered repeatedly without the fear of causing any allergic response in the body It has high fibrin specificity and fewer side effects (Nawaz et al, 2020) and works more or less in the same way as streptokinase. This article has compared the feasibility of industrial production and the market values of these two agents
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