Sylvia Haas's Antithrombotics Weekly
Emeritus Professor Sylvia Haas, MD
Sylvia Haas is Emeritus Professor of Medicine and was Director of the Haemostasis and Thrombosis Research Group at the Institute for Experimental Oncology and Therapy Research, Technical University of Munich, Germany. Her scientific focus is the development of new antithrombotic therapies, laboratory monitoring of anticoagulants, biomarkers, and tumour-associated thrombosis. She is a member of several international professional societies and is on the editorial boards for several peer-reviewed journals. Click here for a full biography.
Progress in Anticoagulation: From shotgun to single target anticoagulation
London 6th June 2016
For decades, there were only two anticoagulants, both discovered by chance: unfractionated heparin (UFH) and the vitamin K antagonists (VKAs). Despite their substantial limitations, they led to great advances in medicine. For example, haemodialysis and extracorporeal circulation would have been impossible without heparin; heparin and VKAs are inseparable partners in the treatment of venous thromboembolism (VTE); and VKAs remain an essential part of stroke prevention in atrial fibrillation.
Find full article here: From serendipity to targeted drugs (Week 10)
Coagulation Cascade: Numbers and Names
London 30th May 2016
For the development of safer and more effective anticoagulation, a better understanding of the coagulation process was needed. While the two-phase process reported by Paul Morowitz in 1904 was accepted, there was still some uncertainty about the details of the components involved.
Find full article here: From serendipity to targeted drugs (Week 9)
Warfarin: From rat poison to life saver
London 23rd May 2016
Just as Ed Carlson’s odyssey through the snowstorm to meet Karl Link triggered Link’s breakthrough discovery, the clinical development of warfarin was also sparked by a memorable incident. In 1951, a marine attempted suicide with warfarin, but was unsuccessful. In fact, he made a complete recovery, and this surprising outcome prompted the first clinical studies of warfarin as a therapeutic anticoagulant. Warfarin was soon registered under the trade name Coumadin®, and in 1954 it was approved by the US Food and Drug Administration (FDA) for medical use.
Find full article here: From serendipity to targeted drugs (Week 8)
From herds of cattle to warfarin:
The discovery and early development of coumarin derivatives
London 16th May 2016
The history of another effective pharmacological anticoagulant is no less complex, or apparently random, than that of heparin. In the 1920s, cattle in the US and Canada were dying in mysterious circumstances. Veterinary investigations blamed internal bleeding, supposedly caused by feeding the animals inadequately dried sweet-clover hay, giving rise to the name “sweet-clover disease”. In the past farmers had simply disposed of damp, mouldy hay; however, many were forced to use it as animal feed during the economic depression of the 1920s and 30s. In 1929, veterinary surgeon Lee Roderick showed that the acquired coagulation disorder was caused by what he called a “plasma prothrombin defect”. The advice from veterinarians was simple: don’t feed mouldy hay to animals.
Find full article here: From serendipity to targeted drugs (Week 7)
Standardisation of heparin: Weighing gold on a cattle balance
London 9th May 2016
In the 1920s, the road from the laboratory to the hospital was much shorter than it is today. After Jay McLean’s discovery in 1916, and further development by William Howell, heparin was soon available commercially to treat thrombosis, even though not adequately purified and standardised.
Find full article here: From serendipity to targeted drugs (Week 6)
Thrombosis and its management in the early 20th century - Initial steps towards thromboprophylaxis and -treatment
London 2nd May 2016
The theory of infectology was dominant at the beginning of the early 20th century, with many scientists believing that infection played a role in thrombus development. Avoiding infection was seen as an early method of thromboprophylaxis. At this time, the awareness of the relationship between contemporary methods of trauma treatment and thrombosis was low.
Find full article here: From serendipity to targeted drugs (Week 5)
Rudolf Virchow – The ‘Thrombosis Adviser’ most comprehensive in scope?
London 25th April 2016
When Rudolf Virchow described changes in blood composition, changes in blood flow and changes in the vascular wall as the three pillars of thrombogenesis in his classic book Thrombose und Embolie in the 19th century, his focus was exclusively on venous thromboembolism.
Find full article here: From serendipity to targeted drugs (Week 4)
“If we go to the last frontier, where there are still elements with the character of totality… we come to the cells.” — Rudolf Virchow
London 18th April 2016
It was 160 years ago that Rudolf Virchow introduced the modern view of thromboembolism, in his classic book Thrombose und Embolie. He proposed the three pillars of thrombogenesis, which have established themselves in history as “Virchow’s Triad”: changes in the composition of the blood; changes in the flow of the blood; and changes in the blood vessel wall.
Find full article here: From serendipity to targeted drugs (Week 3)
“I retested again and again until I was satisfied that an extract of liver… possessed a strong anticoagulant action” — Jay McLean
London 11th April 2016
First I want to thank you so much for your great feedback on my first post last week. I received dozens of private messages which is very motivating to continue. Thus, let's start with this week’s installment of our tour of the history of anticoagulation, where I want to take a quick look at what we may call the start of the modern era of pharmacological anticoagulation.
Find full article here: From serendipity to targeted drugs (Week 2)
From serendipity to targeted drugs
London 3rd April 2016
This year marks 100 years since the discovery of heparin. I have dedicated some decades of my life to the exciting and fast-evolving field of antithrombotic therapies as a Professor of Medicine at the Technical University of Munich. Now I would like to take the opportunity of this centenary to share with you some personal thoughts about the history of thrombosis and coagulation research. This foray into the past is my way of describing the ‘stony road’ of anticoagulation, but it also opens the possibility for comments and discussion. I would be pleased to invite my many fellows and companions to join me on what I hope will become a virtual journey – from serendipity to targeted antithrombotics.
What can you expect? Find full article here: From serendipity to targeted drugs (Week 1)