Delving into the Latest Updates on Ulinastatin with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

UTI, Ulinastatin (JP17), hUTI

+ [13]

Target

Trypsin

Action

inhibitors

Mechanism

Trypsin inhibitors

Therapeutic Areas

Infectious DiseasesDigestive System DisordersOther Diseases

Active Indication

PancreatitisShock, HemorrhagicShock, Septic+ [4]

Inactive Indication

Acute Lung InjuryReperfusion InjuryRespiratory Distress Syndrome, Adult

Originator Organization

Mochida Pharmaceutical Co., Ltd.

Active Organization

Shanghai Bao Pharmaceuticals Co., Ltd.

Mochida Pharmaceutical Co., Ltd.

Jiangsu Aidea Pharmaceutical Co., Ltd.

+ [1]

Inactive Organization-

Drug Highest PhaseApproved

First Approval Date

Japan (16 Apr 1985),

PancreatitisShock, HemorrhagicShock, Septic+ [1]

RegulationOrphan Drug (European Union)

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Structure/Sequence

Sequence Code 14926724

Source: *****

This study investigated the etiology, clinical features, and management of acute hydrogen sulfide (H2S) poisoning in Zhoushan. A retrospective analysis was conducted on 10 patients admitted to our hospital between August and September 2023 due to two incidents of acute H2S poisoning. The first incident involved fishermen working in a fishing cabin (6 patients), while the second involved sanitation workers during sewer maintenance (4 patients). Among the patients, 4 had severe poisoning, 3 had moderate poisoning, and 3 had mild poisoning. Corneal chemical injuries were observed in 4 severe patients, and chest CT scans showed bilateral infiltrative changes in 7 patients. Elevated lactate concentrations, and low oxygenation indices were noted in all severe patients. Severe cases received intensive care, including tracheal intubation, mechanical ventilation, corticosteroids, methylene blue, ulinastatin, and hyperbaric oxygen therapy. Patients with mild to moderate symptoms received supportive treatments, including oxygen therapy and hyperbaric oxygen therapy. With the exception of one fatality, all other patients were discharged after successful treatment. Fishing boat cabins and decomposed sewage channels in island areas are common sites for acute H2S poisoning. Rapid identification of H2S poisoning and evaluation are crucial. Early airway management is essential for severe cases to prevent vital organ hypoxia.

01 Jan 2025·Perfusion

Perioperative oxygenation impairment related to type a aortic dissection

Review

Author: Jiang, Yu ; Liu, Qindong ; Yang, Xiaofang ; Guan, Yulong ; Hei, Feilong

Type A aortic dissection (TAAD) is a life-threatening disease with high mortality and poor prognosis, usually treated by surgery. There are many complications in its perioperative period, one of which is oxygenation impairment (OI). As a common complication of TAAD, OI usually occurs throughout the perioperative period of TAAD and requires prolonged mechanical ventilation (MV) and other supportive measures. The purpose of this article is to review the risk factors, mechanisms, and treatments of type A aortic dissection-related oxygenation impairment (TAAD-OI) so as to improve clinicians’ knowledge about it. Among risk factors, elevated body mass index (BMI), prolonged extracorporeal circulation (ECC) duration, higher inflammatory cells and stored blood transfusion stand out. A reduced occurrence of TAAD-OI can be achieved by controlling these risk factors such as suppressing inflammatory response by drugs. As for its mechanism, it is currently believed that inflammatory signaling pathways play a major role in this process, including the HMGB1/RAGE signaling pathway, gut-lung axis and macrophage, which have been gradually explored and are expected to provide evidences revealing the specific mechanism of TAAD-OI. Numerous treatments have been investigated for TAAD-OI, such as nitric oxide (NO), continuous pulmonary perfusion/inflation, ulinastatin and sivelestat sodium, immunomodulation intervention and mechanical support. However, these measures are all aimed at postoperative TAAD-OI, and not all of the therapies have shown satisfactory effects. Treatments for preoperative TAAD-OI are not currently available because it is difficult to correct OI without correcting the dissection. Therefore, the best solution for preoperative TAAD-OI is to operate as soon as possible. At present, there is no specific method for clinical application, and it relies more on the experience of clinicians or learns from treatments of other diseases related to oxygenation disorders. More efforts should be made to understand its pathogenesis to better improve its treatments in the future.

01 Jan 2025·Cell Reports Medicine

Protective effect of ulinastatin against negative inflammatory response and organ dysfunction in acute aortic dissection surgery: The PANDA trial

Article

Author: Liu, Xiang ; Li, Ao ; Zhao, Sheng ; Wu, Ying ; Ma, Chao ; Yang, Ji-Nong ; Tang, Zhi-Wei ; Zhang, Hong-Jia ; Li, Hai-Yang ; Wu, Zhong ; Fan, Guo-Liang ; Liu, Nan ; Diao, Yi-Fei ; Shao, Yong-Feng ; Zhang, Ying-Yuan ; Liu, Hong ; Yue, Hong-Hua ; Ni, Bu-Qing ; Chen, Jun-Quan ; Zhu, Kai ; Xu, Xiu-Fan ; Qian, Si-Chong

Ulinastatin is a protease-inhibiting drug with anti-inflammatory and other pharmacological properties. Little is known regarding its role following acute type A aortic dissection (ATAAD) surgery. We perform a randomized controlled trial to investigate the protective effect of ulinastatin against negative inflammatory response and organ dysfunction in ATAAD surgery (PANDA). The primary outcome of mean daily Sequential Organ Failure Assessment (SOFA) score from baseline to 7 days of surgery is 8.80 (SD, 4.11) in the ulinastatin group and 8.61 (SD, 4.47) in the control group (mean difference between groups was 0.04; 95% confidence interval [CI], -0.24 to 0.33; p = 0.765). Systemic inflammatory response syndrome (SIRS) within 7 days of surgery is lower in the ulinastatin group than in the control group (p < 0.001). Additional ulinastatin to standard treatment is likely to reduce SIRS rates instead of preventing organ dysfunction, highlighting the potential importance of the benefits of anti-inflammatory pharmacotherapeutics. The trial is registered on clinicaltrials.org (NCT04711889).

100 Deals associated with Ulinastatin

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External Link

KEGG	Wiki	ATC	Drug Bank
D05183	Ulinastatin	B02AB05	DB12038

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Pancreatitis	Japan	Mochida Pharmaceutical Co., Ltd.	16 Apr 1985
Shock, Hemorrhagic	Japan	Mochida Pharmaceutical Co., Ltd.	16 Apr 1985
Shock, Septic	Japan	Mochida Pharmaceutical Co., Ltd.	16 Apr 1985
Shock, Traumatic	Japan	Mochida Pharmaceutical Co., Ltd.	16 Apr 1985

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Reperfusion Injury	Phase 2	China	Jiangsu Aidea Pharmaceutical Co., Ltd.	03 Jul 2019
Respiratory Distress Syndrome, Adult	Phase 2	China	Techpool Bio-Pharma Co., Ltd.	01 Aug 2016
Acute Lung Injury	Phase 2	China	Techpool Bio-Pharma Co., Ltd.	18 Aug 2014
Systemic Inflammatory Response Syndrome	Phase 2	China	Techpool Bio-Pharma Co., Ltd.	18 Aug 2014
Intraoperative Complications	Phase 1	China	Jiangsu Aidea Pharmaceutical Co., Ltd.	30 Jan 2022
Pancreatitis, Chronic	Preclinical	Global	Shanghai Bao Pharmaceuticals Co., Ltd.	21 Jan 2025
Shock	Preclinical	Global	Shanghai Bao Pharmaceuticals Co., Ltd.	21 Jan 2025

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03387774 (ASCO2024) Manual	Phase 3	Advanced Nasopharyngeal Carcinoma	179	UlinastatinUlinastatin	sosnpqpgvi(hxvohgigcu) = idqbjqxpem ydvrusrnqx (jmcrifshdg ) View more	Positive	24 May 2024
				ulinastatin (Control)	sosnpqpgvi(hxvohgigcu) = yxatkwdboa ydvrusrnqx (jmcrifshdg ) View more
DDW2023	Not Applicable	Post-ERCP Pancreatitis	-	Ulinastatin	(yzojrmommy) = ohcvrqxzlc qzxdddblcp (aboxyevuvv ) View more	-	08 May 2023
ISN WCN2023	Not Applicable	SOFA scores \| d-dimer \| serum procalcitonin levels ... View more	200	Ulinastatin	aoxzewrmri(qckdhonssm) = qqolppbilq tzzoedcrrh (izbiexetdm ) View more	Positive	01 Mar 2023
NCT01060189 (Pubmed \| J Cardiothorac Surg)	Not Applicable	-	426	Ulinastatin	zycepwbicu(gfkpnxlsbu) = ydswuuqfno anrxtnniqu (aypbdjocgo )	Positive	14 May 2020
				Tranexamic acid	zycepwbicu(gfkpnxlsbu) = fttdqjuagu anrxtnniqu (aypbdjocgo )
ERA2016	Not Applicable	Acute Kidney Injury	150	Ulinastatin	(tchatwawzl) = dabjtqjwpe xzbvulwton (klsmlsedpi ) View more	Positive	14 May 2016
				ULINASTATIN (Control group)	mltviiduvt(mwlxueyrdy) = dqcbrqamlh crvewdnqek (nlqfmwoyjm )
NCT01132521 (Pubmed \| Clin Gastroenterol Hepatol)	Phase 4	Post-ERCP acute pancreatitis	406	Ulinastatin	(toviyzopcw) = tppfyvtqaw iquluddhvz (zjkpkbtmee )	Positive	01 Apr 2005
				Placebo	(toviyzopcw) = nfoygkqfvz iquluddhvz (zjkpkbtmee )