PS 16-25 CARDIOPROTECTIVE OF ORAL LUMBROKINASE PURIFIED AND EXTRACTED FROM EARTHWORM (Lumbricus rubellus) AS NOVEL ORAL FIBRINOLYTIC THERAPY IN IMPROVING CORONARY BLOOD FLOW

Objective: Lumbrokinase had shown high specificity for fibrin, made it better and safer than any fibrinolytic agent. Hereby, we assessed the therapeutic effects of a novel oral fibrinolytic agent, lumbrokinase, and its bioactive component of fibrinolytic enzyme product-lumbrokinase. Design and method: A comprehensive computer literature search was conducted to find relevant published articles on this topic. We used a search algorithm based on a combination of the terms “Lumbrokinase”, “Oral Fibrinolytic Therapy” and “Bioactive Protein DLBS1033”. The search was updated from February 2015 until April 2015. To expand our search, references of the retrieved articles were also screened. A total of 39 articles were retrieved, of which 9 original papers, published from 2003 to 2014, were selected for the review. Results: Lumbrokinase can significantly decrease (P≤0.05) the recalcification time, comparing to the control group. In the treatment group, aPTT was prolonged, t-PA activity and D-dimer level increased, while the content of fibrinogen decreased significantly. There were no significant changes of PPT and PAI activity in both groups. Clotting time was decreased from 180 ± 10 sec to 120 ± 8 sec. Lumbrokinase also decreased the infarct size of myocardium in patient with stable angina. Myocardial reperfusion rate of lumbrokinase at dose of 20, 40, and 80 mg kg [-1] was 8%, 35% and 47%. Following active treatment of Oral Lumbrokinase in at least 1 month, the mean Summed Stress Score and Summed Difference Score decreased by 39% and 37%, respectively the anginal symptom was ameliorated in 12 of 20 patients. No adverse reaction including major or minor bleeding was observed. Conclusions: The administration of oral lumbrokinase was found to have remarkable effects on promoting blood-clots lysis with minimally risk of bleeding. Further experiment with greater samples and longer duration should be done to make sure Lumbrokinase's effect as safety trombolytic agent.