Factor XIa–specific IgG and a reversal agent to probe factor XI function in thrombosis and hemostasis

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Science Translational Medicine  24 Aug 2016:
Vol. 8, Issue 353, pp. 353ra112
DOI: 10.1126/scitranslmed.aaf4331

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To clot or not: Anticoagulation without bleeding

Current drugs designed to prevent blood clots, heart attack, or stroke also increase the risk of hazardous bleeding. Toward testing whether selective block of one branch of the coagulation cascade might inhibit clotting without causing bleeding, David et al. developed an antibody that occupies and blocks the active site of a critical protein called FXIa. This antibody inhibited clotting of human blood and prevented blood vessel block in animal models but did not cause bleeding. So that the antibody can be used safely in people, the authors also developed a second antibody that can reverse the action of the first.