Tranexamic acid prevents blood clots from breaking down and reduces bleeding. However, its role in traumatic brain injury remains uncertain. The CRASH-3 trial is a randomised trial that will examine the effect of tranexamic acid (versus placebo) on death and disability in 13,000 patients with traumatic brain injury.
What is TXAcentral.org
what is tranexamic acid
In September 1962, writing in the Keio Journal of Medicine, Japanese researchers Shosuke and Utako Okamoto reported the invention of tranexamic acid - a drug that inhibits the enzymatic breakdown of fibrin blood clots by plasmin.
Plasminogen, a glycoprotein pro-enzyme produced by the liver, is converted into plasmin by tissue plasminogen activator (TPA). The plasminogen molecule is folded into loops called kringles that stick out like fingers. Plasminogen binds to fibrin via lysine-binding sites on the tips of these kringles. If the lysine residues on fibrin are enzymatically removed, the binding of plasminogen is inhibited.
TPA also binds to fibrin thus localizing and enhancing plasmin formation. Plasmin bound to fibrin is also less susceptible to inhibitors. Plasmin splits fibrin into fibrin degradation products. This exposes more lysine residues which bind more plasminogen, thus accelerating fibrinolysis. TXA inhibits fibrinolysis by reducing the binding of plasminogen to fibrin.