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antithrombin III (Atenotiv / ATenativ / ATnativ)

✓ Approved

Pfizer, Inc. · SERPINC1 · Cell-based Therapies

What is antithrombin III?

antithrombin III is a cell-based therapies developed by Pfizer, Inc.. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesAtenotiv, ATenativ, ATnativ
CompanyPfizer, Inc.
Drug ClassCell-based Therapies
Molecular TargetSERPINC1
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, Pfizer, Inc.

Mechanism of Action

Molecular Targets

antithrombin III acts on 1 molecular target:

SERPINC1serpin family C member 1 (ATIII, AT3D)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

antithrombin III is developed for 3 unique indications across 3 therapeutic areas.

Therapeutic AreaConditionPhase
Congenital, familial and genetic disordersAntithrombin III deficiency✓ Approved
Vascular disordersThrombosis✓ Approved
Surgical and medical proceduresAdjuvant therapy✓ Approved

Related Research Articles

PubMedbioRxiv : the preprint server for biology2026-07-17

A Multidimensional Analysis of the Bimodal Piperaquine Response in Plasmodium falciparum.

Kane John J, Schall Aubrey A, Checkley Lisa A LA, Shoue Douglas A DA et al.

Malaria remains a pressing global health challenge, with the continued emergence of resistance threatening the long-term efficacy of artemisinin-based combination therapies (ACTs). Piperaquine (PPQ), an important partner drug in artemisinin-based combination therapies exhibits a unique bimodal dose-response phenotype associated with reduced susceptibility, yet the biological mechanism underlying this phenotype remains unknown. This phenotype is strongly associated with mutations in pfcrt and copy number amplification of plasmepsin II/III ( pm II/III ). Given that plasmepsins play a central role in hemoglobin degradation within the blood stage parasite digestive vacuole, and that PPQ accumulates within this compartment and perturbs heme detoxification, this phenotype likely reflects alterations in fundamental biological processes alongside drug-specific effects. We used isogenic PPQ-resistant parasite clones differing only in pm II/III copy number to integrate phenotypes with metabolic changes, and transcriptional responses to ascertain the impact of genotype combinations on parasite response to PPQ. Across increasing PPQ concentrations, parasites with elevated pm II/III copy number exhibited distinct metabolic responses compared to single-copy parasites, specifically, an altered abundance of peptides derived from hemoglobin degradation, directly implicating a core biological pathway long associated with plasmepsin function. The combination of metabolic and transcriptional data with phenotypic measurements supports a model in which increased plasmepsin expression enhances the parasite's capacity to sustain hemoglobin digestion and associated metabolic activity under high PPQ concentrations. This points to a mechanistic basis for continued parasite survival, indicating that changes in hemoglobin processing within the digestive vacuole contribute to the bimodal response to PPQ. Molecular dynamics simulations further support a direct interaction between PPQ and PM II/III, as a mechanism by which these proteins impact PPQ response dynamics through both modulation of hemoglobin digestion and protein-drug interactions within the digestive vacuole.

PMID 42465291
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PubMedHernia : the journal of hernias and abdominal wall surgery2026-07-17

Postoperative quality of life after minimally invasive repair of giant hiatal hernias.

Tirelli Flavio F, Lorenzon Laura L, Galati Cristina C, Chicchi Francesca F et al.

Type III and IV hiatal hernias require surgical repair to improve symptoms and prevent complications. Long-term patient-reported outcomes following minimally invasive repair, particularly with robotic-assisted techniques, remain incompletely described. This single-center retrospective cohort study evaluated consecutive patients who underwent elective hiatoplasty for type III or IV hiatal hernia between 2014 and 2024. Quality of life (QoL) was assessed using validated scores (GERD-HRQL, DeMeester symptom score) and a 5-point Likert satisfaction scale. The primary outcome of interest was postoperative QoL. Secondary outcomes included complications, recurrence, and associations with surgical technique (robotic vs. laparoscopic), mesh use, and fundoplication. Eighty patients were selected from 152 treated during the study period. The cohort comprised 71.3% robotic-assisted and 22.5% laparoscopic procedures (6.2% converted). QoL was assessed at a median of 30 months' follow-up. Postoperative median DeMeester symptom score was 1.0 (IQR 0.0-2.0), while median GERD-HRQL was 4.0 (IQR 0.0-8.0). The median satisfaction using the Likert scale was 5.0 (IQR 4.0-5.0). Major complications (Clavien-Dindo ≥ III) occurred in 5.0% of patients, with a 30-day readmission rate of 1.3%. Recurrence was documented in 21.2% (7 out of 33 patients with complete radiological follow-up data), with symptomatic recurrence in 6.1%. Higher BMI and symptomatic recurrence were significantly associated with lower quality-of-life scores (p < 0.05). No significant differences in postoperative QoL, complications, or recurrence were observed between robotic and laparoscopic approaches, with or without mesh reinforcement or fundoplication (p > 0.05). Minimally invasive hiatoplasty for type III and IV hiatal hernias achieves excellent long-term quality of life and high patient satisfaction independent of surgical approach, mesh use, or fundoplication. Preoperative BMI optimization, may enhance postoperative outcomes.

PMID 42467270
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PubMedJournal of the American Chemical Society2026-07-17

Influence of Primary Coordination Sphere on Anion Rebound Selectivity in Nonheme Fe Enzyme-Catalyzed C(sp3)-H Functionalization: A Comparative Experimental and Computational Study of EgtB and ACCO.

Zhao Liu-Peng LP, Guo Rui R, Mai Binh Khanh BK, Chen Heyu H et al.

Developing enzymatic mechanisms for C-F bond formation remains a long-standing challenge. Here, we repurposed the biosynthetic nonheme Fe enzyme EgtB, which features a three-histidine facial triad, to catalyze C(sp3)-H fluorination reactions. Directed evolution of EgtB afforded two new-to-nature fluorine atom transferases with opposite enantiopreference, EgtBCHF1 and EgtBCHF2, with up to 28-fold improved total activity. In contrast to our previously evolved nonheme Fe fluorine atom transfer biocatalyst ACCOCHF, which contains a two-histidine-one-carboxylate facial triad, the evolved EgtBCHF variants displayed unexpected hydroxylation activity. 18O-labeling experiments showed that the hydroxy group originated from water rather than residual O2. Computational studies suggested that the three-histidine-supported Fe(III) center exhibits enhanced Lewis acidity compared to the two-histidine-one-carboxylate system, allowing deprotonation of Fe(III)-bound water to form a Fe(III)-OH species that catalyzes radical hydroxylation. Primary coordination-sphere mutagenesis in EgtB and ACCO further supported the critical role of Fe coordination chemistry in controlling radical rebound reactivity and selectivity. Computational studies revealed that Fe coordination chemistry strongly influences both fluorine atom abstraction and radical rebound, with the intrinsic C-X (X = F, OH, and N3) bond forming radical rebound preference following the order N3 > OH > F. Furthermore, multivariate linear regression analysis revealed that fluorine atom abstraction is primarily governed by the intrinsic Fe-F bond strength, whereas fluorine rebound is predominantly controlled by the electronic structure of the Fe(III) intermediate. Together, these findings provide mechanistic insights into nonheme Fe enzymology and reprogramming toward selective radical rebound reactions, including challenging C-H fluorination.

PMID 42464761
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PubMedAesthetic plastic surgery2026-07-17

Hair Removal with 755 nm Alexandrite Laser via Subcutaneous Route in Stage-III Ear Reconstruction by Expansion.

Wang Tiange T, Sun Xiaochen X, Jiang Haiyue H, Huang Lvping L

Congenital microtia reconstruction often introduces unwanted hair onto the new auricle. Laser hair removal can address this issue, but conventional external treatments require multiple sessions, increasing the overall treatment time, discomfort, and cost. Preclinical studies suggest that delivering laser energy from the flap's underside may improve efficiency by directly targeting hair follicles. We evaluated an intraoperative subcutaneous laser depilation approach applied during stage-III surgery to improve hair removal in this setting. A prospective cohort study included 44 microtia patients undergoing stage-III auricular reconstruction. 23 patients received an intraoperative 755 nm Alexandrite laser via subcutaneous route during surgery, while 21 patients had a standard external laser session one week before surgery. Laser settings were adjusted for each: subcutaneous treatments used 10-12 J/cm2 with 3 ms pulses, versus 14-20 J/cm2 with 20 ms pulses externally. Hair counts per cm2 were measured before treatment and two months after. Percentage hair reduction, complications, and patient satisfaction were compared between groups, with P < 0.05 considered significant. Both methods produced significant hair reduction at 2 months. The subcutaneous group achieved 48.3% mean hair count reduction versus 44.7% in the epidermal group (P < 0.001). The subcutaneous approach required lower laser fluence (11.04 vs 16.29 J/cm2, P < 0.001). No laser-related complications were observed. Patient satisfaction was high in both groups. Intraoperative subcutaneous 755 nm Alexandrite laser depilation integrated into stage-III ear reconstruction appeared to be a safe and effective approach for reducing hair on the reconstructed auricle. Compared with conventional preoperative external laser treatment, this method showed a trend toward greater hair reduction while using lower fluence. This technique may reduce the need for multiple separate laser sessions and improve patient convenience. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID 42463533
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PubMedCureus2026-07-17

Multimodal Interdisciplinary Management of Level III Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus: The Role of Preoperative Embolization, Intracaval Balloon Control, and Radical Nephrectomy With Inferior Vena Cava Thrombectomy.

Abushamma Faris F, Alami Ibraheem I, Abu Aisheh Mohammed Tawfiq MT, Demyati Khaled K et al.

Renal cell carcinoma with tumor thrombus extending into the inferior vena cava (IVC) above the hepatic veins (Mayo level III) is among the most technically demanding scenarios in urooncological surgery. We describe the case of a previously healthy 59-year-old gentleman who presented with a large right renal mass and a 9 cm tumor thrombus extending from the right renal vein into the intrahepatic IVC. After multidisciplinary discussion, the patient underwent a combined urovascular procedure preceded by a same-day interventional radiology (IR) intervention comprising selective right renal artery embolization, embolization of the highly vascular caval tumor thrombus, and the placement of an accommodating intracaval balloon for suprahepatic vascular control. A rooftop incision was used for radical nephrectomy with IVC thrombectomy under triple-level caval control and contralateral renal vein control; intraoperative cavography by the IR team confirmed complete extraction of the thrombus and a patent IVC. Estimated blood loss was minimal, and no transfusion was required. The combination of preoperative selective embolization, intracaval balloon assistance, and intraoperative cavography may improve hemostatic control, reduce the risk of intraoperative tumor embolization, and provide a reproducible adjunct to conventional surgical thrombectomy for level III IVC tumor thrombi. Further prospective studies and larger case series are mandated to define the incremental benefit of each component.

PMID 42465181
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PubMedOphthalmology and therapy2026-07-17

180-Degree Nuclear Flip: A Safety and Efficacy Assessment of a Phacoemulsification Technique for Cataract Nuclei of Grade III and Below.

Chen Ruibo R, Xu Tao T, Shi Guorong G, Xi Chunyan C et al.

This prospective randomized controlled trial aims to evaluate the effectiveness and safety of a 180° nuclear flip technique in phacoemulsification cataract surgery, comparing it with the traditional endocapsular approach for cataracts of Emery-Little grade III and below. A total of 142 patients were randomly assigned to either the 180° nuclear flip group (n = 71) or the conventional endocapsular phacoemulsification group (n = 71). The primary outcomes measured were total phacoemulsification time (TPT) and effective phacoemulsification time (EPT). Secondary outcomes were the incidence of postoperative corneal endothelial cell loss (ECL) at 7 and 28 days, as well as intraoperative complications including posterior capsule rupture (PCR). The mean TPT was substantially shorter in the flip group (43.75 ± 17.16 s) compared to the conventional group (58.45 ± 22.27 s) (P < 0.0001). Similarly, the mean EPT was also significantly reduced in the flip group (11.08 ± 5.25 s vs. 14.87 ± 8.54 s, P = 0.0046). There were no PCR cases in the flip group, whereas there was one case (1.4%) in the traditional group. At 28 days postoperatively, the mean ECL rate of the flip group (3.7%) was lower than that of the conventional group (4.9%), although this difference did not reach statistical significance. The 180° nuclear flip technique is a safe, efficient, and effective method for managing cataracts of grade III hardness and below. It may help reduce the risk of complications, improves intraoperative stability by creating a more spacious operating field, and significantly reduces phacoemulsification time. Video available for this article. chictr.org.cn identifier, ChiCTR2500105241.

PMID 42463970
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