Drug Database
ST

streptokinase (Heberkinase)

✓ Approved

YM BioSciences Inc. · PLG · Recombinant Proteins

What is streptokinase?

streptokinase is a recombinant proteins developed by YM BioSciences Inc.. It is approved for therapeutic indications via injectable (others) or intravenous (iv).

Drug Profile

Brand NamesHeberkinase
CompanyYM BioSciences Inc.
Drug ClassRecombinant Proteins
Molecular TargetPLG
RouteInjectable (Others), Intravenous (IV)
StatusApproved
Sources: ClinicalTrials.gov, YM BioSciences Inc.

Mechanism of Action

Molecular Targets

streptokinase acts on 1 molecular target:

PLGplasminogen (HAE4)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

streptokinase is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Cardiac disordersMyocardial infarction✓ Approved

Related Research Articles

PubMedBMC cardiovascular disorders2026-07-15

Recurrent bilateral lower limb arterial embolism secondary to left ventricular thrombus in peripartum cardiomyopathy successfully treated with systemic streptokinase thrombolysis: a rare case report.

Ibrahim Raghad R, Alharbi Mohamad M, Hossin Huda H, Ibrahim Rahaf R et al.

Peripartum cardiomyopathy (PPCM) is an uncommon but potentially life-threatening form of heart failure occurring toward the end of pregnancy or during the months following delivery in women without pre-existing heart disease. Left ventricular systolic dysfunction predisposes patients to intracardiac thrombus formation and systemic thromboembolic complications, which are associated with significant morbidity and mortality. A 35-year-old multiparous woman presented shortly after spontaneous vaginal delivery of an intrauterine fetal demise with acute right lower-limb ischemia and heart failure. Transthoracic echocardiography demonstrated severe left ventricular systolic dysfunction (LVEF approximately 35%), severe functional mitral regurgitation, pulmonary hypertension, and a large left ventricular thrombus. She underwent urgent Fogarty embolectomy followed by therapeutic anticoagulation with unfractionated heparin and warfarin. Despite therapeutic anticoagulation (INR 2.0 and activated partial thromboplastin time approximately 90 seconds), she developed recurrent bilateral acute lower-limb ischemia five days later. Because of profound hemodynamic instability and prohibitive surgical risk, systemic streptokinase thrombolysis was administered. Repeat echocardiography performed immediately after thrombolysis demonstrated complete resolution of the left ventricular thrombus. Follow-up echocardiography one week later showed significant recovery of left ventricular systolic function (LVEF 45-50%), improvement of mitral regurgitation to mild-to-moderate, and reduction in pulmonary artery systolic pressure. This case highlights the importance of early recognition of thromboembolic complications in PPCM and demonstrates that systemic streptokinase thrombolysis may represent an effective life- and limb-saving therapeutic option in carefully selected patients when surgical or catheter-based interventions are not feasible.

PMID 42449265
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PubMedInternational journal of emergency medicine2026-07-12

Extensive coronary thrombosis following cannabis use in a young adult: a case report.

Saha Rupendra Nath RN, Duggal Bhanu B, Chawla Raghuraj R, Swain Akash A et al.

Cannabis use has been increasingly associated with acute coronary syndromes in young adults without conventional cardiovascular risk factors. The psychoactive compound Δ⁹-tetrahydrocannabinol (THC) exerts sympathomimetic, endothelial, and prothrombotic effects that may precipitate myocardial infarction through platelet activation and vasospasm. A 34-year-old man, a chronic cannabis user, presented with acute anterior ST-segment elevation myocardial infarction. Coronary angiography demonstrated a large thrombus involving the left main and proximal left anterior descending arteries, with complete mid-LAD occlusion (TIMI 0). In view of the extensive thrombus burden, 300,000 International units of intracoronary streptokinase followed by 1,200,000 IU intravenously was administered, resulting in significant thrombus resolution and restoration of TIMI II flow. The patient recovered uneventfully on dual antiplatelet therapy, statin, and anticoagulation. Cannabis associated thrombosis may involve multiple interrelated mechanisms: (i) catecholamine surge with tachycardia and vasospasm, (ii) endothelial dysfunction, and (iii) direct platelet activation via CB₁ and CB₂ receptors leading to increased thromboxane A₂ and P-selectin expression. This case illustrates a possible association between chronic cannabis exposure and large-vessel thrombosis in the absence of significant angiographic atherosclerosis. Intracoronary fibrinolysis may be considered in selected cases with prohibitive thrombus load where primary PCI is unsafe. This case underscores the prothrombotic potential of cannabis and highlights the need to recognize its cardiovascular risks. Understanding the cannabinoid-platelet-vascular axis may help prevent and manage cannabis-related coronary events. Not applicable as not a clinical trial.

PMID 42436387
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PubMedEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026-07-08

Streptococcal toxic shock syndrome caused by ST525 Streptococcus dysgalactiae subsp. equisimilis with genomic characterization of virulence and antimicrobial resistance.

Tsuji Shuma S, Fukushima Shinnosuke S, Gotoh Kazuyoshi K, Iio Koji K et al.

Streptococcus dysgalactiae subsp. equisimilis (SDSE) is an emerging cause of severe invasive infections. We describe the clinical course of an immunocompromised patient with advanced breast cancer who developed streptococcal toxic shock syndrome, necrotizing fasciitis, and disseminated intramuscular abscesses caused by a multidrug-resistant Lancefield group G SDSE isolate, alongside a comprehensive genomic characterization of its virulence and antimicrobial resistance profiles. Genomic analysis identified the isolate as emm subtype stG840.0 and sequence type 525 (ST525), harboring genes encoding several virulence-associated factors, including an emm-like gene encoding an M-like surface protein, streptokinase, streptolysin O, streptolysin S, and SpeG. Through comprehensive genomic analysis of the highly virulent SDSE isolate, we provided insights into its underlying genetic background. Further accumulation of genomic data is expected to fully elucidate the mechanisms of virulence and antimicrobial resistance in SDSE.

PMID 42418061
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PubMedJACC. Case reports2026-06-18

Kounis Syndrome Triggered by Hymenoptera Stings and Exacerbated by Streptokinase.

Chai Siew Yap SY, Liew Kai Soon KS, Soh Kok Ming KM, Subramanian Seetha Devi SD et al.

Kounis syndrome (KS) is an allergy-mediated acute coronary syndrome that is frequently under-recognized and potentially life threatening. A 52-year-old man developed an inferior ST-segment elevation myocardial infarction following a bee swarm attack. Standard thrombolysis with streptokinase triggered severe hemodynamic collapse and systemic hemorrhage. Upon recognizing KS, management was shifted to steroids and antihistamines, leading to complete recovery. Recurrence was documented 8 years later following an ant bite. This case illustrates how standard acute coronary syndromes treatments, such as antigenic thrombolytics, can inadvertently exacerbate the allergic cascade in KS. It highlights the need to maintain a high index of suspicion when cardiac symptoms follow an allergic trigger. Avoid antigenic thrombolytics when KS is suspected to prevent iatrogenic clinical deterioration. Primary percutaneous coronary intervention and early allergy management are the preferred clinical strategies.

PMID 42313027
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PubMedArchives of microbiology2026-06-06

Mechanisms underlying pyogenic bacterial infections of the skin.

Huang Can C, Yan Xueqin X, Xu Xiangxiang X, Yang Yaru Y et al.

Pyogenic skin infections are commonly caused by Staphylococcus aureus (SA), Streptococcus pyogenes (GAS), and Pseudomonas aeruginosa (PA). Although these pathogens differ markedly in phylogeny, cell structure, and ecological adaptation, they converge on a coordinated pathogenic cascade encompassing adhesion, invasion, immune evasion, remodeling of the suppurative microenvironment, and nutrient acquisition. This review systematically compares the common pathological mechanisms underlying SA, GAS, and PA, while also delineating pathogen-specific virulence strategies of SA, GAS, and PA across key stages of infection, with representative molecular determinants including surface adhesins and coagulase in SA, M protein and streptokinase in GAS, and type IV pili and the Psl exopolysaccharide in PA. Particular focus is placed on how these bacteria evade complement- and phagocyte-mediated clearance, disrupt neutrophil function, remodel neutrophil extracellular traps (NETs) dynamics, alter coagulation-fibrinolysis balance, adapt to hypoxic lesions, and compete for restricted host nutrients. Although the three pathogens converge on pyogenic lesion formation as a shared pathological endpoint, they elicit distinct histopathological and clinical lesion phenotypes, including localized abscesses, rapidly progressive necrotizing soft-tissue infections, and chronic non-healing exudative wounds. These similarities and differences indicate that suppuration is not merely the endpoint of inflammation, but a dynamic pathogenic microenvironment jointly shaped by bacterial virulence and host responses. A clearer understanding of these common pathological axes and pathogen-specific differences provides a theoretical basis and new perspectives for the development of antibacterial and host-directed therapeutic strategies in pyogenic skin infections.

PMID 42249917
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PubMedJACC. Case reports2026-06-03

4D TEE-Guided Thrombolysis for Mechanical Mitral Valve Obstruction.

Tulsidas Gitte Pramod P, Khedkar Umesh U, Kharche Milind M

To describe, step by step, how 4-dimensional transesophageal echocardiography (4D TEE) can differentiate thrombus-predominant mechanical mitral valve obstruction from pannus and thereby guide urgent thrombolytic therapy. A 24-year-old man with a 25-mm mechanical mitral prosthesis presented with NYHA functional class III dyspnea, pulmonary congestion, and a subtherapeutic international normalized ratio of 1.2. Transthoracic echocardiography showed markedly elevated transmitral gradients, and cine-fluoroscopy demonstrated restricted single-leaflet motion. TEE confirmed prosthetic obstruction, whereas 4D TEE provided the decisive mechanistic information by showing a large mobile thrombus with coexisting left ventricular-side pannus, indicating thrombus-predominant obstruction. Streptokinase thrombolysis restored bileaflet mobility and reduced transprosthetic gradients markedly. Elevated prosthetic gradients and restricted leaflet motion confirm obstruction but do not reliably distinguish thrombus from pannus. Mixed pathology may be missed if multimodality imaging is not performed. In mechanical mitral valve obstruction, 4D TEE can define the dominant mechanism of obstruction, guide selection of thrombolysis vs surgery, and document treatment success.

PMID 42233911
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