Structural Requirements of Carbohydrate Based Heparin Alternatives

A carbohydrate-based antithrombotic drug with a reduced risk of inducing HIT antigen(s) should meet the following criteria (Greinacher et al., 1995):

The molecule should not be branched to reduce its flexibility and to minimize charge clusters.

Its DS should be lower than 1.0 per monosaccharide, if its chain length exceeds 10 monosaccharides.

Its MW should be lower than 2.4 kDa (about seven monosaccharides), if its DS is higher than 1.0.

If the MW is higher than 2.4 kDa and the DS higher than 1.0, then at least the therapeutic concentration must be lower than that exhibiting cross-reactivity with HIT antibodies.

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