INTRODUCTIO'NThrombin is the principal enzyme that acts in concert with other activated factors of the hemocoagulative system to regulate clot formation in response to vascular tissue clamage. Although cu.thrombin is highly specific toward fibrinogen as its natural substrate, its szruccurai homology to other serine proteases may preclude the development of specific and effective active-site directed inhibitors which could be useful to treat thrombotic disorders, Indeed a large number of synthetic or substratemrelated inhibitors have been reported [l], but most of them suffer from vaeious drawbacks such as low potency, poor selectivity or potential toxicity. The most potent inhibitor of Mthrombin known is hirudin [2,3], a '7 kDa family of isoproteins isolated from the glandular extracts of the leech Wirudo medicinalis. I-Iirudin forms a high affinity non-covalent stoichiometric complex with a-thrombin (Ki = 10'" to lo-*' M), but does not inhibit trypsin, kaltikrein or other hcmocoagulant swine proteases (41. It is now known that the high affinity is due to the multiple interactions of hirudin with cu-thrombin while the specificity stems from the interaction with at least one complementary binding site that is unique to CYthrombin [5,6]. This putative 'anion' exosite may also be required for fibrinogen binding. We have previously demonstrated that desulfohirudin'5'65 corresponding to the carboxyl termincrl fragment of recombinant hirudin variant 1 (r-HVl) can inhibit the amidolytic activity of human cr-thrombin towards synthetic substrates [7]. Although the inhibition by this native fragment was weak and the mechanism partially competitive compared to rhirudin, a modification of the NHZ-terminal residues by substituting D-Phe and Arg in positions 45 and 47 respectively, afforded an inhibitor with a Ki = 2.8 ZL 0.9 nM against human a-thrombin. The enhancement of enzyme affinity compared to the corresponding native fragment was attributed to favored interaction with the S1 and S3 subsites of the catalytic center while the G-terminal region comprising residues 55-65 could serve as an anchor that binds to the putative 'anion' exosite.tlbbreviu&ms: NOE, nuclear Qvsrhaussr enhancement; Boc-AOGO, SN-ten-butyloxycarbonyl-4-oxo-8.tosyl guanidinooctanoic acid; TFA, trifluoroacetic acid; AMC, 'I-amino-l-methyl coumarin; APTT, activated partial thromboplastin time In this communication, we report that this model was used to obtain a new class of reversible inhibitors prototyped by P49 (Pig. 1) with high enzyme affinity and whose in vitro plasma antithrombin activity approaches the level of r-hirudin despite the drastically reduced Published by Elsevier Science Publishers B. V.