Discovery and development of direct thrombin inhibitors the binding site for the globular amino-terminal domain and exosite 1 is the binding site for the acidic carboxy-terminal domain of hirudin. Native hirudin, a 65-amino-acid polypeptide, is produced in the parapharyngeal glands of medicinal leeches. Hirudins today are produced by recombinant biotechnology using yeast. These recombinant hirudins lack a sulfate group at Tyr-63 and are therefore called desulfatohirudins. They have a 10-fold lower binding affinity to thrombin compared to native hirudin, but remain a highly specific inhibitor of thrombin and have an inhibition constant for thrombin in the picomolar range. Renal clearance and degradation account for the most part
Salivary microbiome useful alternative to stool as an indicator of bacterial dysbiosis in systemic disease." The sugar concentration in salivary secretions can vary. Blood sugar levels are reflected in salivary gland secretions. High salivary glucose (HSG) levels are a glucose concentration ≥ 1.0 mg/d, n = 175) and those with low salivary glucose (LSG) levels are < 0.1 mg/dL n = 2,537). Salivary gland secretions containing high levels of sugar change the oral microbiome and contributes to an environment that is conductive to the formation of dental caries and gingivitis. Organisms of the salivary microbiome reside in the three major salivary glands: