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Ecallantide is a potent, selective, and reversible recombinant protein inhibitor of plasma kallikrein. It is indicated for the treatment of acute attacks of hereditary angioedema (HAE) in patients 12 years and older. Ecallantide works by binding to plasma kallikrein and blocking its activity, thereby inhibiting the conversion of high molecular weight kininogen to bradykinin—a key mediator in HAE attacks. The drug is produced using recombinant DNA technology in Pichia pastoris yeast cells and consists of a 60-amino-acid sequence with three intramolecular disulfide bonds. Ecallantide was developed using phage display technology and shares some sequence similarity with tissue-factor pathway inhibitor (TFPI). It does not cure HAE but provides symptomatic relief during acute episodes[1][2][4][6].
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