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rNIF-Hirulog (NY-101) is a recombinant fusion protein developed by Shandong New Era Pharmaceutical (a subsidiary of Lunan Pharmaceutical Group) for the treatment of acute ischemic stroke. This bifunctional molecule combines a recombinant neutrophil inhibitory factor (rNIF) with bivalirudin (Hirulog). The rNIF component, originally derived from the hookworm *Ancylostoma caninum*, is a potent antagonist of the Mac-1 integrin (CD11b/CD18), which prevents neutrophil adhesion to the vascular endothelium and reduces inflammatory tissue damage. The bivalirudin component is a direct thrombin inhibitor that provides anticoagulant activity by binding to both the active site and exosite I of thrombin. By simultaneously inhibiting neutrophil-mediated inflammation and thrombin-mediated thrombosis, rNIF-Hirulog aims to reduce ischemia-reperfusion injury and improve clinical outcomes in stroke patients. The drug has progressed to Phase 2 clinical trials in China.
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