Heparin has been used extensively as an antithrombotic and anticoagulant for close to 100 years. This anticoagulant activity is attributed mainly to the pentasaccharide sequence, which potentiates the inhibitory action of antithrombin, a major inhibitor of the coagulation cascade. More recently it has been elucidated that heparin exhibits anti-inflammatory effect via interference of the formation of neutrophil extracellular traps and this may also contribute to heparin's antithrombotic activity. This illustrates that heparin interacts with a broad range of biomolecules, exerting both anticoagulant and nonanticoagulant actions. Since our previous review, there has been an increased interest in these nonanticoagulant effects of heparin, with the beneficial role in patients infected with SARS2-coronavirus a highly topical example. This article provides an update on our previous review with more recent developments and observations made for these novel uses of heparin and an overview of the development status of heparin-based drugs.

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肝素及相关药物的药理学：更新

近 100 年来，肝素已被广泛用作抗血栓形成剂和抗凝剂。这种抗凝活性主要归因于五糖序列，它增强了抗凝血酶的抑制作用，抗凝血酶是凝血级联反应的主要抑制剂。最近，已经阐明肝素通过干扰中性粒细胞胞外陷阱的形成而表现出抗炎作用，这也可能有助于肝素的抗血栓形成活性。这说明肝素与范围广泛的生物分子相互作用，发挥抗凝和非抗凝作用。自我们上次审查以来，人们对肝素的这些非抗凝作用越来越感兴趣，其中对感染 SARS2 冠状病毒的患者的有益作用是一个高度热门的例子。