Elevated plasma levels of α₂‐plasmin inhibitor–plasmin complex in patients with rheumatic diseases. Possible Role of Fibrinolytic Mechanism in Vasculitis

Abstract

Plasma levels of az-plasmin inhibitor (a2PI) and a,-plasmin inhibitor-plasmin complex (a2PlPC) were measured by sandwich enzyme-linked immunosorbent assay, using a recently developed monoclonal anti-a2PI antibody, in patients with collagen diseases. Twenty patients had systemic lupus erythematosus (SLE), 4 of whom also had vasculitis, 11 patients had rheumatoid arthritis (RA), 4 of whom also had vasculitis, and 5 patients had other types of vasculitis. There was no significant difference in azPl levels between the 3 patient groups and the control groups. However, plasma levels of a,PIPC in all 3 patient groups were significantly higher than those in the control group. Moreover, plasma concentrations of a2PIPC in SLE patients with vasculitis were statistically significantly higher than those in SLE patients without vasculitis. These concentrations were also higher in RA patients with vasculitis than in RA patients without vasculitis, although the difference was not statistically significant. Our findings indicate that measurement of plasma %PIPC levels is useful for detecting and evaluating the severity and activity of vasculitis in patients with collagen diseases.

Comparison of Textilinin-1 with Aprotinin as Serine Protease Inhibitors and as Antifibrinolytic Agents

“…Most plasmin-mediated effects such as cell invasion, chemotaxis, tissue remodelling, ovulation, migration of tumour and immune cells and wound healing are due to the proteolytic cleavage of extracellular proteins [29][30][31][32][33] . As plasmin is involved in these processes the therapeutic applications for plasmin inhibitors include treatment of the chronic infl ammatory diseases such as joint diseases [34,35] , in particular rheumatoid arthritis [36,37] , along with arteriosclerosis [38] and restriction of cell proliferation during cancer [39] .…”

Novel aspects and new roles for the serine protease plasmin

“…Moreover, monocytes from these patients exhibit increased uPAR expression that might indirectly contribute to the enhanced plasminogen activation detected on monocytes from patients with rheumatoid arthritis [36,37]. Indeed, patients also show an increase, although to a different extent, in the levels of plasmin-a 2 -antiplasmin complexes in synovial fluid as well as in plasma [38,39]. Increased plasmin production is not restricted solely to the pathological processes during rheumatoid joint diseases, but is also observed in other inflammatory joint diseases [39,40].…”

Studies on Changes in Parameters of the Coagulation and Fibrinolysis in Association with Extracorporeal Shock Wave Lithotripsy

“…1). Determination was performed with an enzyme immunoassay for TAT, PIC and D-D, and a latex agglutination test for FDP [8,9). The results were tested for statistical significance by the paired t test.…”

“…TAT is an inacti vated complex of thrombin, which is a coagulation factor, and its inhibitory factor antithrombin III [8]. It reflects precisely the condition of thrombin production so as to be useful for determination of acceleration of various coagu lation factors [9]. PIC is a complex of cb-plasmin inhibitor and plasmin.…”