Cited 18 times since 2007 (1 per year) source: EuropePMC Journal of thrombosis and haemostasis : JTH, Volume 6, Issue 1, 25 4 2007, Pages 151-157 Development of a new test for the global fibrinolytic capacity in whole blood. Rijken DC, Hoegee-de Nobel E, Jie AF, Atsma DE, Schalij MJ, Nieuwenhuizen W
Background
The development of global tests for the fibrinolytic capacity in blood is hampered by the low base-line fibrinolytic activity in blood, by the involvement of both plasmatic components and blood cells in the fibrinolytic system and by the loss of fibrinolytic activity as a result of the action of plasminogen activator inhibitor-1 (PAI-1).
Objective
To develop a new test for the global fibrinolytic capacity (GFC) of whole blood samples.
Methods and results
Collection of blood in thrombin increased the subsequent generation of fibrin degradation products. This was ascribed to rapid clot formation and concomitant reduction of in vitro neutralization of tissue-type plasminogen activator (tPA) by PAI-1. On the basis of this observation, the following test was designed: blood samples were collected in thrombin with and without aprotinin and clots were incubated for 3 h at 37 degrees C. The GFC was assessed from the difference between the fibrin degradation products in the two sera. The assay was applied to blood samples from patients and healthy subjects. Other hemostasis parameters were determined in plasma samples taken simultaneously. The GFC varied considerably (normal range 0.13-13.6 microg mL(-1)); physical exercise strongly increased the GFC. Statistically significant correlations were found with tPA activity, PAI-1 activity and fibrinogen level. A mixture of antibodies against tPA and urokinase-type plasminogen activator (uPA) completely inhibited the GFC. An inhibitor of activated thrombin-activatable fibrinolysis inhibitor (TAFI) accelerated fibrinolysis 8-fold.
Conclusion
The new test represents a global assessment of the main fibrinolytic factors in plasma and potentially those associated with blood cells.
