Weitz J I, Leslie B, Ginsberg J
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
J Clin Invest. 1991 Mar;87(3):1082-90. doi: 10.1172/JCI115069.
Despite its affinity for fibrin, tissue plasminogen activator (t-PA) administration causes systemic fibrinogenolysis. To investigate the mechanism, t-PA was incubated with plasma in the presence or absence of a fibrin clot, and the extent of fibrinogenolysis was determined by measuring B beta 1-42. In the presence of fibrin, there is a 21-fold increase in B beta 1-42 levels. The potentiation of fibrinogenolysis in the presence of fibrin is mediated by soluble fibrin degradation products because (a) the extent of t-PA induced fibrinogenolysis and clot lysis are directly related, (b) once clot lysis has been initiated, fibrinogenolysis continues even after the clot is removed, and (c) lysates of cross-linked fibrin clots potentiate t-PA-mediated fibrinogenolysis. Fibrin degradation products stimulate fibrinogenolysis by binding t-PA and plasminogen because approximately 70% of the labeled material in the clot lysates binds to both t-PA- and plasminogen-Sepharose, and only the bound fractions have potentiating activity. The binding site for t-PA and plasminogen is on the E domain because characterization of the potentiating fragments using gel filtration followed by PAGE and immunoblotting indicates that the major species is (DD)E complex, whereas minor components include high-molecular weight derivatives containing the (DD)E complex and fragment E. In contrast, D-dimer is the predominant species found in the fractions that do not bind to the adsorbants, and it has no potentiating activity. Thus, soluble products of t-PA-induced lysis of cross-linked fibrin potentiate t-PA-mediated fibrinogenolysis by providing a surface for t-PA and plasminogen binding thereby promoting plasmin generation. The occurrence of this phenomenon after therapeutic thrombolysis may explain the limited clot selectivity of t-PA.
尽管组织型纤溶酶原激活剂(t-PA)对纤维蛋白有亲和力,但给予t-PA会导致全身性纤维蛋白原溶解。为了研究其机制,将t-PA在有或无纤维蛋白凝块存在的情况下与血浆一起孵育,并通过测量Bβ1-42来确定纤维蛋白原溶解的程度。在有纤维蛋白存在的情况下,Bβ1-42水平增加了21倍。纤维蛋白存在时纤维蛋白原溶解的增强是由可溶性纤维蛋白降解产物介导的,因为(a)t-PA诱导的纤维蛋白原溶解程度和凝块溶解直接相关,(b)一旦开始凝块溶解,即使在凝块去除后纤维蛋白原溶解仍会继续,并且(c)交联纤维蛋白凝块的裂解物增强t-PA介导的纤维蛋白原溶解。纤维蛋白降解产物通过结合t-PA和纤溶酶原刺激纤维蛋白原溶解,因为凝块裂解物中约70%的标记物质与t-PA-琼脂糖和纤溶酶原-琼脂糖都结合,并且只有结合部分具有增强活性。t-PA和纤溶酶原的结合位点在E结构域,因为使用凝胶过滤随后进行PAGE和免疫印迹对增强片段进行表征表明主要成分是(DD)E复合物,而次要成分包括含有(DD)E复合物和片段E的高分子量衍生物。相比之下,D-二聚体是在不与吸附剂结合的部分中发现的主要成分,并且它没有增强活性。因此,t-PA诱导的交联纤维蛋白溶解的可溶性产物通过为t-PA和纤溶酶原结合提供表面从而促进纤溶酶生成来增强t-PA介导的纤维蛋白原溶解。治疗性溶栓后这种现象的发生可能解释了t-PA有限的凝块选择性。
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