Plasminogen Activator Inhibitor-2 and Alpha-Fetoprotein in Various Liver Disease States

SummaryThis paper is an attempt to assess the relevance of the inhibitors of fibrinolysis for clot lysis in selected disease states and to discuss the mechanisms leading to acquired abnormal levels of such inhibitors. When compared to 20 control subjects the 30 hypertriglyceridemic patients (14 with type IIb and 16 with type IV) displayed significantly (p <0.001) increased plasma plasminogen activator inhibitor (PAI) activity (221 ± 88% and 290 ± 104% respectively; mean ± SD), moderately (p <0.01) increased α2 antiplasmin (α2AP) level (112 ± 11% and 115 ± 16%) and accordingly an obviously prolonged dilute blood clot lysis time (DBCLT). Neither PAI activity and α2AP level nor DBCLT were significantly different from controls in the 10 patients with hyperlipoproteinemia type IIa. The 18 patients with severe hepatic cirrhosis had low α2AP level (59 ± 19.7%) and accelerated clot lysis, while mean PAI activity (160 ± 87%) was slightly (p <0.05) increased. In the 17 nephrotic patients α2AP was increased (115 ±12%) while PAI activity was similar to controls and DBCLT rather shorter. Two liver secretion enzymes, namely serum Cholinesterase and plasma protein C, were found to be decreased in cirrhotic patients, similar to control values in hyperlipoproteinemia type Ha and obviously increased in nephrotic patients as well as in hypertriglyceridemic subjects. The relevance of PAI and α2AP for clot lysis was considered in relation to data in the literature concerning the behaviour of t-PA and factor XIII. Enhanced hepatic synthesis of protease inhibitors and factor XIII as a possible cause of delayed clot lysis in hypertriglyceridemia was envisaged.

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Behaviour of tissue plasminogen activator, plasminogen activator inhibitor 1 and their complex in various disease states

Blood Coagulation & Fibrinolysis ◽

10.1097/00001721-199208000-00005 ◽

1992 ◽

Vol 3 (4) ◽

pp. 389-393 ◽

Cited By ~ 4

Author(s):

H. Niwano ◽

H. Takahashi ◽

W. Tatewaki ◽

K. Wada ◽

Y. Seki ◽

...

Keyword(s):

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Plasminogen Activator Inhibitor ◽

Plasminogen Activator Inhibitor 1 ◽

Disease States ◽

Tissue Plasminogen ◽

Activator Inhibitor

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Plasminogen Activator Inhibitor 1 and Plasminogen Activator Inhibitor 2 in Various Disease States

Thrombosis and Haemostasis ◽

10.1055/s-0038-1642556 ◽

1988 ◽

Vol 59 (01) ◽

pp. 007-012 ◽

Cited By ~ 124

Author(s):

Egbert K O Kruithof ◽

Annelise Gudinchet ◽

Fedor Bachmann

Keyword(s):

Plasminogen Activator ◽

Extracorporeal Circulation ◽

Malignant Tumors ◽

Plasminogen Activator Inhibitor ◽

Acute Phase Reactant ◽

Postoperative Phase ◽

Plasminogen Activator Inhibitor 1 ◽

Disease States ◽

Activator Inhibitor ◽

Pai 1

SummaryThe association of increased PA-inhibitor (PAI) activity and of PAI-1 and PAI-2 antigen levels with different pathological conditions was studied in a collective of over 300 patients. PAI-1 and PAI-2 levels were measured by specific radioimmunoassays. A good correlation was observed of PAI activity with PAI-1 antigen (r = 0.718; p <0.0001) but not with PAI-2 (r = 0.070; n.s.). Both in the controls and in the patients, PAI activity and PAI-1 antigen showed an extremely large range of values. PAI activity ranged from 0.5 to 68 U/ml and PAI-1 antigen from 6 to 600 ng/ml. Increased PAI activity and PAI-1 antigen was observed in patients with malignant tumors, cardiovascular or thromboembolic disease, in the postoperative phase, with hepatic insufficiency, after trauma and after extracorporeal circulation. The large spectrum of disease states with increased PAI activity and PAI-1 antigen reinforces previous suggestions that PAI-1 is an acute phase reactant. After extracorporeal circulation, PAI activity and PAI-1 concentrations strongly increased within one hour, remained elevated for at least one week and returned to preoperation values within 7 days.PAI-2 values ranged from below detection limit (15 ng/ml), observed in half of the plasmas, to 485 ng/ml in a pregnant woman. High values of PAI-2 were only observed in pregnancy.

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