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Query: EC:3.4.21.68 (
tissue plasminogen activator
)
11,311
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We determined during the acute stage of myocardial infarction selected fibrinolysis variables (
tissue-type plasminogen activator
, intrinsic plasminogen activators,
tissue-type plasminogen activator
inhibition, C1-inactivator) and related the observed changes to changes in two acute phase reactants (C-reactive protein, fibrinogen). Acute myocardial injury induce significant increases in blood of
tissue-type plasminogen activator
inhibition (day one, p less than 0.05), C-reactive protein (day three, p less than 0.01), fibrinogen (day six, p less than 0.01), and C1-inactivator (day eight, p less than 0.01). Tissue-type plasminogen activator activity measured as C1-inactivator resistant fibrinolytic activity showed a minimum day two after the acute attack (p less than 0.01), whereas plasminogen activator activities arising from the intrinsic system of fibrinolysis remained constant. The observed changes did not parallel the occurrence of
deep vein thrombosis
indicated by a positive Tc-plasmin test (41% of the patients).
...
PMID:Depression of tissue plasminogen activator (t-PA) activity and rise of t-PA inhibition and acute phase reactants in blood of patients with acute myocardial infarction (AMI). 244 88
In about 50% of the cases of spontaneous
deep vein thrombosis
a congenital deficiency of an inhibitor of coagulation or an insufficient fibrinolytic mechanism can be detected. In arterial thromboembolism a connection with hyperactive platelets or with a diminished availability of
tissue plasminogen activator
can be found in about 70%. However, in these cases the defect which provokes thrombosis is mostly acquired and is connected with hyperlipidemia and/or with atherosclerotic alterations of the vessel wall. A study on patients with thromboembolic tendency and detectable risk factors was carried out. A total of 470 patients could be observed for 2 years under an adequate antithrombotic prophylaxis. The occurrence of thromboembolic episodes 2 years prior to prophylaxis and 2 years under prophylaxis was compared. In venous cases thrombosis could be controlled almost completely by coumarins when the underlying cause was a deficient plasmatic inhibitor. In patients with diminished fibrinolysis there was only a partial effect of oral anticoagulants. A better result could be obtained when pentosan polysulfate was administered. In arterial thromboembolism the results of prophylaxis were less convincing. The efficacy of ASA in patients with an increased platelet function was only moderate. In addition, ASA hat to be discontinued in about 20% of the patients because of gastrointestinal problems. Pentosan polysulfate in patients with a diminished fibrinolytic capacity had a fairly good effect and resulted in a 60% reduction of thromboembolic manifestations. It is shown that an exact diagnosis of the underlying deficiency which is likely to cause thrombosis can also improve the efficacy and the specificity of prophylaxis.
...
PMID:Antithrombotic therapy in patients with known risk factors for thromboembolism. 248 12
We report a 45-year-old female patient with recurrent spontaneous
deep vein thrombosis
associated with an isolated hypoplasminogenemia (plasminogen activity and antigen level of 42% and 37%, respectively). The plasminogen molecule was normal as demonstrated by a normal activation by
tissue plasminogen activator
, electrophoretic mobility on crossed immunoelectrophoresis, molecular weight, and binding to lysine sepharose. All other hemostatic parameters predisposing to recurrent thrombosis were normal. A stimulation test with desmopressin acetate (DDAVP) showed a normal plasma rise of both
tissue plasminogen activator
and factor VIIIR:WF. This isolated plasminogen deficiency apparently is due to a decreased synthesis of a normal plasminogen molecule and is associated with a severe thrombotic tendency.
...
PMID:Severe thrombotic tendency associated with a type I plasminogen deficiency. 249 30
Nine patients with, and 11 without, venous thromboses (
DVT
) from two families were studied. In family 1, four members with, and one without,
DVT
had
t-PA
activity below the lower limit of the controls (21.3 IU/ml, n = 19) after 20 min venous occlusion (VO). After VO
t-PA
antigen (
t-PA
:Ag) was below the lowest value of the controls (22.8 ng/ml) in all five cases with low
t-PA
activity. All the family members, both with and without thrombosis, had normal
t-PA
inhibitor activities (PAI). In family 2
t-PA
activity after VO was low in three symptomatic and four asymptomatic family members.
t-PA
:Ag was also low in four of these. PAI level was normal in all but one family member. Mild type I von Willebrand's disease was discovered in four members of family 2. Deficient
t-PA
:Ag response was found in two of these. Antithrombin III, protein C and protein S were normal in both families. It is concluded that low fibrinolytic capacity, independent of PAI, is associated with familial
DVT
. Our data suggests autosomal dominant inheritance.
...
PMID:Familial hypofibrinolysis and venous thrombosis. 249 18
A previously described bioimmunoassay for
tissue-type plasminogen activator
(t-PA) has been modified in terms of antibody concentration and conditions of incubation to achieve a sensitivity range of approximately 5-500 IU/L of t-PA. A similar assay has been developed for urinary-type plasminogen activator (U-PA), also known as urokinase (UK), achieving a sensitivity range of approximately 5-500 X 10(-1) IU/L. The direct sensitive t-PA assay has been demonstrated to be a quantitative alternative to the traditional semiquantitative euglobulin clot lysis time (ECLT) assay, with correlation coefficients of 0.967 and 0.914, depending on the laboratory where the ECLT was carried out. This assay has the added advantages of avoiding loss of t-PA or UK during the formation of the euglobulin fraction and of calibration in terms of International Standards for both t-PA and UK. With both these assays, it has been demonstrated that the enhanced fibrinolytic activity observed after exercise results from increased levels of t-PA while the level of UK in plasma remains unaltered. Free t-PA (10-60 IU/L) has been demonstrated in resting plasma, whereas the level of free UK activity was 50-100 IU/L. Venous occlusion of matched groups of subjects with and without
deep venous thrombosis
(
DVT
) showed a wide variation of response in t-PA levels in each group and no change in UK levels. There was no difference between the
DVT
and non-
DVT
groups, and this suggests that the notion of the "nonresponder" being more prone to thrombosis needs to be reexamined.
...
PMID:Sensitive and direct assays for functionally active plasminogen activators (tissue-type and urokinase-type) in plasma. 250 7
Pulmonary embolism can produce severe cardiopulmonary dysfunction characterized by pulmonary artery hypertension, right ventricular failure, and hypoxemia. The search for the source of a pulmonary embolus, by exploration of the veins of the lower limbs and the inferior vena cava should be systematically carried out in all cases of pulmonary embolus which are not immediately life-threatening to the patient. The treatment of
deep vein thrombosis
associated with pulmonary embolism with thrombolytic agents has been proposed and utilized for approximately 20 years. Although superior results have been claimed with thrombolytic agents, the use of this type of treatment remains limited to massive or sub-massive pulmonary embolism. Fibrinolytic agents with high specificity for fibrin in the thrombi and little systemic activation of the fibrinolytic system have been developed and tested in preliminary clinical trials of patients with acute pulmonary embolism. The largest published experience available has been with recombinant
tissue plasminogen activator
(rtPA). The acylated streptokinase-plasminogen complex (APSAC) and pro-urokinase also gave promising results. All these agents were accompanied by unexpectedly high incidence of systemic activation of the fibrinolytic system and by hemorrhagic complications with frequencies similar to those that follows the use of first generation products (urokinase and streptokinase). Hence, their superior clinical efficacy must be clearly proven before they are substituted for a more widely available and less expensive drug, such as streptokinase.
...
PMID:Pathogenesis and management of acute pulmonary embolism. 251 49
The plasma concentrations of tissue plasminogen activator (t-PA) antigen, cortisol, testosterone, dehydroepiandrosterone sulphate, FSH and LH were studied in 33 men undergoing major abdominal surgery. Significant positive correlation was found between the concentrations of
t-PA
antigen and cortisol, suggesting that the adrenal cortex has a role in the regulation of extrinsic fibrinolysis. These two variables, however, did not distinguish between patients with postoperative
deep vein thrombosis
(diagnosed by 125I-fibrinogen uptake test) and those without this complication. Such distinction was possible, however, with another steroid hormone of the adrenal cortex, dehydroepiandrosterone sulphate. At present, no explanation in terms of haemostatic mechanisms can be offered for this finding.
...
PMID:Relationships between tissue plasminogen activator, steroid hormones and deep vein thrombosis. 293 51
Using affinity chromatography on lysine Sepharose 4B, a fast-acting
tissue plasminogen activator
inhibitor (t-PAI) was partially purified from t-PAI-rich plasma from patients with recurrent
DVT
. Its inhibition of tissue plasminogen activator (t-PA) was demonstrated in functional assays and its reaction with 125I-
t-PA
was analyzed by autoradiography following SDS-PAGE (sodium dodecyl sulfate polyacrylamide gel electrophoresis). When the t-PAI was mixed with an equimolar concentration of
t-PA
at 37 degrees C, the half-life of free one-chain and two-chain 125I-
t-PA
was 1.8 and 0.8 min, respectively. The rate of complex formation between 125I-
t-PA
and t-PAI was similar both in patient plasma, pregnancy plasma and platelet lysates made from platelet-rich normal, patient and pregnancy plasma. The molecular weights of the complexes between
t-PA
and the inhibitors in patient plasma and in the different platelet lysates were identical, while that of the inhibitor complex formed in pregnancy plasma was found slightly higher by SDS-PAGE indicating that the pregnancy plasma t-PAI differs from the fast-acting t-PAI found in plasma from thrombotic patients and in platelet lysates.
...
PMID:Plasminogen activator inhibitors in plasma and platelets from patients with recurrent venous thrombosis and pregnant women. 308 15
Euglobulin lysis time (ELT),
tissue plasminogen activator
(
tPA
), and the fast-acting inhibitor of
tPA
, were measured pre-operatively in 128 patients who underwent elective major abdominal surgery.
Deep venous thrombosis
(
DVT
) was detected by 125I-labelled fibrinogen scan in 37 patients (29 per cent) after operation. Pre-operatively, there was diminished euglobulin lysis activity (332 +/- 197 versus 255 +/- 156 min, mean +/- s.d.; P less than 0.025), and
tissue plasminogen activator
activity (4.2 +/- 9.9 versus 7.7 +/- 14.3 milliunits/ml, mean +/- s.d.; P = 0.094) in patients who subsequently developed postoperative
DVT
compared with those who did not. There was no significant difference between the two groups in the level of inhibition of
tissue plasminogen activator
(160.6 +/- 75.4 per cent versus 152.5 +/- 77.5 per cent, mean +/- s.d.; n = 47). Stepwise logistic discriminant analysis of the data obtained preoperatively showed that
tissue plasminogen activator
, a more specific measure of fibrinolytic activity, was a weaker predictor of
DVT
than euglobulin lysis time. The results confirm other observations which indicate that lowered fibrinolytic activity is a risk factor for postoperative
DVT
. In addition, they suggest that this is not due entirely to low levels of activity of
tissue plasminogen activator
in plasma.
...
PMID:Indicators of depressed fibrinolytic activity in pre-operative prediction of deep venous thrombosis. 310 52
The fibrinolytic system was investigated in 120 patients with spontaneous or recurrent
deep vein thrombosis
(
DVT
) without any known organic disease able to explain by itself the occurrence of a thrombosis and without any known defect of antithrombin III, Heparin Cofactor II, Protein C, or Protein S. The assays included: Euglobulin fibrinolytic activity (EFA),
tissue-type plasminogen activator
related antigen (t-PA-Ag) and plasminogen activator inhibitor activity (PA inhibitor), which were measured before and after 10 min of venous occlusion (V.O.). On the basis of the results, the patients could be classified in 3 groups: good responders with an at least two-fold increase of EFA after venous occlusion (n = 76), poor responders with a lesser increase of EFA due to deficient release of
t-PA
(n = 12), and poor responders with a normal
t-PA
release but an increased level of PA-Inhibitor (n = 32). The poor responders due to deficient
t-PA
release (10% of total) had a higher incidence of recurrence of
deep vein thrombosis
, than the other groups (p less than 0.01). An overall correlation was found between the level of PA-Inhibitor activity and the triglyceride level (r = 0.40, p less than 0.01), suggesting that these elevations may be due to a common cause, at least in some of the patients. It is concluded that a poor fibrinolytic response to venous occlusion occurs in 35 percent of
DVT
patients.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Deficient t-PA release and elevated PA inhibitor levels in patients with spontaneous or recurrent deep venous thrombosis. 310 59
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