Thrombin-activatable fibrinolysis inhibitor deficiency in cirrhosis is not associated with increased plasma fibrinolysis.

Abstract

BACKGROUND AND AIMS:

The bleeding tendency of patients suffering from cirrhosis is in part ascribed to accelerated fibrinolysis. In this study, the role of the recently discovered inhibitor of fibrinolysis, thrombin-activatable fibrinolysis inhibitor (TAFI) in cirrhosis was examined.

METHODS:

In 64 patients with cirrhosis of varying severity, TAFI antigen levels were measured by enzyme-linked immunosorbent assay and compared with TAFI levels in control subjects. Furthermore, a plasma-based fibrinolysis assay was performed in the presence and absence of a specific inhibitor of activated TAFI.

RESULTS:

TAFI levels were decreased in cirrhosis. Mean TAFI levels were 66% in Child's A, 55% in Child's B, 47% in Child's C cirrhosis, and 26% in acute liver failure. Decreased TAFI antigen levels were highly correlated with antithrombin and alpha(2)-antiplasmin activity levels. Clot lysis times and clot lysis ratio (defined as ratio between clot lysis time in the absence and presence of a specific inhibitor of activated TAFI) of cirrhotics were not significantly different from healthy controls.

CONCLUSIONS:

Despite decreased levels of TAFI and other components of the fibrinolytic system, no evidence of increased plasma fibrinolytic potential in cirrhosis is observed using the plasma-based assay of this study. The reduction of antifibrinolytic factors in cirrhosis is compensated by the concomitant reduction in profibrinolytics.

• Authors: T Lisman, F W Leebeek, L O Mosnier, B N Bouma, J C Meijers, H L Janssen, H K Nieuwenhuis, P G De Groot
• Journal: Gastroenterology (Gastroenterology) Vol. 121 Issue 1 Pg. 131-9 (Jul 2001) ISSN: 0016-5085 [Print] United States
• PMID: 11438502 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens
• Antithrombins
• Fibrin Fibrinogen Degradation Products
• fibrin fragment D
• Carboxypeptidases
• Carboxypeptidase B2

Topics

• Antigens (blood)
• Antithrombins (metabolism, pharmacology)
• Blood Coagulation (drug effects)
• Carboxypeptidase B2
• Carboxypeptidases (deficiency, pharmacology)
• Fibrin Fibrinogen Degradation Products (metabolism)
• Fibrinolysis (drug effects)
• Humans
• Liver Cirrhosis (blood, classification, immunology)
• Time Factors