Fibrinolytic Activity in Some Human Body Fluids

CNS fibrinolysis: a review of the literature with a pediatric emphasis

In vitro studies of cerebrospinal fluid indicate that normal cerebrospinal fluid contains very low levels of fibrinolytic enzymes but that fibrinolytic activity is higher in pathologic compared with normal conditions and in older compared with younger patients. Because of the low endogenous fibrinolytic activity of the central nervous system, intraventricular fibrinolytic therapy has been studied in adult and pediatric patients for the treatment of intraventricular hemorrhage/posthemorrhagic hydrocephalus and subarachnoid hemorrhage with secondary cerebral vasospasm. A review of the literature about endogenous and exogenous fibrinolysis studies of animals, adult humans, and pediatric humans reveals a record of predominant safety and efficacy. Although its use in the adult population for the treatment of subarachnoid hemorrhage with secondary vasospasm has become an accepted therapy in some centers, its use in the pediatric population is less common. It is no longer considered in the treatment of meningitis, but its role in the treatment of intraventricular hemorrhage/posthemorrhagic hydrocephalus is still being investigated.

Differentiation of proactivator from tissue plasminogen activator with low molecular weight in the paranasal mucous membrane

It has been shown that large amounts of fibrinolytic enzyme are contained in tissue extracts of the paranasal mucous membrane in patients with chronic sinusitis. However, the fibrinolytic enzyme in the tissue extracts has not yet been characterized by biochemical techniques. In the present study, proactivator was differentiated from tissue plasminogen activator with low molecular weight in extracts of the paranasal mucous membrane and the existence of the proactivator was thus demonstrated in tissue extracts. By analogy with the proactivator in antrochoanal polyps, this proactivator may play an important role in the proliferation and enlargement of the paranasal mucous membrane.

Fibrinolytic enzyme in tracheobronchial secretion of rats: existence of plasminogen activator

It is known that a plasminogen activator exists in the secretion of various organs, i.e., the existence of plasminogen activator in milk, tears, saliva, seminal fluids, urine and bile has been already demonstrated. However, the existence of the fibrinolytic enzyme in tracheobronchial secretions has not been known until this time. We found a new method to collect the tracheobronchial secretion of rats, and succeeded in detecting the fibrinolytic activity in the tracheobronchial secretions. Furthermore, it was found that the substance exhibiting the fibrinolytic activity in this secretion was not protease but plasminogen activator. In addition, some chemical properties of this plasminogen activator are presented, and the physiological and pathophysiological significances of it are discussed in this paper.

A protease-antiprotease system in antrochoanal polyp. I. Evidence for the existence of proactivator

Tissue extract of antrochoanal polyps showed a faint lysis area on standard fibrin plates, but streptokinase (SK)-added tissue extract showed a large lysis area. No fibrinolytic activity was observed on plasminogen-free fibrin plates. It is concluded, therefore, that the fibrinolytic activity observed after SK addition is indicative of the existence of SK-responsive protein proactivator. The tissue extract did not contain plasminogen or antiprotease against trypsin or papain. It was stable at neutral pH at 37 degrees C and stable at acid pH at 70 degrees C. The role of proactivator is discussed in relation to the growth or enlargement of antrochoanal polyps.

Coagulative and fibrinolytic properties of ascitic fluid associated with ovarian tumors

Ascitic fluid samples from 19 patients with ovarian carcinoma, 3 with a benign ovarian tumor, and 5 with cirrhosis of the liver were examined for their content of coagulation factors and components of the fibrinolytic system. The concentration of trypsin inhibitors in the ascitic fluid was significantly higher in the presence of carcinoma. Large amounts of FDP were found in the ascitic fluid in all patients with malignant tumors, but not in the other two groups. Determination of FDP may therefore make it possible to differentiate between malignant and nonmalignant ascitic fluid.

Coagulation abnormalities in subarachnoid hemorrhage

Coagulation and fibrinolytic studies were performed in 30 subarachnoid hemorrhage patients and 30 age-matched and sex-matched controls.

Systemic abnormalities were detected in the following tests: recalcification time, fibrinogen, partial thromboplastin time, K value of thromboelastogram and euglobulin lysis time.

The data suggest that subarachnoid hemorrhage patients with fibrinogen values over 400 mg% have a low probability of survival.

Test abnormalities probably reflect tissue damage and/or meningeal reaction to the subarachnoid hemorrhage. Similar abnormalities can be noted in patients with cerebral trauma and in some patients with nonhemorrhagic cerebrovascular disease. 1

Our data reveal that subarachnoid hemorrhage patients may exhibit simultaneously evidence suggesting increased coagulability and activation of fibrinolytic mechanisms. Under these circumstances administration of agents to suppress lytic activity might lead to disastrous consequences such as widespread intervascular coagulation (consumption coagulopathy).

Components of the fibrinolytic system in synovial joints. Normal bovine compared with normal and abnormal human synovial joints

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