Thrombin-activatable fibrinolysis

Although the fibrinolytic pathway is activated when thrombin binds to thrombomodulin, the thrombin-thrombomodulin complex, in addition to activating protein C (APC), activates a fibrinolysis inhibitor called the thrombin-activatable fibrinolysis inhibitor (TAFIa). Thus plasmin generation and, in turn, fibrinolysis are... 

In much the same way the number of interventions are possible at the level of fibrinolysis including thrombin-activateable fibrinolysis inhibitor, agents that block factor Xllla or inhibit plasminogen activator inhibitor therapy. 

Bouma, B. N, Meijers, J. C. (2003). Thrombin-activatable fibrinolysis inhibitor (TAFI, plasma procarboxypeptidase B, procarboxypeptidase R, procarboxypeptidase U). J. Thromb. Haemost., 1, 1566-1574. 

Nagashima, M., Werner, M., Wang, M., Zhao, L., Light, D. R., Pagila, R., Morser, J., Verhallen, P. (2000). An inhibitor of activated thrombin-activatable fibrinolysis inhibitor potentiates tissue-type plasminogen activator-induced thrombolysis in a rabbit jugular vein thrombolysis model. Thromb. Res., 98, 333-342. 

Bajzar L. Thrombin activatable fibrinolysis inhibitor and an antifibrinolytic pathway. Thrombosis Vascular Biol 2000 20( 12) 251 1-2518. 

Lau HK, Segev A, Hegele RA, et al. Thrombin-activatable fibrinolysis inhibitor (TAFI) a novel predictor of angiographic coronary restenosis, Thromb Haemost 2003 90(6) I 187-1 191. 

Alpha 2-antiplasmin and alpha 2-macroglobulin. These inactivate plasmin. Plasmin activity is also reduced by thrombin-activatable fibrinolysis inhibitor, which modifies fibrin to make a less potent co-factor for the t-PA-mediated plasminogen. 

In two patients with hemophilia with antibodies to both human and porcine factor VIII, continuous recombinant factor Vila resulted in hematuria (21). In neither case was a cause of the hematuria found. The author suggested that mucosal bleeds, such as hematuria, are characterized by high fibrinoljdic activity locally and may require higher peak concentrations of factor VII to generate sufficient thrombin to achieve and sustain hemostasis. The need for a full thrombin burst could relate to the role of thrombin in the activation of thrombin-activatable fibrinolysis inhibitor. 

Plasminogen/plasmin Tissue plasminogen activator (tPA)/urokinase a2-Antiplasmin Thrombin-activatable fibrinolysis inhibitor... 

Once thrombin binds to Tm, the complex cuts two unrelated plasma proteins, thrombin activatable fibrinolysis inhibitor (TA fibrinolysis inhibitor) and protein C, instead of fibrinogen, transglutaminase and factors Vm and V (Sect. 11.3.4). The thrombin-Tm activated (cleaved) TA fibrinolysis inhibitor is a carboxypeptidase that removes the C-terminal lysine residues. These residues are present in fibrin D-E region fragments (Fig. 11.10) following initial plasmin action, and their loss prevents a rapid acceleration of fibrinolysis (Sect. 11.4.2). 

S.S.A. An, 1. Suh, Binding of thrombin activatable fibrinolysis inhibitor (TAFl) to plasminogen may play a role in the fibrinolytic pathway. Bull. Korean Chem Soc. 29 (11) (2008) 2209. 

Fujimoto H, Gabazza EC, Hataji O, et al. Thrombin-activatable fibrinolysis inhibitor and protein C inhibitor in interstitial lung disease. Am J Respir Crit Care Med 2003 167 1687-1694. 

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