title: Selected parameters of fibrinolysis system in patients with dermatitis herpetiformis.
abstract: BACKGROUND
  Dermatitis herpetiformis (DH) is a very rare bullous dermatitis of autoimmune origin. It is a syndrome involving dermal and intestinal pathology, in which vesicopapular skin lesions are accompanied by gluten-dependent enteropathy. The diagnosis of DH is based on immunopathological investigation of unaffected skin bioptate (presence of granular IgA deposits in the upper portions of dermal papillae).
  
  
  METHODS
  The study was carried out in a group of 33 patients, including 23 males and 10 females aged 22-78 (mean age 44.7 years). The following fibrinolysis system parameters were determined in the sera of all patients: tissue plasminogen activator concentration (t-PA: Ag), urokinase plasminogen activator concentration (u-PA: Ag), plasminogen activator inhibitor concentration (PAI-Ag), plasminogen level, alpha-2 antiplasmin activity (alpha-2-AP), plasmin-- alpha-2 antiplasmin complexes concentration (PAP).
  
  
  RESULTS
  Mean t-PA concentration in DH patients was 5.52 ng/ml, vs. 4.8 ng/ml in controls. The respective u-PA concentrations amounted to 0.33 ng/ml, and 0.39 ng/ml. PAI-1 concentration was markedly higher in DH patients (36.2 ng/ml) than in controls (22.40 ng/ml), whereas plasminogen level was significantly lower (86.0% vs. 115.9%). In patients, alpha-2-AP activity was 92% and was lower than in controls -103.4%. DH patients demonstrated also higher concentrations of PAP complexes (327.45 ng/ml) than the control group (203.03 ng/ml).
  
  
  CONCLUSIONS
  Patients with DH were found to have lower plasminogen and alpha-2 antiplasmin levels and increased concentrations of PAP complexes, which indicates increased plasminogenesis in vivo. Increased type 1 plasminogen activator inhibitor level (PAI-1) may reflect a chronic inflammatory condition present in DH patients.
authors.affiliation: Department and Clinic of Dermatology, Medical University of Bydgoszcz, Bydgoszcz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Wankiewicz
authors.forename: Izabela
authors.initials: I
authors.lastname: Iwan-Zietek
authors.forename: Maria
authors.initials: M
authors.lastname: Kotschy
authors.forename: Zenon
authors.initials: Z
authors.lastname: Gwieździński
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases; D003874:Dermatitis Herpetiformis / Q000473:pathology*; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010958:Plasminogen / Q000096:biosynthesis; D015849:Plasminogen Inactivators / Q000097:blood; D012737:Sex Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood; D000979:alpha-2-Antiplasmin / Q000096:biosynthesis
chemical_list: D007070:Immunoglobulin A; D015849:Plasminogen Inactivators; D000979:alpha-2-Antiplasmin; D010958:Plasminogen; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator