title: Monitoring of functional plasminogen in the blood of patients on fibrinolytics.
abstract: There are no reliable data on functional plasminogen in the blood of patients receiving fibrinolytic treatment. Here, artifactual in vitro changes of functional plasminogen were prevented by arginine stabilization blood samples of myocardial infarction patients: 12 received 36.4 mg reteplase in bolus, and 1 patient received 100 mg tissue plasminogen activator in continuous infusion. Arginine (1.5 M, 1.3 mL, pH 8.7) was used to stabilize 2.6 mL ethylenediaminetetraacetic acid-blood. The arginine-stabilized plasma was analyzed with a functional oxidative assay for plasminogen. Functional plasminogen decreased within 2 minutes of reteplase treatment by about 40% and by about 80% after 60 minutes. Lowest plasminogen concentrations were found in plasmas with highest plasmin activities. Chloramine oxidation of purified Glu-plasminogen increased its activation by urokinase up to 3-fold. Arginine stabilization allows reliable determinations of functional plasminogen in the blood of patients receiving fibrinolytics, enabling the rapid diagnosis of prothrombotic plasminogen consumption. The present findings support the profibrinolytic action of chloramines.
authors.affiliation: Department of Laboratory Medicine, Hospital of Philipps-University, Marburg, Germany. thstief@med.uni-marburg.de
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Stief
authors.forename: Anette
authors.initials: A
authors.lastname: Richter
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
authors.forename: Harald
authors.initials: H
authors.lastname: Renz
mesh_terms: D001120:Arginine; D015415:Biomarkers / Q000097:blood; D001800:Blood Specimen Collection; D002700:Chloramines; D016903:Drug Monitoring / Q000379:methods*; D005341:Fibrinolysin / Q000378:metabolism; D005342:Fibrinolysis / Q000187:drug effects*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy*; D016877:Oxidants; D010084:Oxidation-Reduction; D010958:Plasminogen / Q000378:metabolism*; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000627:therapeutic use; D015203:Reproducibility of Results; D013696:Temperature; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014105:Tosyl Compounds
chemical_list: D015415:Biomarkers; D002700:Chloramines; D005343:Fibrinolytic Agents; D016877:Oxidants; D011994:Recombinant Proteins; D014105:Tosyl Compounds; C016300:chloramine-T; D010958:Plasminogen; D001120:Arginine; C087896:reteplase; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin