title: Does plasmin have anticoagulant activity?
abstract: The coagulation and fibrinolytic pathways regulate hemostasis and thrombosis, and an imbalance in these pathways may result in pathologic hemophilia or thrombosis. The plasminogen system is the primary proteolytic pathway for fibrinolysis, but also has important proteolytic functions in cell migration, extracellular matrix degradation, metalloproteinase activation, and hormone processing. Several studies have demonstrated plasmin cleavage and inactivation of several coagulation factors, suggesting plasmin may be not only be the primary fibrinolytic enzyme, but may have anticoagulant properties as well. The objective of this review is to examine both in vitro and in vivo evidence for plasmin inactivation of coagulation, and to consider whether plasmin may act as a physiological regulator of coagulation. While several studies have demonstrated strong evidence for plasmin cleavage and inactivation of coagulation factors FV, FVIII, FIX, and FX in vitro, in vivo evidence is lacking for a physiologic role for plasmin as an anticoagulant. However, inactivation of coagulation factors by plasmin may be useful as a localized anticoagulant therapy or as a combined thrombolytic and anticoagulant therapy.
authors.affiliation: Joseph J Jacobs Center for Thrombosis and Vascular Biology, Department of Cardiovascular Medicine, Lerner Research Institute Cleveland Clinic, Cleveland, Ohio 44195, USA. hooverj@ccf.org
authors.forename: Jane
authors.initials: J
authors.lastname: Hoover-Plow
mesh_terms: D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology*; D001779:Blood Coagulation Factors / Q000378:metabolism; D005164:Factor IX / Q000378:metabolism; D005165:Factor V / Q000378:metabolism; D005169:Factor VIII / Q000378:metabolism; D005170:Factor X / Q000378:metabolism; D005341:Fibrinolysin / Q000502:physiology*; D005342:Fibrinolysis / Q000502:physiology; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008074:Lipoproteins / Q000378:metabolism; D051379:Mice
chemical_list: D001779:Blood Coagulation Factors; D005343:Fibrinolytic Agents; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D005165:Factor V; D005169:Factor VIII; D005164:Factor IX; D005170:Factor X; D005341:Fibrinolysin
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