Plasmin inhibition increases MMP-9 activity and decreases vein wall stiffness during venous thrombosis resolution

Nicholas A Dewyer1, Vikram Sood, Erin M Lynch

  • 1Jobst Vascular Surgery Laboratory, Section of Vascular Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Abstract

Insights

Pharmacological inhibition of the plasmin system led to larger deep venous thrombosis (DVT) but reduced vein wall injury in rats. This suggests a redundant mechanism for DVT resolution involving matrix metalloproteinase-9 (MMP-9).

Area of Science:

  • Vascular Biology
  • Thrombosis Research
  • Biomedical Science

Background:

  • Deep venous thrombosis (DVT) resolution involves complex interactions between the plasmin and matrix metalloproteinase (MMP) systems.
  • Understanding these interactions is crucial for developing effective DVT treatments.
  • This study investigates the impact of inhibiting the plasmin system on DVT resolution and associated vein wall damage.

Purpose of the Study:

  • To test the hypothesis that pharmacological inhibition of the plasmin system impairs DVT resolution and exacerbates vein wall damage.
  • To elucidate the role of MMPs in the context of plasmin system inhibition during DVT resolution.

Main Methods:

  • A rat model of stasis deep venous thrombosis (DVT) was established via inferior vena cava (IVC) ligation.
  • Rats received intravenous control saline or aprotinin (AP) to inhibit the plasmin system.
  • Thrombosed IVCs were analyzed after 7 days for thrombus weight, perfusion, collagen, d-dimer, MMP-2, MMP-9, inflammatory markers, and leukocyte infiltration.

Main Results:

  • Aprotinin treatment resulted in significantly larger DVT weights (2-fold increase) compared to controls.
  • Vein wall stiffness was reduced by 50% in AP-treated rats, indicating less biomechanical injury.
  • A significant 5-fold increase in vein wall MMP-9 activity was observed in the AP group, suggesting its compensatory role in DVT resolution.

Conclusions:

  • Inhibition of the plasmin system with aprotinin leads to larger thrombi but reduced vein wall injury.
  • Increased vein wall MMP-9 activity may represent a redundant mechanism for DVT resolution.
  • These findings highlight the complex interplay of enzymatic systems in DVT resolution and suggest potential therapeutic targets.

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