Fibrinolysis in the upper gastrointestinal tract

Area of Science:

• Gastroenterology
• Hematology
• Physiology

Background:

• Fibrinolytic activity, the breakdown of blood clots, plays a crucial role in hemostasis.
• The stomach and duodenum are sites prone to bleeding, necessitating an understanding of local clot-dissolving mechanisms.

Purpose of the Study:

• To investigate the levels and sources of fibrinolytic activity within the upper gastrointestinal tract.
• To explore the relationship between local fibrinolysis and gastrointestinal bleeding, particularly in conditions like gastroduodenitis.

Main Methods:

• Comparative analysis of fibrinolytic activity in gastric venous blood, arterial blood, and peripheral venous blood.
• Histochemical examination of stomach and duodenal tissues to identify fibrinolysis activators.
• Assay of fibrinolytic activity in gastric juice from healthy individuals, peptic ulcer patients, and those with erosive haemorrhagic gastroduodenitis.

Main Results:

• Significantly higher fibrinolytic activity was observed in gastric venous blood compared to arterial and peripheral venous blood.
• Fibrinolysis activators were localized in the blood vessels of the stomach wall and in the mucosal cells of the stomach and duodenum.
• Pronounced fibrinolytic activity was detected in the gastric juice of patients with erosive haemorrhagic gastroduodenitis, unlike healthy individuals or peptic ulcer patients.
• Patients with a history of hemorrhagic episodes exhibited considerably higher fibrinolytic activity.

Conclusions:

• The stomach wall and mucosal cells are identified as sources of local fibrinolysis.
• Elevated local fibrinolytic activity correlates with erosive haemorrhagic gastroduodenitis and a history of bleeding.
• Findings suggest a potential link between local fibrinolysis in the upper gastrointestinal tract and the occurrence of bleeding.