慢性の大血管性血栓栓塞動性肺高血圧における内生性線維解離系
M A Olman1, J J Marsh, I M Lang
1Division of Pulmonary and Critical Care Medicine, University of California, San Diego.
Circulation
|October 1, 1992
まとめ
慢性血栓塞栓性肺高血圧 (CTEPH) は,繊維分解の障害を含む. 組織型プラズミノゲン活性化剤 (t-PA) とプラズミノゲン活性化剤阻害剤-1 (PAI-1) レベルがCTEPH患者で変化している一方で,それらの活動が状態を完全に説明することはありません.
科学分野:
- 心血管科学の研究について
- 血液学 ヘマトロジ
- 肺内医学 肺内医学 肺内医学
背景:
- 慢性肺動脈栓塞性肺高血圧 (CTEPH) は,中枢肺動脈における組織的な血栓による肺動脈高血圧によって特徴付けられます.
- CTEPHにおける低血栓溶解の背後にある正確なメカニズムは不明である.
- この研究では,CTEPHの病原性におけるプラズマ線維分解の役割を調査しています.
研究 の 目的:
- CTEPH患者におけるプラズマ線維分解の主要な決定因子を評価する.
- CTEPH患者の組織型プラズミノゲン活性化剤 (t-PA) とプラズミノゲン活性化剤阻害剤-1 (PAI-1) の免疫学的および機能的レベルを定量化するために.
主な方法:
- 32人のCTEPH患者と年齢マッチングした対照群のt-PAとPAI-1抗原と血小板不足血 (PPP) の活性を定量化.
- t-PAとPAI-1の反応を評価するために,実験的に誘発された静脈閉塞.
- 免疫プレシピテーションとフィブリンオートグラフィは,t-PA/PAI-1複合体を分析する.
主要な成果:
- CTEPH患者では,対照群と比較して,t-PAとPAI-1抗原のベース値が高くなりました.
- t-PAとPAI-1の酵素活性において,グループ間で有意な差異は認められなかった.
- CTEPH患者では,静脈閉塞後のt-PA抗原とPAI活性が著しく増加しました.
- いくつかのCTEPH患者における基礎t-PA抗原の上昇は,主にPAI-1と複合していることが判明しました.
結論:
- 繊維分解系における異常,特に変化したt-PAとPAI-1レベルは,CTEPH.で存在します.
- 静脈閉塞に対する高い静止プラズマPAI-1活性や鈍化したt-PA反応は,CTEPHの病因を完全に説明できません.
- この発見は,CTEPHにおける繊維分解因子の複雑な相互作用を示唆しており,t-PAはPAI-1に結合している可能性が高い.
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