Different Tissue Plasminogen Activator Release in the Arm and Leg during Venous Occlusion Is Equalized after DDAVP Infusion

Dušan Keber; Mojca Stegnar; Cornelis Kluft

doi:10.1055/s-0038-1645689

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1990; 63(01): 072-075
DOI: 10.1055/s-0038-1645689

Original Article

Schattauer GmbH Stuttgart

Different Tissue Plasminogen Activator Release in the Arm and Leg during Venous Occlusion Is Equalized after DDAVP Infusion

Authors

Dušan Keber

The Trnovo Hospital of Internal Medicine, University Clinical Center, Ljubljana, Yugoslavia, The Netherlands
Mojca Stegnar

The Trnovo Hospital of Internal Medicine, University Clinical Center, Ljubljana, Yugoslavia, The Netherlands
Cornelis Kluft

^*The Gaubius Institute, Leiden, The Netherlands

Abstract

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Summary

The mechanism of tissue plasminogen activator (t-PA) release during arm and leg venous occlusions and DDAVP (1 desamino- 8-D-arginine vasopressin) infusion was studied in 10 healthy males. The following determinations were carried out on venous blood: t-PA antigen (ELISA), t-PA activity, and t-PA inhibitor (PAI) activity (amidolytic assays). Before DDAVP, there was a 270% t-PA antigen increase in the arm at the end of occlusion as opposed to only a 40% increase in the leg. After DDAVP, t-PA antigen at the end of arm and leg occlusion reached an equal level which was significantly higher than in the arm before DDAVP. The study produced no evidence of PAI release during venous occlusion of a limb. It is concluded that DDAVP is able to elicit t-PA release from arm as well as from leg vessels. The poor fibrinolytic response of leg vessels to venous occlusion is not due to a high PAT release or t-PA stores depletion in leg vessels, but rather to low basal t-PA release in leg vessels.

Keywords

Tissue plasminogen activator - Venous occlusion - DDAVP - Mechanism of release

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References

References
1 Pandolfi M, Nilsson IM, Robertson B, Isacson S. Fibrinolytic activity of human veins. Lancet 1967; 2: 127-128
2 Noordhoek HegtV. Distribution and variation of fibrinolytic activity in the walls of human arteries and veins. Haemostasis 1976; 5: 355-372
3 De Cossart L, Marcuson RW. Vascular plasminogen activator and deep vein thrombosis. Br J Surg 1983; 70: 369-370
4 Robertson BR, Pandolfi M, Nilsson IM. Response of local fibrinolytic activity to venous occlusions of arms and legs in healthy volunteers Acta Chir Scand 1972; 138: 437-440
5 Karaca M, Nilsson IM. Fibrinolytic activity in hemiplegic patients. Acta Med Scand 1971; 189: 325-329
6 Keber D. The increase of leg fibrinolytic potential after reduction of hydrostatic stimulus. Thromb Haemostas 1983; 50: 731-734
7 Gader AM A, Da Costa J, Cash JD. A new vasopressin analogue and fibrinolysis. Lancet 1973; 2: 1417-1418
8 Mannucci PM, Aberg M, Nilsson IM, Robertson B. Mechanism of plasminogen activator and factor VIII increase after vasoactive drugs. Br J Haematol 1975; 30: 81-93
9 Ranby M, Bergsdorf N, Nilsson T, Mellbring G, Winblad B, Bucht G. Age dependance of tissue plasminogen activator concentration in plasma, as studied by an improved enzyme-linked immunosorbent assay. Clin Chem 1986; 32: 2160-2165
10 Verheijen JH, Chang GT G, Kluft C. Evidence for the occurrence of a fast-acting inhibitor for tissue-type plasminogen activator in human plasma. Thromb Haemostas 1984; 51: 392-395
11 Verheijen JH, Mullaart E, Chang GT G, Kluft C, Wijngaards G. A simple and sensitive spectrophotometric assay for extrinsic (tissue-type) plasminogen activator applicable to measurements in plasma. Thromb Haemostas 1982; 48: 266-269
12 Keber D. On the use of different correction factors for hemoconcen-tration. Thromb Haemostas 1983; 49: 245
13 Snedecor GW, Cochran WG. Statistical Methods. University Press; Ames: 1972
14 Winer BJ. Statistical Principles in Experimental Design. McGraw Hill; London, Mladinska knjiga, Ljubljana: 1970
15 Keber D. Mechanism of tissue plasminogen activator release during venous occlusion. Fibrinolysis 1988; 2 (Suppl. 02) 96-103
16 Nilsson T, Wallen P, Mellbring G. In vivo metabolism of human tissue-type plasminogen activator. Scand J Haematol 1984; 33: 49-53
17 Brommer EJ P, Barrett-Bergshoeff MM, Allen RA, Schicht I, Bertina RM, Schalekamp MA D H. The use of desmopressin acetate (DDAVP) as a test of the fibrinolytic capacity of patients - analysis of responders and non-responders. Thromb Haemostas 1982; 48: 156-161
18 Kruithof EK O, Nicoloso G, Bachmann F. Plasminogen activator inhibitor 1: Development of a radioimmunoassay and observations on its plasma concentration after venous occlusion and platelet aggregation. Blood 1987; 70: 1645-1653
19 Bergsdorf N, Nilsson T, Wallen P. An enzyme linked immunosorbent assay for determination of tissue plasminogen activator applied to patients with thromboembolic disease. Thromb Haemostas 1983; 50: 740-744
20 Wiman B, Ljungberg B, Chmielewska J, Urden G, Blombäck M, Johnsson H. The role of the fibrinolytic system in deep vein thrombosis. J Lab Clin Med 1985; 105: 265-270