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Reduced alpha-2-antiplasmin activity

MedGen UID:
904513
•Concept ID:
C4280703
•
Finding
HPO: HP:0040245

Definition

Reduced activity of alpha-2-antiplasmin. This protein inactivates the protease plasmin that drives fibrinolysis. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVReduced alpha-2-antiplasmin activity

Professional guidelines

PubMed

Fibrinogen, factor XIII and α(2)-antiplasmin genotypes are associated with inflammatory activity and anti-citrullinated protein antibodies.
Hoppe B, Schwedler C, Edelmann A, Pistioli A, Poddubnyy D, Burmester GR, Häupl T
Thromb Res 2020 Jul;191:90-96. Epub 2020 May 3 doi: 10.1016/j.thromres.2020.04.043. PMID: 32408093
Recent advances in understanding endogenous fibrinolysis: implications for molecular-based treatment of vascular disorders.
Bodary PF, Wickenheiser KJ, Eitzman DT
Expert Rev Mol Med 2002 Mar 26;4(7):1-10. doi: 10.1017/S1462399402004362. PMID: 14987391
Current status of pulmonary thromboembolism--incidence, diagnosis, classification, pathogenesis, and treatment.
Hasegawa H
Jpn Circ J 1984 Jan;48(1):100-10. doi: 10.1253/jcj.48.100. PMID: 6198531

Recent clinical studies

Etiology

Fibrinogen dysfunction and fibrinolysis state in patients with hepatitis B-related cirrhosis.
Liu Y, Zhuang Y, Xu G, Wang X, Lin L, Ding Q
Hematology 2024 Dec;29(1):2392028. Epub 2024 Sep 2 doi: 10.1080/16078454.2024.2392028. PMID: 39222052
Impaired fibrinolysis and increased clot strength are potential risk factors for thrombosis in lymphoma.
Bønløkke ST, Fenger-Eriksen C, Ommen HB, Hvas AM
Blood Adv 2023 Nov 28;7(22):7056-7066. doi: 10.1182/bloodadvances.2023011379. PMID: 37756519Free PMC Article
Fibrinogen and Antifibrinolytic Proteins: Interactions and Future Therapeutics.
Pechlivani N, Kearney KJ, Ajjan RA
Int J Mol Sci 2021 Nov 21;22(22) doi: 10.3390/ijms222212537. PMID: 34830419Free PMC Article
α2-Antiplasmin: New Insights and Opportunities for Ischemic Stroke.
Reed GL, Houng AK, Singh S, Wang D
Semin Thromb Hemost 2017 Mar;43(2):191-199. Epub 2016 Jul 29 doi: 10.1055/s-0036-1585077. PMID: 27472428Free PMC Article
Natural heterogeneity of α2-antiplasmin: functional and clinical consequences.
Abdul S, Leebeek FW, Rijken DC, Uitte de Willige S
Blood 2016 Feb 4;127(5):538-45. Epub 2015 Dec 1 doi: 10.1182/blood-2015-09-670117. PMID: 26626994

Diagnosis

Impaired fibrinolysis and increased clot strength are potential risk factors for thrombosis in lymphoma.
Bønløkke ST, Fenger-Eriksen C, Ommen HB, Hvas AM
Blood Adv 2023 Nov 28;7(22):7056-7066. doi: 10.1182/bloodadvances.2023011379. PMID: 37756519Free PMC Article
Management of disseminated intravascular coagulation associated with aortic aneurysm and vascular malformations.
Yamada S, Asakura H
Int J Hematol 2021 Jan;113(1):15-23. Epub 2020 Nov 11 doi: 10.1007/s12185-020-03028-z. PMID: 33175341
Defective α(2) antiplasmin cross-linking and thrombus stability in a case of acquired factor XIII deficiency.
Mitchell JL, Wright S, Kazi S, Watson HG, Mutch NJ
Br J Haematol 2017 Sep;178(5):794-799. Epub 2017 May 17 doi: 10.1111/bjh.14759. PMID: 28516512
Evaluation of Fibrinolytic Inhibitors: Alpha-2-Antiplasmin and Plasminogen Activator Inhibitor 1 in Patients with Obstructive Sleep Apnoea.
Zakrzewski M, Zakrzewska E, Kiciński P, Przybylska-Kuć S, Dybała A, Myśliński W, Pastryk J, Tomaszewski T, Mosiewicz J
PLoS One 2016;11(11):e0166725. Epub 2016 Nov 18 doi: 10.1371/journal.pone.0166725. PMID: 27861608Free PMC Article
Implications of excessive fibrinolysis and alpha(2)-plasmin inhibitor deficiency in patients with severe head injury.
Kushimoto S, Yamamoto Y, Shibata Y, Sato H, Koido Y
Neurosurgery 2001 Nov;49(5):1084-9; discussion 1089-90. doi: 10.1097/00006123-200111000-00011. PMID: 11846901

Therapy

Reduced protein carbonylation on hormone therapy is associated with improved fibrinolysis in postmenopausal women: the impact of PAI-1 and TAFI activity.
Piróg M, Ząbczyk M, Natorska J, Jach R, Undas A
J Thromb Thrombolysis 2024 Oct;57(7):1216-1224. Epub 2024 Jul 9 doi: 10.1007/s11239-024-03006-w. PMID: 38981979Free PMC Article
α2-Antiplasmin: New Insights and Opportunities for Ischemic Stroke.
Reed GL, Houng AK, Singh S, Wang D
Semin Thromb Hemost 2017 Mar;43(2):191-199. Epub 2016 Jul 29 doi: 10.1055/s-0036-1585077. PMID: 27472428Free PMC Article
Alpha2-antiplasmin: potential therapeutic roles in fibrin survival and removal.
Lee KN, Jackson KW, Christiansen VJ, Chung KH, McKee PA
Curr Med Chem Cardiovasc Hematol Agents 2004 Oct;2(4):303-10. doi: 10.2174/1568016043356228. PMID: 15320781
Alpha 2-antiplasmin supplementation inhibits tissue plasminogen activator-induced fibrinogenolysis and bleeding with little effect on thrombolysis.
Weitz JI, Leslie B, Hirsh J, Klement P
J Clin Invest 1993 Apr;91(4):1343-50. doi: 10.1172/JCI116335. PMID: 7682569Free PMC Article
Acquired alpha-2-antiplasmin deficiency in acute promyelocytic leukaemia.
Avvisati G, ten Cate JW, Sturk A, Lamping R, Petti MG, Mandelli F
Br J Haematol 1988 Sep;70(1):43-8. doi: 10.1111/j.1365-2141.1988.tb02432.x. PMID: 2460126

Prognosis

Development of a chemiluminescence assay for tissue plasminogen activator inhibitor complex and its applicability to gastric cancer.
Ji Y, Qin Y, Tan Q, Qiu Y, Han S, Qi X
BMC Biotechnol 2024 May 8;24(1):30. doi: 10.1186/s12896-024-00850-9. PMID: 38720310Free PMC Article
Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity.
Okazaki E, Barion BG, da Rocha TRF, Di Giacomo G, Ho YL, Rothschild C, Fatobene G, de Carvalho Moraes BDG, Stefanello B, Villaça PR, Rocha VG, Orsi FA
J Thromb Thrombolysis 2024 Apr;57(4):721-729. Epub 2024 Mar 25 doi: 10.1007/s11239-024-02961-8. PMID: 38523179
Implications of excessive fibrinolysis and alpha(2)-plasmin inhibitor deficiency in patients with severe head injury.
Kushimoto S, Yamamoto Y, Shibata Y, Sato H, Koido Y
Neurosurgery 2001 Nov;49(5):1084-9; discussion 1089-90. doi: 10.1097/00006123-200111000-00011. PMID: 11846901
Acquired alpha-2-antiplasmin deficiency in acute promyelocytic leukaemia.
Avvisati G, ten Cate JW, Sturk A, Lamping R, Petti MG, Mandelli F
Br J Haematol 1988 Sep;70(1):43-8. doi: 10.1111/j.1365-2141.1988.tb02432.x. PMID: 2460126
Inactivation of factor XII active fragment in normal plasma. Predominant role of C-1-inhibitor.
de Agostini A, Lijnen HR, Pixley RA, Colman RW, Schapira M
J Clin Invest 1984 Jun;73(6):1542-9. doi: 10.1172/JCI111360. PMID: 6725552Free PMC Article

Clinical prediction guides

Fibrinogen dysfunction and fibrinolysis state in patients with hepatitis B-related cirrhosis.
Liu Y, Zhuang Y, Xu G, Wang X, Lin L, Ding Q
Hematology 2024 Dec;29(1):2392028. Epub 2024 Sep 2 doi: 10.1080/16078454.2024.2392028. PMID: 39222052
Reduced protein carbonylation on hormone therapy is associated with improved fibrinolysis in postmenopausal women: the impact of PAI-1 and TAFI activity.
Piróg M, Ząbczyk M, Natorska J, Jach R, Undas A
J Thromb Thrombolysis 2024 Oct;57(7):1216-1224. Epub 2024 Jul 9 doi: 10.1007/s11239-024-03006-w. PMID: 38981979Free PMC Article
Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity.
Okazaki E, Barion BG, da Rocha TRF, Di Giacomo G, Ho YL, Rothschild C, Fatobene G, de Carvalho Moraes BDG, Stefanello B, Villaça PR, Rocha VG, Orsi FA
J Thromb Thrombolysis 2024 Apr;57(4):721-729. Epub 2024 Mar 25 doi: 10.1007/s11239-024-02961-8. PMID: 38523179
Fibrinogen, factor XIII and α(2)-antiplasmin genotypes are associated with inflammatory activity and anti-citrullinated protein antibodies.
Hoppe B, Schwedler C, Edelmann A, Pistioli A, Poddubnyy D, Burmester GR, Häupl T
Thromb Res 2020 Jul;191:90-96. Epub 2020 May 3 doi: 10.1016/j.thromres.2020.04.043. PMID: 32408093
α2-Antiplasmin: New Insights and Opportunities for Ischemic Stroke.
Reed GL, Houng AK, Singh S, Wang D
Semin Thromb Hemost 2017 Mar;43(2):191-199. Epub 2016 Jul 29 doi: 10.1055/s-0036-1585077. PMID: 27472428Free PMC Article

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