Plasminogen activator inhibitor 2 reduces peritoneal fibrinolytic activity in inflammation

Fibrinolysis in peritoneal tissue may play a role in the development of intra‐abdominal adhesions. The plasminogen‐activating capacity of human peritoneum results largely from the presence of tissue plasminogen activator (tPA). Inflammation reduces peritoneal plasminogenactivating activity and leads to the appearance of plasminogen activator inhibitor (PAI) type 1. The role of PAI‐2 in the inhibition of peritoneal fibrinolysis during inflammation was investigated in this study. The plasminogen‐activating activity of peritoneal biopsy homogenates (seven inflamed, seven normal), measured using a fibrin plate technique, was reduced in inflamed compared with normal tissue (median <0·07 versus 13·9 units/cm2, P < 0·01); tPA antigen levels were not significantly different (median 1·02 versus 1·34 ng/ml). PAI‐1 and PAI‐2 antigens were not detected in normal human peritoneum but were present in inflamed peritoneum (median concentration 8·8 ng/ml for PAI‐1, 26·7 ng/ml for PAI‐2). These inhibitors may be important factors in adhesion formation by contributing to the abolition of peritoneal plasminogen‐activating activity.

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