In vitro plasma clot-lysis tests might carry some relevant information in vivo fibrinolysis, especially as an indicator of fibrinolytic inhibitors. In vitro clot-lysis experiments, induced by thrombin/tPA mixtures were performed, utilising a microplate light-scattering assessment method. The tests were repeated using the same plasma samples in each patients/controls in a microplate, which was covered by cultured endothelial-cell monolayer (umbilical vein, HUVEC). Clot lysis speed proved to be 1.5-2.0 times slower with HUVEC milieu in the control group (n=79). In insulin dependent diabetes mellitus (n=18) the same inhibition induced by HUVEC was observed, whereas in non-insulin dependent diabetics (n=36) the inhibition proved to be significantly weaker than in the controls. It is probably due to the elevated circulating PAI-1 levels in this type of diabetes. In the cirrhotic patients (p=41) this inhibition was stronger and resulted in a 5-fold reduction of lysis speed. Our results suggest, that cirrhotic plasma is able to accelerate the release of fibrinolytic inhibitors from HUVEC, which phenomenon may also contribute to the complex alterations of fibrinolysis in cirrhotic patients. In vitro plasma clot-lysis, performed in the presence or absence of HUVEC may give further information on fibrinolysis in a variety of clinical conditions.
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