Lytic resistance of fibrin containing red blood cells

Nikolett Wohner, Péter Sótonyi, Raymund MacHovich, László Szabó, Kiril Tenekedjiev, Marta M.C.G. Silva, Colin Longstaff, Krasimir Kolev

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OBJECTIVE-: Arterial thrombi contain variable amounts of red blood cells (RBCs), which interact with fibrinogen through an eptifibatide-sensitive receptor and modify the structure of fibrin. In this study, we evaluated the modulator role of RBCs in the lytic susceptibility of fibrin. METHODS AND RESULTS-: If fibrin is formed at increasing RBC counts, scanning electron microscopy evidenced a decrease in fiber diameter from 150 to 96 nm at 40% (v/v) RBCs, an effect susceptible to eptifibatide inhibition (restoring 140 nm diameter). RBCs prolonged the lysis time in a homogeneous-phase fibrinolytic assay with tissue plasminogen activator (tPA) by up to 22.7±1.6%, but not in the presence of eptifibatide. Confocal laser microscopy using green fluorescent protein-labeled tPA and orange fluorescent fibrin showed that 20% to 40% (v/v) RBCs significantly slowed down the dissolution of the clots. The fluorescent tPA variant did not accumulate on the surface of fibrin containing RBCs at any cell count above 10%. The presence of RBCs in the clot suppressed the tPA-induced plasminogen activation, resulting in 45% less plasmin generated after 30 minutes of activation at 40% (v/v) RBCs. CONCLUSION-: RBCs confer lytic resistance to fibrin resulting from modified fibrin structure and impaired plasminogen activation through a mechanism that involves eptifibatide-sensitive fibrinogen-RBC interactions.

Original languageEnglish
Pages (from-to)2306-2313
Number of pages8
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number10
Publication statusPublished - Oct 1 2011



  • blood cells
  • fibrin
  • fibrinolysis
  • plasminogen activators
  • platelet receptor blockers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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