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The fibrinolytic system, also known as the plasminogen-plasmin system, is composed of plasminogen activators that convert plasminogen to the proteolytic enzyme plasmin and is maintained in a state of balance by inhibitors of plasminogen activators and of plasmin. There are four known plasminogen activator inhibitors: PAI-1, PAI-2, activated protein C inhibitor (also known as PAI-3), and thrombin-activatable fibrinolytic inhibitor (TAFI), of which PAI-1 has the most influence on many physiologic and pathologic functions. TAFI also inhibits plasmin along with α2-antiplasmin, α2-macroglobulin, and other serine protease inhibitors. Excess activity of plasminogen activator inhibitors (PAIs) and plasmin inhibitors can result in thrombosis. In this chapter, we will highlight the physiology and pathogenesis of the fibrinolytic system.

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Disturbances in the Fibrinolytic Pathway

  • 章节

  • 发表日期：

    2026年

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  • Insia Fatima Rizvi,
  • Syed Ali Abutalib,
  • Jerrold H. Levy

摘要

The fibrinolytic system, also known as the plasminogen-plasmin system, is composed of plasminogen activators that convert plasminogen to the proteolytic enzyme plasmin and is maintained in a state of balance by inhibitors of plasminogen activators and of plasmin. There are four known plasminogen activator inhibitors: PAI-1, PAI-2, activated protein C inhibitor (also known as PAI-3), and thrombin-activatable fibrinolytic inhibitor (TAFI), of which PAI-1 has the most influence on many physiologic and pathologic functions. TAFI also inhibits plasmin along with α2-antiplasmin, α2-macroglobulin, and other serine protease inhibitors. Excess activity of plasminogen activator inhibitors (PAIs) and plasmin inhibitors can result in thrombosis. In this chapter, we will highlight the physiology and pathogenesis of the fibrinolytic system.