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Thromb Haemost 2019; 119(02): 223-233
DOI: 10.1055/s-0038-1676638
Coagulation and Fibrinolysis
Georg Thieme Verlag KG Stuttgart · New York

Disturbed Laminar Blood Flow Causes Impaired Fibrinolysis and Endothelial Fibrin Deposition In Vivo

Lars Glise
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Pia Larsson
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Sverker Jern
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Jan Borén
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Malin Levin
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Tor Ny
2   Department of Medical Biochemistry and Biophysics, Umeå University, Umeå, Sweden
,
Per Fogelstrand   *
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
,
Niklas Bergh   *
1   Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
› Author Affiliations
Funding This study was funded by the Swedish Research Council VR 2015–02517, Swedish Society of Medicine SLS-500111, Swedish Research Council 522–2010–2823, Sahlgrenska University Hospital ALF research grant ALFGBG 622301, Stiftelsen Sigurd och Elsa Goljes Minne LA2017–0197 and Sahlgrenska University Hospital Research Grants 90170–8181.
Further Information

Publication History

03 May 2018

04 November 2018

Publication Date:
02 January 2019 (online)

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Abstract

Endothelial expression of tissue-type plasminogen activator (t-PA) is crucial for maintaining an adequate endogenous fibrinolysis. It is unknown how endothelial t-PA expression and fibrinolysis are affected by blood flow in vivo. In this study, we investigated the impact of different blood flow profiles on endothelial t-PA expression and fibrinolysis in the arterial vasculature. Induction of disturbed laminar blood flow (D-flow) in the mouse carotid artery potently reduced endothelial t-PA messenger ribonucleic acid and protein expression, and caused fibrin deposition. En face immunohistochemistry demonstrated that arterial areas naturally exposed to D-flow had markedly lower endothelial t-PA levels than areas with sustained laminar blood flow (S-flow), and displayed pronounced fibrin deposition despite an intact endothelium. In t-PA and plasminogen-deficient mice, fibrin deposition did not extend into S-flow areas, indicating that areas of D-flow and S-flow differ, not only in fibrinolytic capacity, but also in coagulation. Furthermore, plasminogen accumulation was found at D-flow areas, and infusion of recombinant t-PA activated fibrinolysis and significantly reduced the fibrin deposits. In conclusion, D-flow potently impairs the fibrinolytic capacity and causes endothelial fibrin deposition in vivo. Our data also indicate that t-PA is the limiting factor for efficient fibrinolysis at the thrombosis-prone D-flow areas in the arterial vasculature.

Keywords

t-PA - artery - fluid shear - fibrinogen/fibrin

* Per Fogelstrand and Niklas Bergh are senior co-authors of the study.


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