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C Krishnamurti, B Keyt, P Maglasang and BM Alving
Department of Hematology and Vascular Biology, Walter Reed Army Institute
of Research, Washington, DC 20307-5100, USA.
The present study compared the activities of recombinant tissue-type
plasminogen activator (t-PA) and a plasminogen activator inhibitor-1
(PAI-1)-resistant variant t-PA (Kt-PA, KHRR 296-299 AAAA) in preventing
renal fibrin deposition in rabbits with elevated PAI-1 activity. In this
model, all rabbits were infused with endotoxin (10 micrograms/kg), followed
by initiation of thrombin (130 U/kg) 4 hours later, when plasma PAI-1
activity was greater than 200 arbitrary units (AU)/mL (baseline, < 3
AU/mL). Thirty minutes after completion of the 1-hour thrombin infusion,
rabbits were killed and the kidneys fixed and stained for identification of
fibrin deposition. Rabbits received one of the following treatments
initiated 30 minutes before thrombin and continued during the 1-hour
thrombin infusion: (1) saline (n = 7); (2) low-dose t-PA (17 micrograms/kg,
n = 4); (3) higher-dose t-PA (170 micrograms/kg, n = 4); or (4) low-dose
Kt-PA (17 micrograms/kg, n = 6). Fibrin deposition occurred in 86% and 100%
of the rabbits receiving saline or low-dose t-PA, respectively. Fibrin
deposition did not occur in any of the rabbits receiving low-dose Kt-PA or
higher-dose t-PA. Low- dose Kt-PA and higher dose t-PA also caused a
reduction in fibrin deposition when infused after thrombin administration
had been completed. The data provide in vivo evidence that Kt-PA is more
effective than t-PA in preventing fibrin deposition in an animal model that
combines thrombogenic stimulation with increased PAI-1 activity.
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