Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease.

Autor: Gibson BHY; Department of Pharmacology Vanderbilt University Nashville TN USA., Duvernay MT; Department of Pharmacology Vanderbilt University Nashville TN USA.; Department of Orthopaedics Vanderbilt University Medical Center Nashville TN USA.; Center for Bone Biology Vanderbilt University Medical Center Nashville TN USA., Moore-Lotridge SN; Department of Orthopaedics Vanderbilt University Medical Center Nashville TN USA., Flick MJ; Department of Pathology and Laboratory Medicine University of North Carolina-Chapel Hill NC USA.; UNC Blood Research Center Chapel Hill NC USA., Schoenecker JG; Department of Pharmacology Vanderbilt University Nashville TN USA.; Department of Orthopaedics Vanderbilt University Medical Center Nashville TN USA.; Center for Bone Biology Vanderbilt University Medical Center Nashville TN USA.; Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville TN USA.; Department of Pediatrics Vanderbilt University Medical Center Nashville TN USA.
Jazyk: angličtina
Zdroj: Research and practice in thrombosis and haemostasis [Res Pract Thromb Haemost] 2020 Jun 14; Vol. 4 (4), pp. 469-480. Date of Electronic Publication: 2020 Jun 14 (Print Publication: 2020).
DOI: 10.1002/rth2.12355
Abstrakt: The musculoskeletal system is critical for movement and the protection of organs. In addition to abrupt injuries, daily physical demands inflict minor injuries, necessitating a coordinated process of repair referred to as the acute-phase response (APR). Dysfunctional APRs caused by severe injuries or underlying chronic diseases are implicated in pathologic musculoskeletal repair, resulting in decreased mobility and chronic pain. The molecular mechanisms behind these phenomena are not well understood, hindering the development of clinical solutions. Recent studies indicate that, in addition to regulating intravascular clotting, the coagulation and fibrinolytic systems are also entrenched in tissue repair. Although plasmin and fibrin are considered antithetical to one another in the context of hemostasis, in a proper APR, they complement one another within a coordinated spatiotemporal framework. Once a wound is contained by fibrin, activation of plasmin promotes the removal of fibrin and stimulates angiogenesis, tissue remodeling, and tissue regeneration. Insufficient fibrin deposition or excessive plasmin-mediated fibrinolysis in early convalescence prevents injury containment, causing bleeding. Alternatively, excess fibrin deposition and/or inefficient plasmin activity later in convalescence impairs musculoskeletal repair, resulting in tissue fibrosis and osteoporosis, while inappropriate fibrin or plasmin activity in a synovial joint can cause arthritis. Together, these pathologic conditions lead to chronic pain, poor mobility, and diminished quality of life. In this review, we discuss both fibrin-dependent and -independent roles of plasminogen activation in the musculoskeletal APR, how dysregulation of these mechanisms promote musculoskeletal degeneration, and the possibility of therapeutically manipulating plasmin or fibrin to treat musculoskeletal disease.
(© 2020 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and Haemostasis.)
Databáze: MEDLINE
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