Fibrinolysis (clot lysis) mechanism | Hematology | Blood physiology MBBS 1st year lecture

Physiology lecture on Fibrinolysis: The procedure of breaking down the formed fibrin

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Fibrin once formed need to be removed also so that finally tissue repair will take place.

There are a number of proteins which are responsible for fibrinolysis and what they cause is break down fibrin to its degradation products. So these degradation products are known as D-dimers. This is brought about by a protein known as plasmin. Plasmin itself is produced from plasminogen which is produced in liver. Normally plasminogen is not converted to plasmin and only at the site of clot formation is this conversion taking place. So this limits the activity of the plasmin to the site of clot formation.

The plasminogen activation at the site of clot formation occurs by tissue plasminogen activators released from endothelial cells of the vessels. Any active plasmin at other places circulating in blood is inhibited by another protein known as alpha 2 plasmin.

At normal places plasmin is kept in check by alpha 2 plasmin and tissue plasminogen activators are kept in check by plasminogen activator inhibitors.

Pharmacologically this process of fibrinolysis is required when there is acute occlusion of arteries by thrombus or embolus. In that case plasminogen activators are
given intravenously to dissolve the thrombus formed in an unnecessary place.

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