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Endogenous fibrinolysis facilitates clot retraction in vivo

Andre L. Samson, Imala Alwis, Jessica A.A. Maclean, Pramith Priyananda, Brian Hawkett, Simone M. Schoenwaelder and Shaun P. Jackson

Key points

  • Localized vascular injury with thrombin microinjection produces a fibrin network that undergoes myosin IIa-dependent retraction in vivo.

  • Using this model, we demonstrate that endogenous fibrinolysis promotes fibrin clot retraction.

Abstract

Clot retraction refers to the process whereby activated platelets transduce contractile forces onto the fibrin network of a thrombus, which over time increases clot density and decreases clot size. This process is considered important for promoting clot stability and maintaining blood vessel patency. Insights into the mechanisms regulating clot retraction at sites of vascular injury have been hampered by a paucity of in vivo experimental models. By pairing localised vascular injury with thrombin microinjection in the mesenteric circulation of mice, we have demonstrated that the fibrin network of thrombi progressively compacts over a two-hour period. This was a genuine retraction process, as treating thrombi with blebbistatin to inhibit myosin IIa-mediated platelet contractility prevented shrinkage of the fibrin network. Real-time confocal analysis of fibrinolysis after recombinant tPA administration revealed that incomplete proteolysis of fibrin polymers markedly facilitated clot retraction. Similarly, inhibiting endogenous fibrinolysis with tranexamic acid reduced retraction of fibrin polymers in vivo. In vitro clot retraction experiments indicated that subthreshold doses of tPA facilitated clot retraction through a plasmin-dependent mechanism. These effects correlated with changes in the elastic modulus of fibrin clots. These findings define the endogenous fibrinolytic system as an important regulator of clot retraction, and show that promoting clot retraction is a novel and complementary means by which fibrinolytic enzymes can reduce thrombus size.

  • Submitted June 6, 2017.
  • Accepted October 18, 2017.