FIBRINOLYSIS: MODERN VIEW, PATHOLOGY, DIAGNOSTICS

Relevance. Fibrinolysis is an important and integral part of the hemostasis system. Acting in parallel and together, the blood coagulation and fibrinolysis systems protect the body from excessive thrombus formation and vascular occlusion, on the one hand, and help maintain homeostasis by preventing excessive blood loss. On the other hand, as a result of imbalance between the coagulation and fibrinolysis processes, pathological processes such as hemorrhagic syndromes or thrombophilia occur. The fibrinolysis system includes not only plasmin, which directly breaks down the fibrin clot, but also a system of proteins that control plasmin activity: activators and inhibitors of this process.

Aim. To examine modern concepts of the processes of fibrin clot destruction, mechanisms of fibrinolysis control, types of disorders of these mechanisms and manifestations of these disorders, to describe the main tests for determining the activity of various proteins and fibrinolysis products.

Results. The review examines the sequence of reactions of fibrin and fibrinogen cleavage. The main plasminogen activators and plasmin inhibitors are given. The properties of the components participating in fibrinolysis are described. The review also shows the main fibrinolysis disorders: hypo- and hyperfibrinolytic conditions with examples. At the end of the review, the main laboratory tests are given that allow assessing the activity of the fibrinolysis system.

Conclusion. Fibrinolysis is an integral component of the hemostasis system. Fibrinolysis prevents obstruction of blood vessels by fibrin thrombi, recanalizes blood vessels and restores normal blood flow, and participates in the pathogenesis of cardiovascular and other diseases. Understanding the clinical significance of fibrinolysis is important for the diagnosis and treatment of various diseases and conditions associated with disorders in the blood coagulation and thrombus formation system. At the same time, it should be taken into account that laboratory diagnostics of fibrinolytic system disorders is carried out in combination with the study of pro- and anticoagulants, as well as platelets.

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