Enhanced mucosal fibrinolytic activity in gastroduodenal ulcer haemorrhageand the beneficial effect of acid suppression

Citation
Em. Vreeburg et al., Enhanced mucosal fibrinolytic activity in gastroduodenal ulcer haemorrhageand the beneficial effect of acid suppression, ALIM PHARM, 15(5), 2001, pp. 639-646
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
5
Year of publication
2001
Pages
639 - 646
Database
ISI
SICI code
0269-2813(200105)15:5<639:EMFAIG>2.0.ZU;2-H
Abstract
Background: The high mortality rate in patients with upper gastrointestinal breeding appears to be particularly related to re-bleeding. The haemostati c mechanisms that may influence the re-bleeding of ulcers are largely unkno wn. Aim: We studied and analysed fibrinolytic activity in breeding ulcer patien ts and the effect of acid suppression on this activity. Methods: Fibrinolytic activity was analysed in mucosal biopsies from 29 ble eding gastroduodenal ulcer patients and six controls. We analysed revers of D-Dimer, fibrin plate lysis area, plasminogen activator activity, plasmino gen activator inhibitor activity, and plasmin antiplasmin complexes. Results: Significantly more fibrinolytic activity was detected in biopsies from patients with bleeding ulcers compared to controls. Moreover, in patie nts with endoscopic stigmata of recent haemorrhage, mucosal fibrinolytic ac tivity was higher compared to patients without stigmata of recent haemorrha ge. In mucosal biopsies of patients that had used acid suppression before a dmission, a decreased fibrinolytic activity was found compared to patients without such therapy. This effect of acid suppression on fibrinolytic activ ity was confirmed in nine patients before and after a 24-h ranitidine infus ion. Conclusions: Fibrinolytic activity is enhanced in patients with bleeding ga stroduodenal ulcers. Acid suppressive therapy decreases this increased acti vity, which may be one of the mechanisms explaining the potential beneficia l effect of this therapy.