Asthma is associated with reduced fibrinolytic activity, abnormal clot architecture and decreased clot retraction rate

Abstract

The aim of this study was to assess whether steroid-naïve asthma modulates hemostasis. We evaluated the clot retraction rate (CRR), fibrinolysis rate (FR), clot density (CD) (by confocal microscopy), plasma levels of plasminogen activator inhibitor (PAI-1), and factor XIII (FXIII), NO in exhaled breath (FE_NO), spirometry (FEV₁) and eosinophil count (EOS), in 36 patients with allergic, steroid-naïve asthma and in 34 healthy controls. We observed significantly (p<0.001) reduced CRR, FR, FEV₁; and increased FE_NO, EOS, PAI-1, FXIII, and CD in asthmatic patients compared with controls. In asthmatic patients FR negatively correlated with CD, FXIII, PAI-1, FE_NO and EOS, and positively with FEV₁. FXIII positively correlated with CD. CRR negatively correlated with FE_NO and positively with FEV₁ (all p<0.001). These novel findings suggest that asthma itself is associated with decreased CRR and reduced fibrinolytic potential resulting from alterations in clot architecture and elevated levels of plasma FXIII and PAI-1.

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