Euglobin Lysis Time

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Page 4 intravascular activation of fibrinolysis. Plasmin has a wide range of substrates, including factors V and VIII, and will interfere with coagulation by multiple mechanisms. Production of abnormal quantities of plasminogen activator has also been described in certain tumors and acute leukemias. In primary fibrinogenolysis, there will be a marked increase in the spontaneous fibrinolytic activity of plasma. Increased fibrinolytic activity may also be seen, although usually to a lesser extent, in DIC. There are no studies providing detailed comparisons of coagulation and fibrinolytic parameters in primary fibrinogenolysis versus DIC. The utility of the ECL test in making this distinction is uncertain. In clinical practice, DIC should be ruled out on clinical and laboratory grounds before primary defects in fibrinogenolysis are suspected. There is little agreement on the specific clinical indications for employing the ECL test in general patient management. At present, the test appears useful mainly as an investigative and research tool. Additionally, the variety of factors sited above which affect fibrinolysis detract from the specificity and diagnostic utility of the ECL test. FURTHER DEVELOPMENTS In the ECL test, the patient's own fibrin clot serves as the substrate for fibrinolysis. Different substrates may also be used, including casein (caseinolysis) and synthesis esters (esterolysis). The most important modification of the ECL time is the Fibrin ^ Plate assay in which a sample of plasma or euglobulin fraction is placed directly on the surface of a petrie dish containing human or bovine fibrin. At approximately 20 hours, the zone size of fibrinolysis is measured. There is a relatively good correlation between assays of fibrinolysis as measured in the fibrin plate and the ECL test. The fibrin plate assay has a more precise and easily quantifiable endpoint and demands less technician intervention. However, it is not suitable for stat determinations. A recent modification of the ECL test used the addition of radiolabelled fibrinogen to the euglobulin fraction. The rate of radioactivity release is proportional to the fibrinolytic activity of the test plasma. This technique is very precise and has been used to investigate fibrinolytic activity in families with mild bleeding tendencies. For many research and clinical purposes, the ECL test has been supplanted by recently developed assays based on a chromogenic substrate (S- 2251) which is a specific substrate for plasmin and plasminogen activated streptokinase. Using the chromogenic substrate technique, plasminogen activator, plasminogen, plasmin, and anti-plasmins may be easily and readily quantified. REFERENCES 1. Allen RA. Blood sampling techniques for fibrinolytic studies. Thromb Res 23:1-2. 2. Von Kaulla KN, von Kaulla E. "Remarks on the Euglobulin Lysis Time." In: JF Davidson (ed.), Progress in Chemical Fibrinolysis and Thrombolysis, Vol 1. Raven Press: New York, 1975.
fifik^ Page 5 3. Griffiths NJ, et al. Plasma fibrinolytic inhibitors post operation. Surg Gynecol Obst 144:673-676, 1977. 4. Knight MTN, et al. Fibrinolytic response to surgery. Lancet 2:370-373, 1977. 5. Gader AMA. The potentiating effect of corticosteroids on the fibrinolytic system in response to I.V. infusion of adrenalin in man. Haemostasis 17:353- 356, 1982. 6. Heimburger N. "Plasminogen Assay: a review and evaluation of various methods." In: JF Davidson (ed.), Progress in Chemical Fibrinolysis and Thrombolysis, Vol 1. Raven Press: New York, 1975. 7. Prentice CRM. Basis of antifibrinolytic therapy. J Clin Pathol (Suppl.) 33 (suppl 14) pp. 35-40. 8. Horvath AE. The 125I-Fibrinogen Euglobulin Clot Lysis Test. Am J Clin Pathol 70(2):271-274, 1978. 9. Latallo ZS, et al. Assessment of plasma fibrinolytic system with use of chromogenic substrate. Haemostasis 7:138-145, 1978. 10. Blix S. Studies on the fibrinolytic system in the euglobulin fraction of human plasma. Scand J Clin Lab Invest 13(suppl 58), 1961. 11. Arneson H, et al. "A comparison between the ECL time and the fibrin plate method for the estimation of fibrinolytic activity after venous stasis." In: JF Davidson (ed.), Progress in Fibrinolysis, Vol 5. Churchill Livingstone: Edinburgh, 1981. 12. Nilsson IM, et al. "Physiology of Fibrinolysis." In: DL Kline, KNN Reddy (eds.), Fibrinolysis, CRC Press: Boca Raton, Florida, 1980. 13. Theiss W, et al. Systemic fibrinolytic activity and inhibitor levels during treatment of deep venous thrombosis with urokinase and streptokinase. Thrombosis and Haemostasis 5(3):664-668, 1983. 14. Kluft C. Studies on the fibrinolytic system in human plasma: quantitative determination of plasminogen activator and pro-activator. Thrombosis and Haemostasis 41:365-383, 1979. 15. Von Kaulla KN, Schultz RL. Methods for evaluation of human fibrinolysis. Am J Clin Pathol 29:104-112, 1958.
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Euglobin Lysis Time

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