PAI-1与代谢综合征

血浆纤溶酶原激活物抑制剂(PAI)-1是纤溶系统的主要调控因子。近年研究发现,PAI- 1的升高是代谢综合征的一个核心特征,与肥胖、胰岛素抵抗、2型糖尿病、心血管疾病、脂代谢紊乱和高血压等密切相关,甚至可能影响内脏脂肪的蓄积。因此,对PAI—1的直接抑制不仅为降低心血管危险因素提供新的治疗策略,也对治疗肥胖、胰岛素抵抗及2型糖尿病等有益。     

培哚普利对慢性心力衰竭患者血浆t-PA和PAI-1水平的影响

目的评价培哚普利对慢性心力衰竭(CHF)患者血浆组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物-1(PAI-1)水平的影响。方法采用酶联免疫吸附法测定60例CHF患者(CHF组)及20例健康人(正常对照组)血浆t-PA、PAI-1水平。CHF组患者又随机均分为常规治疗亚组和培哚普利亚组。培哚普利亚组在常规治疗基础上加用培哚普利2~4mg,每日1次。所有CHF患者治疗2周后复测血浆t-PA、PAI-1水平。结果CHF患者血浆t-PA、PAI-1水平比正常对照组明显增高(P<0.01)。治疗后,培哚普利亚组血浆PAI-1水平比常规治疗亚组明显降低(P<0.01),血浆t-PA水平比常规治疗亚组明显升高(P<0.01)。结论培哚普利不仅可降低PAI-1水平,而且可升高t-PA水平,改善内源性纤溶功能。     

纤溶酶原激活物抑制物在纤维化肝组织中的表达及其血浆活性检测

目的 研究和探讨纤溶酶原激活物抑制物（ｐｌａｓｍｉｎｏｇｅｎ ａｃｔｉｖａｔｏｒ ｉｎｈｉｂｉｔｏｒ－１,ＰＡＩ－１）在人肝纤维化组织中分布、作用及血浆中活性水平的变化。方法 采用原位杂交和免疫组织化学方法检测正常人,慢性乙型肝炎及肝硬化患者肝组织中ＰＡＩ－１ｍＲＮＡ和蛋白表达,并对蛋白表达的半定量结果与肝纤维化程度进行对比分析。同时采用发色７底物法检测血浆中ＰＡＩ－１活性。结果 随肝纤维化程度的     

胰岛素抵抗状态下HepG2细胞纤维蛋白溶解酶原激活物抑？…

目的 观察胰岛素、胰岛素原对ＨｅｐＧ２细胞纤维蛋白溶解酶原激活物抑制物－１（ＰＡＩ－１）基因表达的影响。方法 将ＨｅｐＧ２细胞置于１０＾－７ｍｏｌ／Ｌ胰岛素培液中２４小时使胰素受体下调将ＨｅｐＧ２细胞导成为胰岛素抵抗的ＨｅｐＧ２细胞,然后分别用胰岛素、胰岛素原（１０＾－９ｍｏｌ／Ｌ）持续刺激ＨｅｐＧ２细胞２４小时,检测培养液中ＰＡＩ的活性、含量及胞浆中ＰＡＩ－１ｍＲＮＡ水平。结果（１）基因状态下胰     

高血压并发不同程度糖代谢异常血浆PAI-1水平变化

目的探讨高血压患者并发不同程度糖代谢异常血浆纤溶酶原激活物抑制剂-1(PAI-1)的相关性及其影响。方法160例高血压病患者,根据空腹血糖(FPG)和OGTT检查2h血糖(2HPG)试验结果分为三组:糖耐量正常(NGT)组、糖耐量异常(IGT)组和糖尿病(DM)组。用酶联免疫双抗体吸附法(ELISA法)测定三组患者血浆PAI-1抗原。结果①单因素方差分析(ANOVA)显示,NGT、IGT和DM三组PAI-1水平差异有统计学意义[(30.25±6.17)ng/ml、(43.12±5.52)ng/ml和(55.04±8.03)ng/ml;P<0.01]。②以PAI-1与年龄、收缩压(SBP)、舒张压(DBP)、FPG、2HPG作直线回归分析,能进入该方程的变量为年龄、SBP、DBP、2HPG。结论高血压患者伴发糖代谢异常及其严重程度与PAI-1升高正相关;年龄、SBP、DBP、2HPG为PAI-1独立影响因素。     

C-reactive protein is directly related to plasminogen activator inhibitor type 1 (PAI-1) levels in diabetic subjects with the 4G allele at position -675 of the PAI-1 gene

Background and aimsC-reactive protein (CRP) has been identified as a possible factor able to promote atherosclerosis. “In vitro” studies have demonstrated that CRP induces plasminogen activator inhibitor type 1 (PAI-1) expression, suggesting a hypofibrinolytic role for CRP. As CRP and PAI-1 levels increase in type 2 diabetic subjects, we decided to study the relationship between CRP and PAI-1, and the role of the 4G/5G polymorphism of the PAI-1 gene on this relationship in a diabetic population without complications.Methods and resultsTwo hundred and ninety-five type 2 diabetic patients (age 60.9 ± 10.5 years) and 290 healthy controls (age 59.2 ± 11.5 years) were enrolled. A significant correlation between PAI-1 and CRP in diabetic subjects was found (r = 0.45, p < 0.001), whereas no relationship was evident in the control subjects between these inflammatory markers. Multiple regression analysis highlighted that CRP is the only one significant variable of PAI-1 antigen in diabetic subjects (partial r = 0.31, p < 0.01). Stratifying by genotype, a positive correlation between PAI-1 and CRP in 4G/4G (partial r = 0.64 p < 0.001) and 4G/5G (partial r = 0.47, p < 0.001) subjects was found, whereas no correlation in 5G/5G was present. Multiple regression analysis confirmed the presence of this correlation in 4G/4G (partial r = 0.45, p < 0.001) and in 4G/5G (partial r = 0.34, p = 0.007) diabetic patients.ConclusionsThese findings demonstrate that CRP plays an important role in the complex mechanism regulating PAI-1 antigen in 4G diabetic carriers.     

纤溶酶原激活物抑制剂-1与肾损伤的相关性分析

目的:探讨纤溶酶原激活物抑制剂-1(PAI-1)与肾损伤的相关性。方法:将慢性肾功能衰竭(CRF)120例患者设为观察组;同期选择健康体检者120例设为对照组。对2组PAI-1进行比较分析。结果:观察组的PAI-1含量明显高于对照组[(12.66±3.24)Au/m L vs(6.97±2.33)Au/m L(P0.05)]。随着病程的延长,观察组的PAI-1含量也呈现明显增加的趋势(P0.05)。观察组的TC、TG与LDL值明显高于对照组(P0.05)。Spearman相关性分析表明观察组的PAI-1含量与血脂各项指标均无显著相关,但是与病程有明显相关性(P0.05)。结论:PAI-1在肾损伤时明显表达增强,与疾病的病程有明显相关性,与血脂表达不存在明显相关性。     

老年糖尿病PAI-1与IR的相关性分析

目的探讨老年糖尿病患者血浆纤溶酶原激活物抑制物-1(PAI-1)活性及基因启动子区4G/5G多态性与胰岛素抵抗(IR)的关系。方法运用等位基因特异性PCR扩增技术对136例老年糖尿病患者PAI-14G/5G多态位点的基因型进行检测,发色底物法测血浆PAI-1活性。结果1老年糖尿病患者血浆PAI-1活性明显升高,空腹胰岛素(FPG)、胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、4G/5G基因类型与PAI-1活性升高密切相关(P<0.05)。2对照组和伴IR的糖尿病患者的4G/4G基因型频率分别为47.2%和32,5%,两组比较无明显差异(P>0.05),IR组不同基因型患者的PAI-1活性差异显著(P<0.01),4G/4G型者PAI-1活性明显高于4G/5G和5G/5G者(P<0.05)。3胰岛素对PAI-1活性的影响无基因依赖性。结论老年糖尿病患者PAI-1活性升高,FPG、HOMA-IR、BMI与PAI-1活性升高有关,甘油三酯对PAI-1活性的调节存在基因型依赖性。     

非酒精性脂肪性肝病大鼠肝脏纤溶酶原激活物及其抑制物mRNA表达

目的　探讨非酒精性脂肪性肝病 (NAFLD)大鼠肝脏组织型纤溶酶原激活物 (t PA )及纤溶酶原激活物抑制物 1(PAI 1)基因表达及其意义。方法　高脂饮食建立SD大鼠NAFLD模型 ,分批于造模第 8、12、16、2 4周处死 ,同期设普通饮食喂养大鼠作对照。通过H E染色和苦味酸VG染色观察肝组织学改变 ,应用RT PCR对肝脏t PA和PAI 1mRNA的表达进行相对定量分析。结果　模型组大鼠于实验 8、12、2 4周分别形成单纯性脂肪肝、脂肪性肝炎以及脂肪性肝炎并肝纤维化。与对照组相比 ,模型组大鼠肝脏PAI 1mRNA表达随造模时间延长而增强 ,于实验 2 4周达高峰( 1.0 2± 0 .11比 0 .5 1± 0 .0 9,P <0 .0 1) ,并与其肝脂肪变及肝组织学损伤程度呈正相关 (r分别为 0 .492和 0 .3 72 ,P分别 <0 .0 1和 <0 .0 5 )。肝脏t PAmRNA表达随造模时间延长而逐渐减少 ,于实验 2 4周降至最低 ( 0 .89± 0 .11比 1.62± 0 .10 ,P <0 .0 1) ,但其仅与肝组织学损伤程度总积分呈负相关 (r =-0 .3 68,P <0 .0 5 )。结论　高脂饮食大鼠肝脏PAI 1及t PA基因表达改变可能参与NAFLD的发病     

中老年男性高尿酸血症患者血浆PAI-1和内皮素水平升高

测定单纯高尿酸血症及其合并糖脂代谢紊乱患者血浆纤溶酶原激活物抑制物1（PAI-1）和内皮素水平。结果显示高尿酸血症患者血浆PAI-1、内皮素水平明显高于正常对照者（均P〈0．01），提示高尿酸血症与血管内皮细胞损伤有关。     

代谢综合征组成成分数与血浆纤溶酶原激活物抑制因子-1水平的关系

目的探讨代谢综合征（MS）组成成分数与血浆纤溶酶原激活物抑制因子-1（PAI-1）水平的关系。方法依据中华医学会糖尿病学分会建议MS诊断标准中MS的4个组成成分（超重或肥胖、高血糖、高血压、血脂紊乱）将121名患者分为4组（M1、M2、M3和M4）,M1、M2、M3和M4组患者分别具有以上的1、2、3和4组成成分。正常对照组（M0）20例。观察各组间的PAI-1水平、PAI-1和各指标间的相关关系以及影响PAI-1的相关因素。结果①M1、M2、M3和M4组血浆PAI-1水平明显高于M0组（P值均〈0．05）;M2、M3和M4组PAI-1水平明显高于M1组（P值均〈0．05）;M3组PAI-1水平较M2组有升高趋势（P=0．078）。②在所有受试者中PAI-1和尿酸（UA）、糖化血清蛋白（GSP）、C-肽（CP）、体重指数（BMI）显著正相关（P值均〈0．05）;PAI-1和高密度脂蛋白（HDL）显著负相关（P〈0．05）。③多元逐步回归分析显示：UA、GSP与PAI-1存在直线回归关系（R^2=0．147）。结论血浆PAI-1水平随着MS组成成分数的增加而增加;GSP和UA是影响PAI-1水平的独立因素。     

Promoter (4G/5G) plasminogen activator inhibitor-1 genotype in Pima Indians: relationship to plasminogen activator inhibitor-1 levels and features of the insulin resistance syndrome

Summary Elevated plasminogen activator inhibitor-1 may contribute to vascular disease in diabetes mellitus. Pima Indians have a low incidence of cardiovascular disease despite having a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) which in this population is not associated with elevated plasminogen activator inhibitor-1 activity. In Caucasians an insertion/deletion (4G/5G) polymorphism in the promoter region of the plasminogen activator inhibitor-1 gene that has been related to activity levels of its protein in plasma differentially binds repressor and enhancer elements. In 265 Pima Indians (133 diabetic, 132 non-diabetic, 129 male, 136 female, mean age 46.6, range 34–68 years) the promoter genotype frequencies were 23.0 % for 4G/4G, 49.8 % for 4G/5G and 27.2 % for 5G/5G compared to 35.4 %, 50.8 % and 13.8 % respectively (χ² = 15.3, 2 df, p < 0.0005) previously reported in Caucasians with NIDDM. The mean plasma activity levels in the three genotypes in the Pima Indians were 18.2, 19.1 and 18.1 U/ml, respectively. Plasminogen activator inhibitor-1 activities correlated with plasma insulin (r = 0.38, p < 0.0001), body mass index (r = 0.24, p < 0.0001), and with triglyceride level (r = 0.12, p = 0.054) but there was no relationship between promoter genotype and activity. A steeper regression slope between plasminogen activator inhibitor-1 activity and triglycerides has been observed in Caucasians with the 4G/4G genotype as compared to Caucasians with the other genotypes. This was not found in the Pima population which may indicate a functional difference in this gene associated with reduced cardiovascular risk and may be involved in the lack of association of plasminogen activator inhibitor-1 levels with NIDDM in Pima Indians. [Diabetologia (1996) 39: 1512–1518] Received: 7 May 1996 and in revised form: 21 August 1996     

血清APN、PAI-1与糖尿病视网膜病变的相关性研究

目的探讨脂联素（APN）和纤溶酶原激活物抑制物-1（PAI-1）在糖尿病视网膜病变（DR）时的变化规律及临床意义。方法 ELISA法检测2型糖尿病无DR患者30例（NDR组）、2型糖尿病合并DR背景期患者30例（BDR组）、2型糖尿病合并DR增殖期患者30例（PDR组）和健康对照30例（NC组）的血清APN和PAI-1水平,氧化酶法测定FPG、TC、TG、HDL-C、LDL-C水平,免疫抑制比浊法测定HbA1c水平,计算BMI。结果 NC组、NDR组、BDR组、PDR组血清APN和PAI-1水平组间比较差异均有统计学意义（P〈0.05）。血清APN与BMI、FPG、LDL-C、TG呈负相关,与HDL-C呈正相关;PAI-1与TG、HbA1c、BMI呈正相关。结论 APN和PAI-1可能参与了DR的发生和发展,高TG血症、肥胖、高血糖可能是导致PAI-1升高和APN降低的原因。     

胰岛素抵抗、组织纤溶酶原激活物抑制物-1与急性冠脉综合征的相关性研究

目的 探讨胰岛素抵抗（IR）、组织纤溶酶原激活物抑制物-1（PA1-1）与急性冠脉综合征（ACS）患者冠脉病变严重程度的关系及对患者近期预后的预测价值,并分析IR与PA1-1的相关性.方法 连续收集2008年2月至2009年7月在我院心内科住院并诊断为ACS的患者165例,按胰岛素抵抗指数水平（HOMA指数）分为2组：胰岛素抵抗（IR）组（HOMA-IR＞5）80例,非IR组（HOMA-IR≤5）85例.分析两组ACS患者间PAI-1水平、冠脉病变严重程度的差异,并观察PAI-1水平及IR对接受经皮冠脉内介入治疗术（PCI）的ACS患者近期预后（6个月）的影响.结果 IR组ACS患者与非IR组相比,PAI-1水平明显升高,且冠脉病变严重程度增高,组间差异有统计学意义（P＜0.05或P＜0.01）;多因素Logistic回归分析显示,PAI-1及IR均是ACS患者近期预后的独立预测因子.结论 纤溶功能紊乱、IR与ACS患者冠脉病变的严重程度相关,PAI-1水平及IR对ACS患者的近期预后有预测价值.     

Tissue plasminogen activator,plasminogen activator inhibitor-1 and von willebrand factor in rheumatoid arthritis

Summary Tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF), all of endothelial origin and active in the haemostasis, were analysed in 74 patients with rheumatoid arthritis. The concentrations were related to extra-articular disease and to the incidence of thromboembolic events (TE) registered in a 2-year follow-up period. Patients with extra-articular disease had a significant increase in PAI-1 activity and reduced tPA release in the venous occlusion test. von Willebrand factor, PAI-1 and also haptoglobin and triglycerides were significantly increased in the group of patients who later suffered from TE. In a multiple regression model, in which cholesterol, triglycerides and lipoprotein (a) showed significant association with TE, vWF had the strongest additive explanatory value. No distinct acute phase pattern of PAI-1 was found in any patient subgroup.     

纤溶酶原激活物抑制剂1与静脉血栓栓塞性疾病

纤溶酶原激活物抑制剂1是纤维蛋白溶解系统的一个成分.许多研究发现血浆纤溶酶原激活物抑制剂1水平和基因多态性与静脉血栓栓塞性疾病的发生有显著的关系.     

组织型纤溶酶原激活剂及其抑制剂与肺血栓栓塞症

肺血栓栓塞症（PTE）的发病与机体的纤溶和凝血系统功能密切相关。组织型纤溶酶原激活物（t-PA）及其抑制物（PAI-1）因调节机体的纤溶系统而在静脉血栓形成及栓塞性疾病的发病机制中发挥重要作用,因此,本文对t—PA和PAI-1与PTE的关系作如下综述。     

Protection by α2-macroglobulin of tissue plasminogen activator against inhibition by plasminogen activator inhibitor-1

Tissue plasminogen activator (tPA) is widely used in the treatment of acute myocardial infarction (MI). However, its thrombolytic efficacy does not correlate with the dose administered. The interactions between tPA, α2-macroglobulin (α2-M), and plasminogen activator inhibitor-1 (PAI-1) were investigated both in vitro and in patients undergoing tPA therapy for MI in an attempt to identify variables that might affect the clinical efficacy of tPA.
Purified α2-M (5.4 mg/ml) protected 16.0% or 22.4% of tPA (12.5 IU/ml) activity from inhibition by PAI-1 at 4 or 8 IU/ml in vitro . Of nine patients treated with 5–20 mega IU of tPA for MI, the plasma activity of tPA remained increased for 15–30 min after the cessation of infusion in eight; the patient who failed to exhibit a persistent increase in tPA activity had a low plasma concentration of α2-M. Total tPA activity, derived from the area under the activity-versus-time curve (AUC), showed a significant inverse correlation with the ratio of the plasma PAI-1 activity to the plasma α2-M concentration. Total tPA activity did not correlate with plasma PAI-1 activity or plasma α2-M concentration alone. Results suggest that α2-M, by binding to tPA, protects the latter against inhibition by PAI-1.     

纤维溶解酶原激活物抑制剂-1对大鼠胚肺成纤维细胞的影响

目的 研究纤维溶解酶原激活物抑制剂-1(PAI-1)对大鼠胚肺成纤维细胞增殖、转化及胶原合成的影响,探讨PAI-1在肺纤维化发生中的作用.方法 体外分离培养Wister 待产孕大鼠胚肺成纤维细胞,应用四甲基偶氮唑盐试验观察不同浓度(5、10、20、40、80 μg/L)的PAI-1刺激12、24和48 h后成纤维细胞的增殖率;选用PAI-1最适浓度20 μg/L刺激48和72 h后,细胞免疫化学法检测增殖细胞核抗原(PCNA)的表达;实时PCR法检测α-平滑肌肌动蛋白(α-SMA)、Ⅰ型胶原24和48 h时mRNA表达的变化.结果各浓度PAI-1刺激成纤维细胞后,以20 μg/L 12 h增殖率及吸光度值最高,分别为62.6%和0.573±0.039.在12 h中,不同浓度组较对照组差异有统计学意义(F=111.112,P=0.000),选择20 μg/L为最适浓度.免疫细胞化学法检测20 μg/L PAI-1刺激48、72 h后,PCNA表达的积分吸光度值分别为3685±686和2530±477,较对照组差异有统计学意义(F=7.85,P=0.020).PAI-1刺激成纤维细胞24和48 h后,α-SMA表达上调(230±11)%和(159±9)%,较对照组差异有统计学意义(F=39.92,P=0.000).Ⅰ型胶原表达上调(92±8)%和(65±12)%,差异有统计学意义(F=32.61,P=0.001).结论 PAI-1可以促进成纤维细胞增殖、转化及胶原合成,可能促进肺间质纤维化的发生和发展.

Abstract：

Objective To explore the effect of plasminogen activator inhibitor-1 (PAI-1) on the proliferation and conversion of rat embryonic lung fibroblasts and the synthesis of collagen, and therefore to explore the function of PAI-1 in pulmonary fibrosis.Methods The embryonic lung fibroblasts from pregnant Wistar rats were isolated and cultured in vitro. The reproduction rate of fibroblasts at 12 h, 24 h, and 48 h after being stimulated by PAI-1 with different concentrations (5, 10, 20, 40, 80, and 100 μg/L) was measured by MTT assay. After being stimulated by PAI-1 with the most suitable concentration (20 μg/L) for 48 h and 72 h, the expression of proliferating cell nuclear antigen (PCNA) was measured by immunocytochemical technique, and the mRNA expression of α-SMA and type-1 collagen at 24 h and 48 h was measured by real-time PCR. Results PAI-1 with different concentrations stimulated the proliferation of fibroblasts. The highest proliferation rate and absorbance in concentration of 20 μg/L and at 12 h were 62.6% and 0.573±0.039. The comparison of different concentrations showed that the difference was significant(F=111.112,P=0.000). Therefore, 20 μg/L was selected as the most suitable concentration. Using immunocytochemical method, the optical density of PCNA at 48 h and 72 h were 3685±686 and 2530±477 after being stimulated with 20 μg/L PAI-1.The comparison showed significant difference(F=7.85,P=0.02). The expression of α-SMA increased (230±11)% and(159±9)% at 24 h and 48 h after being stimulated with 20 μg/L PAI-1, and the difference was significant(F=39.92, P=0.0003). The expression of type-1 collagen increased(92±8)% and (65±12)%, the difference being significant(F=32.61,P=0.0006). Conclusion PAI-1 can promote the proliferation and conversion of fibroblasts and the synthesis of collagen, which may be involved in the pathogenesis of pulmonary interstitial fibrosis.