PAI-1基因多态性与不孕患者子宫内膜发育不良的遗传易感性研究

目的 探讨纤溶酶原激活剂抑制物-1(plasminogen activator inhibitor-1,PAI-1)基因多态性与不孕患者的子宫内膜发育的相关性.方法 选取经B超测量子宫内膜厚度及子宫内膜病理学检查诊断为子宫内膜发育不良不孕患者105例,有正常生育的健康非妊娠妇女85名,应用聚合酶链反应-限制性片段长度多态性分析技术检测PAI-1基因-675位4G/5G多态性.结果 患者组PAI-1基因4G/4G基因频率(48.6%)和4G等位基因频率(66.2%)显著高于对照组(22.4%和47.1%)(P<0.01)差异有统计学意义,与5G/5G基因型比较4G/4G型患者发生子宫内膜反应不良致不孕的相对风险率的比数比(odds ratio,OR)为4.9,95%的可信区间为2.10-10.12.结论 PAI-1基因4G/5G多态性与不孕患者的子宫内膜发育不良密切相关.     

Association of genetic polymorphism in plasminogen activator inhibitor-1 gene with endometrial hypoplasia in infertile women

OBJECTIVE: To investigate the relationship between the plasminogen activator inhibitor (PAI-1) polymorphisms and endometrial hypoplasia in infertile women. METHODS: The study was conducted in 105 primary infertile patients with endometrial hypoplasia diagnosed by pathology and the thickness of endometrium by B-mode ultrasound and 85 controls who were not pregnant and had normal fertility. The -675 4G/5G polymorphism in the PAI-1 gene was detected by polymerase chain reaction-restriction fragment length polymerphim analysis. RESULTS: The frequencies of 4G/4G genotype and 4G allele of the PAI-1 gene were higher in the patient group (48.6% and 66.2%) than in the normal controls (22.4% and 47.1%) (P < 0.01). ThePAI-1 4G/4G genotype was significantly associated with endometrial hypoplasia in the infertile patients (OR=4.9, 95% CI: 2.10-10.12). CONCLUSION: The present findings suggest that the 4G/5G polymorphism of the PAI-1 gene was associated with endometrial hypoplasia in infertile patients.     

纤溶酶原激活剂抑制物-1基因启动子区-6754G/5G多态性与中国人冠心病的关联研究

目的　研究纤溶酶原激活剂抑制物 - 1(plasminogen activator inhibitor- 1,PAI- 1)基因启动子区 - 6 75 4 G/ 5 G多态性与中国人冠状动脉粥样硬化性心脏病 (coronary heartdisease,CHD,简称冠心病 )发病的关系。方法　应用聚合酶链反应 -限制性片段长度多态性分析 ,对 12 1名健康人和 12 6例冠心病患者(其中急性心肌梗塞 4 7例 ,陈旧性心肌梗塞 39例 ,心绞痛 4 0例 )进行了 PAI- 1基因 4 G/ 5 G多态性分析。结果　 PAI- 1基因 4 G等位基因频率冠心病组 (0 .6 0 )显著高于正常对照组 (0 .4 8) (χ2 =7.6 3,P<0 .0 1) ;4 G/4 G基因型基因频率冠心病组 (0 .397)显著高于正常对照组 (0 .190 ) (χ2 =12 .6 7,P<0 .0 1) ,与 5 G/ 5 G基因型相比 ,对冠心病的比数比 (odds ratio,OR)为 2 .5 4 ,95 %的可信区间 (confidence interval,CI) :1.2 2～ 5 .2 7(P<0 .0 5 ) ,差异有显著性 ,而 4 G/ 5 G基因型对冠心病的 OR为 1.2 8,95 % CI:1.4 5～ 2 .38(P>0 .0 5 ) ,差异无显著性。结论　PAI- 1基因 4 G/ 4 G基因型与中国汉族人冠心病的发病有关联 ,4 G/ 4 G基因型个体易发生冠心病     

纤溶酶原激活剂抑制物-1基因启动子区4G/5G多态性与妊娠高血压综合征的关系

目的　探讨纤溶酶原激活剂抑制物 - 1(plasminogen activator inhibitor- 1,PAI- 1)基因启动子区 4 G/ 5 G多态性与妊娠高血压综合征 (pregnancy- induced hypertension syndrome,PIHs)发病的相关性。方法　应用聚合酶链反应 -限制性片段长度多态性分析 ,检测了 171例 PIHs患者 (PIHs组 )和 193名正常妊娠妇女 (对照组 )的 PAI- 1基因 4 G/ 5 G多态性。结果　 (1) PIHs组 PAI- 1基因型频率分布 :4 G/ 4 G型为4 7.4 % ,4 G/ 5 G型为 4 1.5 % ,5 G/ 5 G型为 11.1% ;PIHs组 4 G等位基因频率 (0 .6 81)和 4 G/ 4 G型频率(47.4 % )显著高于正常对照组孕妇 (0 .4 95和 2 1.2 % ) (P<0 .0 0 1)。 (2 )重度 PIHs患者组 4 G/ 4 G型和 4 G等位基因频率 (6 1.3%和 0 .75 8)显著高于轻度 PIHs组 (35 .8%和 0 .6 2 3) (P<0 .0 0 1) ;中度 PIHs组 (42 .8%和0 .6 5 2 )和轻度 PIHs组比较差异无显著性 (P>0 .0 5 )。 (3) 4 G/ 4 G基因型孕妇发生 PIHs的相对风险率的比数比为 3.34,95 %的可信区间为 2 .14～ 5 .2 2。结论　 PAI- 1基因 4 G/ 5 G多态性参与 PIHs的发病 ,纯合子4 G/ 4 G基因型可能是 PIHs发病的重要危险因素之一。     

The plasminogen activator inhibitor 1 4G/5G polymorphism is not associated with longevity: a study in octogenarians

Accumulating evidence suggests that plasma levels of the plasminogen activator inhibitor 1 (PAI-1) may modulate the risk of coronary artery disease. The regulation of PAI-1 levels underlies not only environmental but also genetic influences. The 4G/5G polymorphism of the PAI-1 gene has recently gained additional relevance as a possible cardiovascular risk factor, as the 4G allele may be associated with enhanced expression of the PAI-1 gene. This retrospective cohort study examined the effect of the PAI-1 4G/5G genotype on longevity among 205 subjects aged 80 years and older. Such studies in larger cohorts have recently become available along with new methods for the rapid and easy determination of gene polymorphisms. We utilized a light-cycler assisted method which is a fast and flexible method of analyzing the PAI-1 4G/5G polymorphism on the gene level. In these 205 persons the 4G/5G allele was found in 96 persons (47%), the 4G/4G variant in 62 (30%), and the 5G/5G allele in 47 (23%). These data are similar to the allele distribution described in other large cohorts not restricted to old age. Thus the results of this study are not suggestive of an important contribution of the PAI-1 genotype on total mortality.     

The 4G/5G polymorphism of the plasminogen activator inhibitor-1 gene is associated with severe preeclampsia

Preeclampsia is associated with thrombosis of the intervillous or spiral artery. A deletion/insertion polymorphism (4G or 5G) in the promoter of the plasminogen activator inhibitor type 1 (PAI-1) gene is suggested to be involved in regulating the synthesis of the inhibitor, 4G allele, being associated with the enhanced gene expression and plasma PAI-1 levels. We assessed the association between preeclampsia and the 4G/5G polymorphism of the PAI-1 gene in 115 preeclamptic patients, 210 pregnant controls, and 298 healthy volunteer controls. The frequency of the homozygotes for the 4G allele was significantly higher in the patients than in the control pregnant women (P = 0.04) or in the healthy volunteers (P = 0.02). The 4G allele frequency was also significantly higher in the patients than in the control group of pregnant women (P = 0.03) and in the healthy volunteers (P = 0.02). These results suggest that the presence of the 4G/4G genotype of the PAI-1 gene is one of the risk factors for preeclampsia. Received: October 14, 1999 / Accepted: January 4, 2000     

Recurrent pregnancy loss and its relation to FV Leiden, FII G20210A and polymorphisms of plasminogen activator and plasminogen activator inhibitor

Thrombophilic disorders and hypofibrinolysis were demonstrated to be risk factors in a majority of women with recurrent pregnancy loss (RPL) and infertility. We investigated the association of FV G1691A mutation, F II G20210A gene polymorphism (PM), 4G/5G PAI-1 and Alu I/D tPA PM in 32 women with infertility and 49 women with at least 2 unexplained early abortions. FV Leiden mutation was significantly more common in women with RPL (10%, p = 0.02) and infertility (19%, p = 0.0005) compared with controls (2%). PAI-1 4G PM and t-PA Alu I PM, alone or in combination, were not associated with RPL or infertility. 9/49 women with RPL showed coagulation disorders with heterozygous FV Leiden mutation (5), FXII (1), protein C (1) or protein S (2) deficiency. However, due to the small number of patients studied, no definite conclusion can be drawn.     

纤溶酶原激活剂抑制剂-1基因4G/5G多态性与卵巢早衰相关性研究

目的探讨纤溶酶原激活剂抑制剂-1(PAI-1)基因启动子区4G/5G多态性与卵巢早衰(POF)发病的相关性。方法应用聚合酶链反应—限制性片段长度多态性分析,检测了83例POF患者(POF组)和56例正常妇女(对照组)的PAI-1基因4G/5G多态性;经阴彩色多普勒检测卵巢大小、卵巢动脉内径、RI指数。结果(1)POF组PAI-1基因分布:4G/4G型为38.6%,4G/5G型为47%,5G/5G型为14.4%;POF组4G等位基因频率(0.621)和4G/4G型频率(38.6%)显著高于正常对照组(0.455和16.1%)(P(0.01)。(2)POF组卵巢大小(2.03 cm×1.1 cm)明显小于对照组(2.9 cm×2.3 cm),卵巢动脉内径明显小于对照组,而卵巢动脉血流阻力指数(0.72±0.04)明显高于对照组(0.47±0.04)。(3)4G/4G基因型妇女发生POF的相对风险率的比数比为3.28,95%的可信区间为1.45~7.43。结论PAI-1基因4G/5G多态性与POF的发病密切相关,纯合子4G/4G基因型可能是POF发病的重要危险因素之一。     

PAI-1基因和纤维蛋白原β链基因多态性与狼疮性肾炎肾小球微血栓的关系

目的 探讨纤溶酶原活化剂抑制物－1（plasminogen activator inhibitor-1,PAI-1）基因和纤维蛋白原β链基因多态性与狼生肾炎（lupus nephritis,LN）肾小球微血栓形成之间的相关性。方法 选取101例LN患者，依据肾活检组织肾小球微栓的有无，将患者分为两组：LN伴血栓（LN＋T）组46例；不伴血栓(LN-T)且55例。应用聚合酶链反应－限制性片段长度多态性和聚合酶链反应－序列长度多态性技术分别分析两修选基因的基因型，正常对照组为128名健康成人。结果 （1）PAI－1基因4G／4G基因型和4G等位基因与LN＋T组显著相关；LN中4G／4G型患者发生肾小球Pan内血栓的相对风险率的比值比（odds ratio,OR）为2.96,95%可信区间（confidence interval,CI）：1.26-6.92；92）纤维蛋白原β链基因G／A＋A／A基因型和A型等位基因与LN＋T组显著相关；LN中A型等位基因携带者发生肾小球Pan内血栓的相对风险率为OR＝2.44，95％CI：0.98－5.59；（3）LN患者若同时兼有上述两的血栓易感基因型，其发生肾小球微血栓的相对风险率明显增加，OR＝4.5,95%CI:1.34-15.12；血栓易感基因型的混合病因分值（45.98%）也高于各自单独的病因分值（PAI－1基因4G／4G型为31.67%、纤维蛋白原β链基因G／A＋A／A基因型为28.23%）。结论 LN肾小球微血栓的形成与PAI－1基因和纤维蛋白原β基因多态性有关，两基因的易栓基因型在LN肾小球微血栓这一病理表型的形成上具有协同效应。     

PAI-1基因4G/5G多态性与特发性肺纤维化的相关性研究

目的探讨纤溶酶原激活剂抑制物-1（plasminogen activator inhibitor-1,PAI-1）基因启动子区4G/5G多态性与特发性肺纤维化（IPF）的相关性。方法应用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析,检测42例IPF患者和164例正常对照组人群PAI-1基因4G/5G多态性。结果PAI-1基因4G/4G、4G/5G、5G/5G基因型频率分布,IPF组分别为31.0%、50.0%、19.0%,对照组分别为17.1%、54.9%、28.0%;4G和5G等位基因频率,IPF组分别为0.560和0.440,对照组分别为0.445和0.555;4G/4G基因型频率IPF组显著高于对照组（P〈0.05）。与4G/5G和5G/5G基因型比较,携带4G/4G型个体发生IPF的风险增加2.18倍,95%CI：1.02～4.68（P〈0.05）。结论PAI-1基因4G/5G多态性与IPF的发病相关,纯合子4G/4G基因型可能是IPF发病的重要危险因素之一。     

Relationship between plasminogen activator inhibitor type-1 (PAI-1) gene polymorphisms and osteoporosis in Turkish women

OBJECTIVE:

The development of osteoporosis is associated with several risk factors, such as genetic structures that affect bone turnover and bone mass. The impact of genetic structures on osteoporosis is not known. Plasminogen activator inhibitor type-1 regulates the bone matrix and bone balance. This study assessed the correlation between plasminogen activator inhibitor type-1 gene 4G/5G polymorphisms and osteoporosis in a population of Turkish women.

METHODS:

A total of 195 postmenopausal female patients who were diagnosed with osteoporosis (Group I) based on bone mineral density measurements via dual-energy x-ray absorptiometry and 90 females with no osteoporosis (Group II) were included in this study. Correlations between PAI-1 gene 4G/5G polymorphisms and osteoporosis were investigated through the identification of PAI-1 gene 4G/5G polymorphism genotypes using the polymerase chain reaction.

RESULTS:

No significant differences in the genotype and allele frequency of 4G/5G plasminogen activator inhibitor type-1 polymorphisms were observed between the two groups, and both groups exhibited the most frequently observed 4G5G genotype.

CONCLUSION:

No correlation between the development of osteoporosis in the female Turkish population and 4G/5G plasminogen activator inhibitor type-1 gene polymorphisms was observed.     

Tissue plasminogen activator, plasminogen activator inhibitors, and activator-inhibitor complex in liver disease.

AIMS--To identify the relative contribution of plasminogen activators, particularly tissue plasminogen activator (t-PA) and specific plasminogen activator inhibitors (PAI-1, PAI-2), to the fibrinolytic changes associated with various types of liver disease or severe chemical and physical damage to the liver. METHODS--Platelet rich (PRP) and platelet poor plasma (PFP) from patients with alcoholic cirrhosis, primary biliary cirrhosis, hepatic malignancy, or paracetamol overdose, or who were undergoing partial hepatectomy or liver transplantation, were assayed for t-PA, PAI-1, t-PA-PAI-1 complex and PAI-2 antigen values using specific enzyme linked immunosorbent assays (ELISAs) developed in this laboratory. RESULTS--Appreciable increases in the plasma concentration of t-PA, PAI-1, and t-PA-PAI-1 were seen in patients with alcoholic cirrhosis, primary biliary cirrhosis, and hepatic malignancy. Liver damage due to paracetamol overdose and partial hepatectomy both resulted in a striking increase in plasma PAI-1 concentration, although concentrations of t-PA and t-PA-PAI-1 complex were less affected. Concentrations of t-PA, PAI-1, and t-PA-PAI-1 complex returned to near normal values after successful liver transplantation in a patient with chronic active hepatitis. PAI-2 was also detected in several patients with chronic liver disorders. CONCLUSIONS--Haemorrhage due to fibrinolytic bleeding is commonly associated with liver disease. The patients studied here all had appreciable increases in circulating t-PA antigen concentrations. This was associated with increased concentrations of PAI-1 antigen and t-PA-PAI-1 complex and the balance between activator and inhibitor did not result in systemic plasmin generation. Reduced PAI-1 activity in cirrhosis or a critical difference in the ratio of t-PA to PAI-1 concentrations may explain the enhanced plasminogen activator activity previously noted in cirrhosis but not metastatic disease. Reduced hepatic clearance of t-PA and t-PA-PAI-1 complex due to impaired liver function may account for increased concentrations of free and complexed t-PA.     

PAI-1基因和MTHFR基因多态性与复发性早期自然流产的关系

目的探讨纤溶酶原激活剂抑制物1(plasminogenactivatorinhibitor1,PAI1)基因和亚甲基四氢叶酸还原酶(methylenetetrahydrofolatereductase,MTHFR)基因多态性与复发性早期自然流产(recurrentearlyspontaneousabortion,RESA)的相关性。方法选取127例RESA非妊娠患者和117名健康非妊娠妇女,应用聚合酶链反应限制性片段长度多态性分析技术检测PAI1基因-675位4G/5G多态性和MTHFR基因C677T位点多态性。结果(1)患者组PAI1基因4G/4G基因型频率(45.7%)和4G等位基因频率(66.1%)显著高于对照组(17.1%和46.6%)(P<0.01),与5G/5G基因型比较,4G/4G型患者发生RESA的相对风险率的比数比(oddsratio,OR)为4.8,95%的可信区间(confidenceinterval,CI):2.23～10.35;(2)MTHFR基因T/T基因型和T等位基因频率患者组(43.3%和66.5%)显著高于正常对照组(21.4%和52.6%)(P<0.01),与C/C基因型比较,T/T型患者发生RESA的相对风险率为OR=3.2,95%CI:1.40～7.30;(3)RESA患者若同时兼有4G/4G和T/T基因型时,发生自然流产的相对风险率明显增加,OR=6.20,95%CI:2.62～14.67。结论PAI1基因4G/5G多态性和MTHFR基因C677T位点多态性与不明原因RESA密切相关,易感基因型4G/4G型和T/T型对RESA的发生具有协同作用。     

PAI-1启动子区4G/5G基因多态性、ACE插入/缺失多态性与脑卒中的相关性

目的探讨纤溶酶原激活物抑制物-1(PAI-1)启动子区基因多态性和血管紧张素转换酶(ACE)插入/缺失多态性与脑卒中的关系。方法 PCR检测203例脑卒中患者和139名健康对照者PAI-1基因启动子区4G/5G多态性、ACE基因插入/缺失多态性,同时应用比色法测定血清ACE活性,发色底物法测定PAI-1活性。结果脑梗死(CI)组PAI-1活性(0.769±0.163 AU/mL)、ACE活性(43.42±14.36 U/L)明显高于对照组(0.652±0.116 AU/mL和31.28±8.64 U/L,P<0.01);CI组PAI-I基因4G纯合子、ACE D/I基因DD纯合子比例明显高于对照组(P<0.01);PAI-I基因4G/4G基因型与ACE基因D/D基因型对CI发病可相互协同作用(P<0.01)。结论 PAI-1基因4G/4G基因型和ACE基因D/D基因型均可能是CI发病的危险因素,且具有协同作用。     

Relationship between tissue plasminogen activator,plasminogen activator inhibitor and CT image in chronic subdural hematoma.

The present study was performed to investigate the relationship between the concentrations of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) and the CT images in 23 cases of chronic subdural hematomas (SDHs). The concentrations of t-PA and PAI-1 were quantified by enzyme-linked immunosorbent assay (ELISA). Chronic SDHs were divided into five groups according to their appearance on computed tomography: high-density (n = 4), isodensity (n = 8), low-density (n = 5), mixed-density (n = 3), layering (n = 3) types. The volume of hematoma was measured with an image analyzing software program. The concentrations of t-PA were higher in layering (41.2 +/- 0.3 ng/ml, mean +/- standard error of the mean) and high-density (40.0 +/- 1.1 ng/ml) types compared to those of low-density (23.3 +/- 4.1 ng/ml) and iso-density (25.1 +/- 3.7 ng/ml) types. The concentrations of PAI-1 were lower in layering (95.9 +/- 1.0 ng/ml) and high-density (103.4 +/- 34.5 ng/ml) types compared to that of low-density (192.5 +/- 2.6 ng/ml) type. So the ratio between t-PA and PAI-1 (t-PA/PAI) was greater in layering and high-density types. The volume of hematoma was larger in mixed-density and layering types but statistically insignificant. These results presumably suggest that the ratio between t-PA and PAI concentration may contribute to the pathogenesis of the chronic SDH.     

Levels of tissue-type plasminogen activator and plasminogen activator inhibitor 1 in disseminated intravascular coagulation syndrome

Since disseminated intravascular coagulation (DIC) may directly reflect the abnormal regulation of the fibrinolytic system by endothelial cells, we have measured the levels of tissue-type plasminogen activator (t-PA), type 1 PA inhibitor (PAI-1) and t-PA . PAI-1 complex which is formed as a result of interaction on the two factors, in the plasma of patients with DIC (n = 51) and healthy controls (n = 42). Antigens of t-PA, PAI-1 and t-PA . PAI-1 complex were significantly increased in the DIC plasma (36.4 +/- 25.1, 106.8 +/- 54.7 and 46.6 +/- 34.5 ng/ml, respectively) compared with those in normal plasma (8.5 +/- 4.3, 54.4 +/- 21.2 and 8.6 +/- 3.5 ng/ml, respectively). The molar ratio of t-PA to PAI-1 was much higher in the DIC plasma (1:3) than in normal plasma (1:6), which caused enhancement of the whole fibrinolytic activity in the DIC plasma. These changes resulted in significant consumption of plasminogen, alpha 2-plasmin inhibitor (alpha 2-PI) and a significant increase of plasmin . alpha 2-PI complex (PPI) and D-dimer. These results suggest that t-PA and its specific inhibitor PAI-1 both of which are secreted from endothelial cells into blood, play an important role on the progress of DIC.     

Tissue plasminogen activator and placental plasminogen activator inhibitor in human gingival fluid

Gingival crevicular fluid (GCF) is an extracellular exudate protecting periodontal tissue. Pathological changes in the periodontium are reflected in the composition of GCF. Crevicular fluid was collected from healthy volunteers on Millipore^® filter disks, and eluted at 100-fold dilution. The samples were tested for fibrinolytic activity and the presence of the plasminogen activators, t-PA and u-PA, and the specific plasminogen activator inhibitors, PAI-1 and PAI-2. In the diluted samples, t-PA was found at concentrations of 4–33 gmg/l, and PAI-2 at concentrations of 19–84 μg/l, whereas u-PA and PAI-1 were hardly detectable. Analyses of parotid and whole saliva yielded no evidence of gingival fluid contamination from these sources. The fibrinolytic activity of gingival fluid was completely quenched both by antibodies against t-PA and by PAI-2, indicating the presence of t-PA in its two chain form which is more susceptible to inhibition. This inhibition by PAI-2 may serve a regulatory purpose and prevent excessive proteolysis and tissue destruction.     

PAI-1启动子区4G/5G基因多态性、ACE插入/缺失多态性与脑卒中的相关性

目的 探讨纤溶酶原激活物抑制物-1(PAI-1)启动子区基因多态性和血管紧张素转换酶(ACE)插入/缺失多态性与脑卒中的关系.方法 PCR检测203例脑卒中患者和139名健康对照者PAI-1基因启动子区4G/5G多态性、ACE基因插入/缺失多态性,同时应用比色法测定血清ACE活性,发色底物法测定PAI-1活性.结果 脑...     

The relationship between plasma t-PA and PAI-1 levels is dependent on epistatic effects of the ACE I/D and PAI-1 4G/5G polymorphisms

Thrombus formation and degradation is partly due to a complex interplay between tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor 1 (PAI-1). There is accumulating evidence that plasma levels of t-PA and PAI-1 may be influenced by an interaction between the fibrinolytic and renin-angiotensin systems. The goal of this study was to conduct an exploratory data analysis to determine whether there is evidence that the relationship (i.e. correlation) between plasma t-PA and PAI-1 is influenced by interactive effects of the angiotensin converting enzyme (ACE) insertion/deletion (I/D) and plasminogen activator inhibitor 1 (PAI-1) 4G/5G polymorphisms in a sample of 50 unrelated African Americans and 117 unrelated Caucasians. In a single-locus analysis, no evidence for heterogeneity of plasma t-PA and PAI-1 correlations among either ACE I/D or PAI-1 4G/5G genotypes was detected. However, using the combinatorial partitioning method for exploratory data analysis, we identified evidence that is suggestive of heterogeneity of plasma t-PA and PAI-1 correlations among multilocus ACE I/D and PAI-1 4G/5G genotypes in African American females, Caucasian females, Caucasian males, but not African American males. From these results, we propose as a working hypothesis that the correlation between plasma t-PA and PAI-1 may be dependent on epistatic effects of the ACE I/D and PAI-1 4G/5G polymorphisms. This study supports the idea that interactions between the fibrinolytic and renin-angiotensin systems play an important role in the genetic architecture of plasma t-PA and PAI-1.