Evaluation of the Global Fibrinolytic Capacity of Whole Blood

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Abstract
Assessment of the global fibrinolytic capacity of whole blood is of great clinical value for the diagnosis of bleeding and thrombotic disorders, the guidance of therapeutic decision-making, and prognosis monitoring. However, due to the complexity of the fibrinolytic system, existing fibrinolysis assays fail to meet clinical diagnostic requirements, and it remains challenging to design a “gold standard” analytical method that can reflect the global fibrinolysis level of blood. Here, we constructed a fibrin clot exhibiting optical interference effects as a fibrinolysis model, and introduced an ordered porous layer interferometry (OPLI) technique for real-time, in situ monitoring of the global fibrinolytic capacity of whole blood. We equated the global fibrinolytic capacity to plasmin activity while effectively suppressing non-specific adsorption under dynamic blood-flow conditions, thereby enabling accurate quantitative evaluation. The developed method was applied to monitor the dose-dependent downregulating effects of the endogenous fibrinolytic inhibitors PAI-1 and α2-AP on whole blood global fibrinolytic activity. Furthermore, this method successfully differentiated and quantified the ranges of global fibrinolytic capacity among hypofibrinolysis, normal fibrinolysis, and hyperfibrinolysis phenotypes. The analytical results showed a strong correlation with corresponding clinical bleeding and thrombosis risk scores. A parallel comparison with the thromboelastography method further validated the clinical applicability of this method.
Funding Information
  • Jiangsu Provincial Key Research and Development Program (BE2021355)
  • Leading Talent Program for Gusu Innovation and Entrepreneurship in Suzhou (ZXL2022635)

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