Fibrinolysis in human peritoneum during operation

Background. A reduced local fibrinolysis seems to be an important mechanism in the formation of adhesions. Peritonitis may cause adhesions, and the aim of the present study was to determine peritoneal fibrinolytic capacity in inflamed and normal peritoneum. Methods. Biopsy specimens from normal and inflamed human peritoneum were taken at the beginning and end of operation. After extraction plasminogen activator activity (PAA) was determined by using a chromogenic substrate assay in the presence or absence of inhibitory antibodies against tissue-type plasminogen activator (t-PA), urokinase of plasminogen activator inhibitor-1. Results. t-PA exerted 95% of the PAA. PAA was significantly reduced (p < 0.01) during peritonitis (3.0 IU/mu g protein; range 0.3 to 4.2) compared with normal peritoneum (7.1 IU/mu g protein; range, 0.6 to 18.1). A significant reduction (p < 0.05) in PAA occurred during operation both in normal peritoneum (3.8 IU/mu g protein; range, 0.8 to 8.6) and in peritonitis 0.6 IU/mu g protein; range, 0.16 to 2.1). Values are given as medians. Conclusions. The main PAA in human peritoneum was t-PA. The activity was decreasing during operation and reduced in peritonitis. This reduction in PAA might be a local response to inflammation.