fibrin and Sarcoidosis

Topics: Adult; Biopsy; Conjunctivitis; Diagnosis, Differential; Fibrin; Gingival Hemorrhage; Gingival Hyperplasia; Granulomatosis with Polyangiitis; Humans; Hyalin; Male; Periodontitis; Plasminogen; Sarcoidosis; Skin Diseases, Genetic

Bronchoalveolar lavage fluids (BALF) from patients with hypersensitivity pneumonitis (HP; n = 35), idiopathic pulmonary fibrosis (IPF, n = 41) and sarcoidosis (SARC, n = 48) were investigated for alterations in the alveolar hemostatic balance. Healthy individuals (n = 21) served as Controls. Procoagulant activity (PCA), tissue factor (TF) activity and F VII activity were assessed by means of specific recalcification assays. The overall fibrinolytic activity (FA) was measured using the (125)I-labeled fibrin plate assay. Fibrinopeptide A (FP-A), D-Dimer, plasminogen activators (PA) of the urokinase (u-PA) or tissue type (t-PA), PA-inhibitor I (PAI-1) and alpha2-antiplasmin (alpha2-AP) were determined by ELISA technique. As compared to Controls, all groups with interstitial lung disease (ILD) displayed an increase in BALF PCA by approximately one order of magnitude, and this was ascribed to enhanced TF activity by >98%. Accordingly, F VII-activity was increased in all ILD groups, and elevated FP-A levels were noted. There was no significant difference in procoagulant activities between the different ILD entities, but the increase in TF was significantly correlated with deterioration of lung compliance. Overall fibrinolytic activity did not significantly differ between ILD entities and Controls, although some reduction in IPF subjects was observed. Nevertheless, changes in the profile of the different pro- and antifibrinolytic compounds were noted. U-PA, but not t-PA levels were significantly reduced in all ILD groups. alpha2-AP was markedly elevated throughout, whereas PAI-1 levels were lowered. As a balance of

Topics: Adolescent; Adult; Aged; Alveolitis, Extrinsic Allergic; Antifibrinolytic Agents; Blood Coagulation Factors; Bronchoalveolar Lavage Fluid; CD4-CD8 Ratio; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Hemostatics; Humans; Lung Compliance; Lung Diseases, Interstitial; Lymphocyte Count; Male; Middle Aged; Neutrophils; Pulmonary Fibrosis; Sarcoidosis; Thromboplastin

Fibrin deposition is prominent in the histopathologic features of chronic interstitial lung disease. Human alveolar macrophages can potentially modulate this process because normal macrophages synthesize and express the initial enzymes of both coagulation and fibrinolytic pathways. In the present study, we examined the cell-associated procoagulant activity of macrophages lavaged from patients with sarcoidosis (n = 14) or idiopathic pulmonary fibrosis (n = 13) and compared the enzyme activities with that of a group of normal volunteers (n = 16). Cells from sarcoid patients had a mean (+/- 1 SD) tissue factor activity of 1,491 +/- 2,160 units/5 X 10(5) cells, as compared with a mean of 480 units (range, 140 to 1,000 units) for normal control subjects. The same cells had a mean plasma Factor VII equivalent of 4.7 ng/10(6) cells, as compared with 0.81 ng/10(6) cells (range, 0.2 to 2.0 ng) for the normal control subjects. The enhanced activity correlated with disease activity as judged by radiographic stage: only patients with Stage II or Stage III disease had consistently elevated procoagulant activity. There was no correlation of procoagulant activity with the percentage of lymphocytes in the alveolar fluid. Cells from patients with idiopathic pulmonary fibrosis also had increased tissue factor (mean, 2,980 +/- 2,619 units) but less consistently elevated Factor VII. There was considerable variation in both procoagulant activity and cell differentials between lavage sites in 10 patients in whom 2 separate lobes were studied concurrently. In addition, we examined the plasminogen activator (PA) activities of lavaged cells and concentrated alveolar fluids.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Factor VII; Female; Fibrin; Fibrinolysis; Humans; Inflammation; Macrophages; Male; Middle Aged; Plasminogen Activators; Pulmonary Alveoli; Pulmonary Fibrosis; Sarcoidosis; Thromboplastin

Direct immunofluorescence studies were carried out in eleven specimens of granuloma annulare. The results (in all cases) indicate the presence of focal deposition of fibrin, localized primarily in the intervascular portion of the dermis, corresponding to the granulomatous and necrobiotic areas. These findings implicate the cellular mechanism of delayed hypersensitivity with focal involvement of the clotting system in the development of granuloma annulare lesion.

Topics: Blood Coagulation; Complement C3; Fibrin; Fluorescent Antibody Technique; Granuloma; Humans; Hypersensitivity, Delayed; Immunity, Cellular; Immunoglobulin M; Necrobiosis Lipoidica; Sarcoidosis; Skin; Skin Diseases

Topics: Abdomen; Antibodies; Blood Coagulation Tests; Blood Protein Disorders; Chromatography; Cold Temperature; Diagnosis, Differential; Ecchymosis; Electrophoresis; Factor XIII; Female; Fibrin; Fibrinogen; Hematuria; Hemorrhagic Disorders; Humans; Immunoglobulin G; Isoniazid; Middle Aged; Pain; Sarcoidosis

Topics: Biopsy; Blood Vessels; Complement System Proteins; Fibrin; Granuloma; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulins; Lymph Nodes; Sarcoidosis; Skin Tests

Topics: Fibrin; Fibrinolysis; Sarcoidosis