Fibrinolysis is the enzymatic process used by the body to remove a fibrin thrombus to restore normal blood flow once damaged endothelium is repaired.
During the clotting process, tissue plasminogen activator (t-PA) released from the blood vessel wall and the plasma proenzyme plasminogen bind to the fibrin thrombus. When activated, plasminogen is converted to plasmin which degrades the
fibrin network, causing the clot to dissolve. During this process, fibrin degradation products (FDPs), i.e. fragments called D-Dimers are produced.
Raised FDP levels in DIC
In Disseminated intravascular coagulation (DIC), activated procoagulants are released into the circulation. Platelets and coagulation factors are consumed and fibrin is deposited in small vessels, activating the fibrinolytic system. The plasmin formed degrades the fibrin (also some fibrinogen), resulting in a build-up of FDPs in the circulation. The FDPs act as anticoagulants interfering with platelet function and fibrin stabilization.
Laboratory tests are available to semi-quantify D-DIMER in plasma.
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