Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease
Abstract The musculoskeletal system is critical for movement and the protection of organs. In addition to abrupt injuries, daily physical demands inflict minor injuries, necessitating a coordinated process of repair referred to as the acute‐phase response (APR). Dysfunctional APRs caused by severe i...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Research and Practice in Thrombosis and Haemostasis |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/rth2.12355 |
| _version_ | 1797711411373146112 |
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| author | Breanne H.Y. Gibson Matthew T. Duvernay Stephanie N. Moore‐Lotridge Matthew J. Flick Jonathan G. Schoenecker |
| author_facet | Breanne H.Y. Gibson Matthew T. Duvernay Stephanie N. Moore‐Lotridge Matthew J. Flick Jonathan G. Schoenecker |
| author_sort | Breanne H.Y. Gibson |
| collection | DOAJ |
| description | Abstract The musculoskeletal system is critical for movement and the protection of organs. In addition to abrupt injuries, daily physical demands inflict minor injuries, necessitating a coordinated process of repair referred to as the acute‐phase response (APR). Dysfunctional APRs caused by severe injuries or underlying chronic diseases are implicated in pathologic musculoskeletal repair, resulting in decreased mobility and chronic pain. The molecular mechanisms behind these phenomena are not well understood, hindering the development of clinical solutions. Recent studies indicate that, in addition to regulating intravascular clotting, the coagulation and fibrinolytic systems are also entrenched in tissue repair. Although plasmin and fibrin are considered antithetical to one another in the context of hemostasis, in a proper APR, they complement one another within a coordinated spatiotemporal framework. Once a wound is contained by fibrin, activation of plasmin promotes the removal of fibrin and stimulates angiogenesis, tissue remodeling, and tissue regeneration. Insufficient fibrin deposition or excessive plasmin‐mediated fibrinolysis in early convalescence prevents injury containment, causing bleeding. Alternatively, excess fibrin deposition and/or inefficient plasmin activity later in convalescence impairs musculoskeletal repair, resulting in tissue fibrosis and osteoporosis, while inappropriate fibrin or plasmin activity in a synovial joint can cause arthritis. Together, these pathologic conditions lead to chronic pain, poor mobility, and diminished quality of life. In this review, we discuss both fibrin‐dependent and ‐independent roles of plasminogen activation in the musculoskeletal APR, how dysregulation of these mechanisms promote musculoskeletal degeneration, and the possibility of therapeutically manipulating plasmin or fibrin to treat musculoskeletal disease. |
| first_indexed | 2024-03-12T07:06:41Z |
| format | Article |
| id | doaj.art-ef606f45d3c84023a06b0b642dcad098 |
| institution | Directory Open Access Journal |
| issn | 2475-0379 |
| language | English |
| last_indexed | 2024-03-12T07:06:41Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Research and Practice in Thrombosis and Haemostasis |
| spelling | doaj.art-ef606f45d3c84023a06b0b642dcad0982023-09-02T23:26:45ZengElsevierResearch and Practice in Thrombosis and Haemostasis2475-03792020-05-014446948010.1002/rth2.12355Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and diseaseBreanne H.Y. Gibson0Matthew T. Duvernay1Stephanie N. Moore‐Lotridge2Matthew J. Flick3Jonathan G. Schoenecker4Department of Pharmacology Vanderbilt University Nashville TN USADepartment of Pharmacology Vanderbilt University Nashville TN USADepartment of Orthopaedics Vanderbilt University Medical Center Nashville TN USADepartment of Pathology and Laboratory Medicine University of North Carolina‐Chapel Hill NC USADepartment of Pharmacology Vanderbilt University Nashville TN USAAbstract The musculoskeletal system is critical for movement and the protection of organs. In addition to abrupt injuries, daily physical demands inflict minor injuries, necessitating a coordinated process of repair referred to as the acute‐phase response (APR). Dysfunctional APRs caused by severe injuries or underlying chronic diseases are implicated in pathologic musculoskeletal repair, resulting in decreased mobility and chronic pain. The molecular mechanisms behind these phenomena are not well understood, hindering the development of clinical solutions. Recent studies indicate that, in addition to regulating intravascular clotting, the coagulation and fibrinolytic systems are also entrenched in tissue repair. Although plasmin and fibrin are considered antithetical to one another in the context of hemostasis, in a proper APR, they complement one another within a coordinated spatiotemporal framework. Once a wound is contained by fibrin, activation of plasmin promotes the removal of fibrin and stimulates angiogenesis, tissue remodeling, and tissue regeneration. Insufficient fibrin deposition or excessive plasmin‐mediated fibrinolysis in early convalescence prevents injury containment, causing bleeding. Alternatively, excess fibrin deposition and/or inefficient plasmin activity later in convalescence impairs musculoskeletal repair, resulting in tissue fibrosis and osteoporosis, while inappropriate fibrin or plasmin activity in a synovial joint can cause arthritis. Together, these pathologic conditions lead to chronic pain, poor mobility, and diminished quality of life. In this review, we discuss both fibrin‐dependent and ‐independent roles of plasminogen activation in the musculoskeletal APR, how dysregulation of these mechanisms promote musculoskeletal degeneration, and the possibility of therapeutically manipulating plasmin or fibrin to treat musculoskeletal disease.https://doi.org/10.1002/rth2.12355acute‐phase reactionfibrinogenmusculoskeletal diseasesplasminogenplasminogen activatorsrheumatic diseases |
| spellingShingle | Breanne H.Y. Gibson Matthew T. Duvernay Stephanie N. Moore‐Lotridge Matthew J. Flick Jonathan G. Schoenecker Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease Research and Practice in Thrombosis and Haemostasis acute‐phase reaction fibrinogen musculoskeletal diseases plasminogen plasminogen activators rheumatic diseases |
| title | Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease |
| title_full | Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease |
| title_fullStr | Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease |
| title_full_unstemmed | Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease |
| title_short | Plasminogen activation in the musculoskeletal acute phase response: Injury, repair, and disease |
| title_sort | plasminogen activation in the musculoskeletal acute phase response injury repair and disease |
| topic | acute‐phase reaction fibrinogen musculoskeletal diseases plasminogen plasminogen activators rheumatic diseases |
| url | https://doi.org/10.1002/rth2.12355 |
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