Anti-t-PA antibodies in acute myocardial infarction after thrombolysis with rt-PA

作者：Cugno Massimo^*; Castelli Roberto; Bisiani Giuliana; Griffini Samantha; Meroni Pier Luigi

来源：European Journal of Internal Medicine, 2010, 21(1): 25-29.

DOI：10.1016/j.ejim.2009.09.011

• Tissue-type plasminogen activator
• Acute myocardial infarction
• Antibodies
• Reocclusion

Background: Thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) is successfully used in acute myocardial infarction with ST elevation (STEMI). Reocclusions follow rt-PA treatment in up to 30% of patients within one year. The infusion of rt-PA may induce the production of anti-t-PA antibodies which Could interfere with the function of the native t-PA molecule.
Methods: In order to detect and characterise anti-t-PA antibodies, plasma samples were collected from 30 STEMI patients (20 treated and 10 not treated with rt-PA) at baseline before rt-PA infusion and then 15, 30, 90 and 180 days after STEM] and from 40 healthy subjects at baseline only. Immunoenzymatic, chromatographic and chromogenic methods were employed.
Results: An increase of anti-t-PA antibodies was observed 15 days (IgM, p = 0.0001) and 30 days (IgG, p = 0.0001) after rt-PA infusion. Six patients had large increases of anti-t-PA IgG which bound the catalytic domain of t-PA (two cases) or kringle 2 domain (four cases), were of IgG1 or IgG3 subclasses and interacted with the t-PA molecule in fluid phase.
Conclusion: The infusion of rt-PA may induce the production of specific antibodies that bind active sites of t-PA, thus potentially reducing its in vivo function.

• 出版日期2010-2