THROMBOSIS AND HEMOSTASIS A delays fibrin clot lysis by altering fibrin structure and attenuating plasminogen binding to fibrin

Alzheimer disease is characterized by the presence of increased levels of the amyloid peptide (A ) in the brain parenchyma and cerebral blood vessels. This accumulated A can bind to fibrin(ogen) and render fibrin clots more resistant to degradation. Here, we demonstrate that A 42 specifically binds to fibrin and induces a tighter fibrin network characterized by thinner fibers and increased resistance to lysis. However, A 42-induced structural changes cannot be the sole mechanism of delayed lysis because A overlaid on normal preformed clots also binds to fibrin and delays lysis without altering clot structure. In this regard, we show that A interferes with the binding of plasminogen to fibrin, which could impair plasmin generation and fibrin degradation. Indeed, plasmin generation by tissue plasminogen activator (tPA), but not streptokinase, is slowed in fibrin clots containing A 42, and clot lysis by plasmin, but not trypsin, is delayed. Notably, plasmin and tPA activities, as well as tPA-dependent generation of plasmin in solution, are not decreased in the presence of A 42. Our results indicate the existence of 2 mechanisms of A 42 involvement in delayed fibrinolysis: (1) through the induction of a tighter fibrin network composed of thinner fibers, and (2) through inhibition of plasmin(ogen)–fibrin binding. (Blood. 2012;119(14):3342-3351)