Endothelium, thrombosis and fibrinolysis

Vascular endothelium is involved in the control of thrombosis by influencing among other things, platelet functions, coagulation and fibrinolysis. Fibrinolysis is due to plasminogen conversion into plasmin by activators, which are efficiently and rapidly controlled by a specific inhibitor. Endothelium plays a pivotal role in these associations. It is a constitutive and inducible source of activators and inhibitor. It provides a favorable microenvironment for plasmin generation at the vessel surface. Furthermore, the fibrinolytic system participating in angiogenesis is implicated in plaque survival. Subjected to a pathological environment, endothelial activation leads to change in endothelial properties especially by increasing the production of inhibitor of plasminogen activators. These modifications could combine to create locally or distantly, a state predisposing to thrombosis.