Abstract
Plasmin is the major fibrinolytic protease responsible for dissolving thrombi by cleavage
of its primary substrate fibrin. In addition, emerging evidence points to other roles
of plasmin: (1) as a back-up for ADAMTS13 in proteolysis of ultra-large von Willebrand
factor (VWF) multimers and (2) as an activator of platelets. Although the molecular
mechanisms of fibrinolysis are well defined, insights on the effects of plasmin on
VWF and platelets are relatively scarce and sometimes conflicting. Hence, this review
provides an overview of the literature on the effects of plasmin on VWF multimeric
structures, on VWF binding to platelets, and on platelet activation. This information
is placed in the context of possible applications of thrombolytic therapy for the
condition thrombotic thrombocytopenic purpura.
Keywords
plasmin - von Willebrand factor - platelets
