Abstract
Fibrin, described on a single-lens microscopy for the first time by Malpighi in 1666
and named by de Fourcroy, has been extensively studied by biochemists, biophysicists,
and more recently by clinicians who recognized that fibrin is the major component
of most thrombi. Elucidation of key reactions leading to fibrin clot formation in
the 1950s and 1960s grew interest in the clinical relevance of altered fibrin characteristics.
Implementation of scanning electron microscopy to image fibrin clots in 1947 and clot
permeation studies in the 1970s to evaluate an average pore size enabled plasma clot
characterization in cohorts of patients. Unfavorably altered fibrin clot structure
was demonstrated by Blombäck's group in coronary artery disease in 1992 and in diabetes
in 1996. Fifteen years ago, similar plasma fibrin clot alterations were reported in
patients following venous thromboembolism. Multiple myeloma was the first malignant
disease to be found to lead to abnormal fibrin clot phenotype in the 1970s. Apart
from anticoagulant agents, in 1998, aspirin was first shown to increase fibrin clot
permeability in cardiovascular patients. The current review presents key data on the
rich history of fibrin research, in particular, those that first documented abnormal
fibrin clot properties in a variety of human disease states, as well as factors affecting
fibrin phenotype.
Keywords fibrin clot - disease - medication - risk factors
