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Asthma is associated with reduced fibrinolytic activity, abnormal clot architecture, and decreased clot retraction rate

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The aim of this study was to assess whether steroid-naive asthma modulates hemostasis. We evaluated the clot retraction rate (CRR), fibrinolysis rate (FR), clot density (CD) (by confocal microscopy), plasma levels of plasminogen activator inhibitor (PAI-1), and factor XIII (FXIII), NO in exhaled breath (FENO), spirometry (FEV1) and eosinophil count (EOS) in 36 patients with allergic, steroid-nave asthma and in 34 healthy controls. We observed significantly (P < 0.001) reduced CRR, FR, and FEV1 and increased FENO, EOS, PAI-1, FXIII, and CD in patients with asthma compared with controls. In patients with asthma, FR negatively correlated with CD, FXIII, PAI-1, FEN, and EOS and positively with FEV1. FXIII positively correlated with CD. Clot retraction rate negatively correlated with FEND and positively with FEV1 (all P < 0.001). These novel findings suggest that asthma itself is associated with decreased CRR and reduced fibrinolytic potential resulting from alterations in clot architecture and elevated levels of plasma FXIII and PAI-1.

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