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Plasminogen is a 92 kDa glycoprotein zymogen synthesized primarily in the liver and circulating in the blood at high concentrations [1, 4]. It is the precursor to plasmin, a major serine protease responsible for fibrinolysis, the process of breaking down fibrin clots into soluble fragments [2, 3]. Activation of plasminogen is mediated by tissue-type plasminogen activator (tPA) or urokinase-type plasminogen activator (uPA), which cleave a specific peptide bond to generate the active two-chain enzyme [1, 2]. Beyond its role in hemodynamics, the plasminogen system participates in extracellular matrix degradation, wound healing, and cell migration [2, 4]. Clinically, this system is targeted by thrombolytic agents to treat acute myocardial infarction and stroke, and by antifibrinolytics to manage surgical or traumatic bleeding [3, 5]. Additionally, purified human plasminogen is used as a replacement therapy for patients with congenital plasminogen deficiency, a rare condition characterized by the formation of fibrin-rich pseudomembranes on mucous membranes [5, 6].
Therapeutic agents either activate plasminogen to promote fibrinolysis (thrombolytics), inhibit its activation or activity to prevent clot breakdown (antifibrinolytics), or replace the protein in cases of congenital deficiency [2, 3, 5].
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