REGULATION OF ENDOTHELIAL-CELL T-PA SYNTHESIS AND RELEASE

The fibrinolytic activity of blood is to a large extent determined by the plasma level of tissue-type plasminogen activator (t-PA). Changes in the plasma level of t-PA are mainly achieved by the endothelium by two mechanisms: (a) a rapid, short-term release of t-PA, which occurs within minutes (acute release, regulated secretion) and (b) a long-term change in the rate of synthesis and constitutive secretion of t-PA. The rapid t-PA release response of the endothelium upon stimulation may play an important role in the dissolution of fibrin at the initial event of fibrin formation, and hence in the prevention of thrombus formation. The rate of constitutive t-PA secretion is an important determinant of the actual levels of t-PA under basal and stimulated conditions. Our insight into the regulation of the synthesis and release of t-PA has extended markedly in the last decade and still adapts by the continuous stream of new experimental data. In this review we summarize our present knowledge about the factors, including intracellular signalling pathways, promoter elements and transcription factors involved in the modulation of t-PA gene expression, with particular reference to the regulation in human endothelial cells. We also discuss the mechanisms underlying acute release of t-PA from the endothelium, and provide evidence that the regulated and constitutive secretion of t-PA are interrelated in several aspects.