Plasmin-α2-antiplasmin complex explained

Plasmin-α2-antiplasmin complex (PAP) is a 1:1 irreversibly formed inactive complex of the enzyme plasmin and its inhibitor α₂-antiplasmin.^{[1] [2] [3] [4]} It is a marker of the activity of the fibrinolytic system and a marker of net activation of fibrinolysis.

PAP levels are increased with pregnancy^[5] and by ethinylestradiol-containing combined birth control pills.^[6] Conversely, levels of PAP do not appear to be affected with menopausal hormone therapy.^[7] PAP levels have been reported to be elevated in men with prostate cancer.^[8]

Notes and References

1. Gebbink MF . Tissue-type plasminogen activator-mediated plasminogen activation and contact activation, implications in and beyond haemostasis . J Thromb Haemost . 9 Suppl 1 . 174–81 . July 2011 . 21781253 . 10.1111/j.1538-7836.2011.04278.x . 26701294 . free .
2. Book: R.F.A. Zwaal . H.C. Hemker . 1 January 1986 . Blood Coagulation . Elsevier . 250– . 978-0-08-086072-5 . 1058474585 .
3. Book: Jun Teruya . 5 January 2021 . Management of Bleeding Patients . 2 . Springer Nature . 41– . 978-3-03-056338-7 . 1058318800 .
4. Book: Kandice Kottke-Marchant . Bruce Davis . 7 May 2012 . Laboratory Hematology Practice . John Wiley & Sons . 460– . 978-1-4051-6218-0 . 1039155353 .
5. Hellgren M . Hemostasis during normal pregnancy and puerperium . Semin Thromb Hemost . 29 . 2 . 125–30 . April 2003 . 12709915 . 10.1055/s-2003-38897 .
6. Douxfils J, Morimont L, Bouvy C . Oral Contraceptives and Venous Thromboembolism: Focus on Testing that May Enable Prediction and Assessment of the Risk . Semin Thromb Hemost . 46 . 8 . 872–886 . November 2020 . 33080636 . 10.1055/s-0040-1714140 . 224821517 .
7. Hemelaar M, van der Mooren MJ, Rad M, Kluft C, Kenemans P . Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review . Fertil Steril . 90 . 3 . 642–72 . September 2008 . 17923128 . 10.1016/j.fertnstert.2007.07.1298 . free .
8. Lippi G, Plebani M, Franchini M, Guidi GC, Favaloro EJ . Prostate-specific antigen, prostate cancer, and disorders of hemostasis . Semin Thromb Hemost . 35 . 7 . 654–64 . October 2009 . 20013532 . 10.1055/s-0029-1242719 .