Review Tale of two systems: the intertwining duality of fibrinolysis and lipoprotein metabolism, 2023, Dai et al.

Tale of two systems: the intertwining duality of fibrinolysis and lipoprotein metabolism
Wen Dai; Mark Castleberry; Ze Zheng

Fibrinolysis is an enzymatic process that breaks down fibrin clots, while dyslipidemia refers to abnormal levels of lipids and lipoproteins in the blood. Both fibrinolysis and lipoprotein metabolism are critical mechanisms that regulate a myriad of functions in the body, and the imbalance of these mechanisms is linked to the development of pathologic conditions, such as thrombotic complications in atherosclerotic cardiovascular diseases.

Accumulated evidence indicates the close relationship between the 2 seemingly distinct and complicated systems—fibrinolysis and lipoprotein metabolism. Observational studies in humans found that dyslipidemia, characterized by increased blood apoB-lipoprotein and decreased high-density lipoprotein, is associated with lower fibrinolytic potential. Genetic variants of some fibrinolytic regulators are associated with blood lipid levels, supporting a causal relationship between these regulators and lipoprotein metabolism. Mechanistic studies have elucidated many pathways that link the fibrinolytic system and lipoprotein metabolism. Moreover, profibrinolytic therapies improve lipid panels toward an overall cardiometabolic healthier phenotype, while some lipid-lowering treatments increase fibrinolytic potential.

The complex relationship between lipoprotein and fibrinolysis warrants further research to improve our understanding of the bidirectional regulation between the mediators of fibrinolysis and lipoprotein metabolism.


Link | Paywall (Journal of Thrombosis and Haemostasis)

 

Lots of "complex relationships" in the body, and probably the majority are still unstudied. If ME is the result of one of these feedback loops or other relationships, studying serum samples won't help if we don't know what we're looking for, and maybe ignoring important factors because the textbooks say they're not important.