Clot removal or fibrinolysis is mediated by the fibrin splitting protease called plasmin. Plasmin is formed from a precursor, plasminogen, by specialized plasminogen activators called t-PA and urokinase-type plasminogen activator (u-PA or urokinase). Streptokinase produced by several strains of haemolytic streptococci and produced commercially, indirectly activates plasminogen, and is therefore therapeutically used to lyse clots. Fibrin degradation products (FDPs) are potent inhibitors of coagulation, and when their plasma levels become elevated, for example, with disseminated intravascular clotting (DIC) and subsequent clot lysis, can cause a bleeding disorder.
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