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The Mechanisms of Thrombin Formation

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Book cover Coagulation and Blood Transfusion

Part of the book series: Developments in Hematology and Immunology ((DIHI,volume 26))

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Abstract

The formation of thrombin in the blood results from a complicated series of chemical and physical interactions; its subsequent inactivation also. In vivo these opposite mechanisms (activation-inactivation) are tuned so precisely that the blood remains fluid in the vessels but any leak is promptly mended. When this equilibrium is disrupted either bleeding or thrombosis will ensue. It is readily possible at this moment to give a plausible scheme of the biochemical reactions that contribute to the formation and to the disappearance of thrombin. It is considered common knowledge that there exist two pathways that explain the mechanism of the coagulation of blood: the intrinsic pathway operative when coagulation is started by contact of blood with glass or other foreign surfaces, and the extrinsic pathway triggered by the addition of tissue thromboplastin. In both cases, calcium is essential. However, these standard schemes of blood coagulation are essentially based on in vitro experiments. They perfectly explain why blood clots in glass or under the influence of a large excess of tissue factor. These situations will not however necessarily apply in vivo. Recent research allows to obtain an idea of what reactions that are biochemically possible indeed are of physiological importance.

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Authors
  1. H. C. Hemker
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  2. S. Béguin
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  3. T. Lindhout
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Editors and Affiliations

  1. Red Cross Blood Bank Groningen-Drenthe, The Netherlands

    C. Th. Smit Sibinga  & P. C. Das  & 

  2. Haemophila and Thrombosis Centre, Milan, Italy

    P. M. Mannucci

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Hemker, H.C., Béguin, S., Lindhout, T. (1991). The Mechanisms of Thrombin Formation. In: Sibinga, C.T.S., Das, P.C., Mannucci, P.M. (eds) Coagulation and Blood Transfusion. Developments in Hematology and Immunology, vol 26. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3900-1_1

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  • DOI: https://doi.org/10.1007/978-1-4615-3900-1_1

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