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Antithrombotics pp 447–476Cite as

Natural Anticoagulants and Their Pathways

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 132))

Abstract

Blood coagulation is a complex process involving blood cell surfaces, plasma proteins, and inhibitory mechanisms. Many of the inhibitory mechanisms are associated with the blood vessel wall. The protein C pathway is one of the major mechanisms involved in controlling blood coagulation. The interaction of the protein C pathway with a highly simplified version of the major coagulation cascade is illustrated in Fig. 1. The blood clotting process occurs when tissue factor is exposed to blood. This triggers either factor X or factor IX activation. Factor IXa complexes with factor Villa to provide an alternative activation mechanism for factor X. Factor Xa, in complex with factor Va, generates thrombin which causes fibrin clots and platelet activation. All of these reactions proceed on the surface of activated or damaged cells when the membrane phospholipid asymmetry is perturbed, resulting in exposure of negatively charged phospholipids. These clotting reactions are offset by natural anticoagulant mechanisms, the most important of which are thought to include the tissue factor pathway inhibitor (Chap. 15), antithrombin-heparin (Chap. 9) and the protein C anticoagulant pathway (depicted in Fig. 1).

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  1. C. T. Esmon
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  1. Drug Development, Parke-Davis Pharmaceutical Research Division, Warner-lambert Company, 2800 Plymouth Road, Ann Arbor, MI, 48105, USA

    Andrew C. G. Uprichard M.D. (Vice President) (Vice President)

  2. Vascular and Cardiac Diseases, Parke-Davis Pharmaceutical Research Division, Warner-Lambert Company, 2800 Plymouth Road, Ann Arbor, MI, 48105, USA

    Kim P. Gallagher Ph.D.

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Esmon, C.T. (1999). Natural Anticoagulants and Their Pathways. In: Uprichard, A.C.G., Gallagher, K.P. (eds) Antithrombotics. Handbook of Experimental Pharmacology, vol 132. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59942-2_16

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  • DOI: https://doi.org/10.1007/978-3-642-59942-2_16

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