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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:17.)
© 2003 American Heart Association, Inc.

Brief Reviews

The Dynamics of Thrombin Formation

Kenneth G. Mann; Saulius Butenas; Kathleen Brummel

From the Department of Biochemistry, University of Vermont, College of Medicine, Burlington, Vt.

Correspondence to Kenneth G. Mann, Department of Biochemistry, 89 Beaumont Ave, Given Building, University of Vermont, Room C-401, College of Medicine, Burlington, VT 05405. E-mail kmann{at}zoo.uvm.edu

The central event of the hemostatic process is the generation of thrombin through the tissue factor pathway. This is a highly regulated, dynamic process in which thrombin itself plays many roles, positively and negatively its production and destruction. The hemostatic process is essential to normal physiology and is also the Achilles heel of our aging population. The inappropriate generation of thrombin may lead to vascular occlusion with the consequence of myocardial infarction, stroke, pulmonary embolism, or venous thrombosis. In this review, we summarize our present views regarding the tissue factor pathway by which thrombin is generated and the roles played by extrinsic and intrinsic factor Xa generating complexes in hemostasis and the roles of the stoichiometric and dynamic inhibitors that regulate thrombin generation.

Key Words: coagulation • fibrinogen • aggregation • coagulation inhibitors

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