The central role of thrombin in hemostasis.
Article Details
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Crawley JT, Zanardelli S, Chion CK, Lane DA
The central role of thrombin in hemostasis.
J Thromb Haemost. 2007 Jul;5 Suppl 1:95-101. doi: 10.1111/j.1538-7836.2007.02500.x.
- PubMed ID
- 17635715 [ View in PubMed]
- Abstract
Following vascular injury, blood loss is controlled by the mechanisms of hemostasis. During this process, the serine proteinase, thrombin, is generated both locally and rapidly at sites of vessel damage. It plays a pivotal role in clot promotion and inhibition, and cell signaling, as well as additional processes that influence fibrinolysis and inflammation. These functions involve numerous cleavage reactions, which must be tightly coordinated. Failure to do so can lead to either bleeding or thrombosis. The crystal structures of thrombin, in combination with biochemical analyses of thrombin mutants, have provided insight into the ways in which thrombin functions, and how its different activities are modulated. Many of the interactions of thrombin are facilitated by exosites on its surface that bind to its substrates and/or cofactors. The use of cofactors not only extends the range of thrombin specificity, but also enhances its catalytic efficiency for different substrates. This explains a paradox (i.e. thrombin is a specific proteinase, and yet one that has multiple, and sometimes opposing, substrate reactions). In this review, we describe the context in which thrombin acts during hemostasis and explain the roles that its exosites and cofactors play in directing thrombin function. Thereafter, we develop the concept of cofactor competition as a means by which the activities of thrombin are controlled.
DrugBank Data that Cites this Article
- Drugs
- Drug Targets
Drug Target Kind Organism Pharmacological Action Actions Human thrombin Coagulation factor V Protein Humans YesActivatorDetails Human thrombin Coagulation factor VIII Protein Humans YesActivatorDetails Human thrombin Coagulation factor XI Protein Humans YesActivatorDetails Human thrombin Coagulation factor XIII A chain Protein Humans YesActivatorDetails Human thrombin Coagulation factor XIII B chain Protein Humans YesActivatorDetails Human thrombin Fibrinogen alpha chain Protein Humans YesActivatorDetails Human thrombin Fibrinogen beta chain Protein Humans YesActivatorDetails Human thrombin Fibrinogen gamma chain Protein Humans YesActivatorDetails Thrombin Coagulation factor V Protein Humans YesActivatorDetails Thrombin Coagulation factor XI Protein Humans YesActivatorDetails Thrombin Coagulation factor XIII B chain Protein Humans YesActivatorDetails