Mechanisms preventing intravascular coagulation in the normal human

Blood flow.

Naturally occurring plasma inhibitors, i.e. the circulating antiproteases. Heparin sulphate-ATIII mechanism. Protein C-thrombomodulin-protein S mechanism. The fibrinolytic system: plasmin.

Endothelial activity: prostacyclin production; ADPase activity; nitric oxide production; tissue type plasminogen activator (tPA) release. Hepatic and phagocytic clearance of activated coagulation factors. Clearance by the liver.

Inactivation by ATIII (proteases except Vila), tissue factor pathway inhibitor (Vila), protein C (factors V and VIII). Elimination of clotting factors from blood.

The zymogen (inactive form) of a serine protease with plasma concentration of 3-5 mg/l. It is synthesised in the liver as a 461 amino acid single chain precursor that contains a signal peptide and a propeptide. It consists of two polypeptide chains, a 150 amino acid light chain and a 260 amino acid heavy chain, linked by a single disulphide bridge. The molecular weight is 62 000.

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