The major physiological control of thrombin generation occurs via the protein C anticoagulant pathway. This pathway maintains normal hemostasis by controlling the conversion of prothrombin into thrombin through a feedback-inhibition mechanism (Figure 4.5). Protein C itself is a serine protease that circulates in the blood as inactive zymogen. As thrombin is generated, it complexes with TM, an endothelial surface membrane protein , to form the physiological enzyme complex that converts zymogen protein C into its active form. APC, along with its cofactor protein S, functions to block thrombin generation
Signal to cytoprotection
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