Monroe Dougald M, Hoffman Maureane
Durham Veterans Affairs Medical Center, Department of Pathology, Duke University Medical Center, Durham, NC, USA.
Arterioscler Thromb Vasc Biol. 2006 Jan;26(1):41-8. doi: 10.1161/01.ATV.0000193624.28251.83. Epub 2005 Oct 27.
The coagulation process has been conceptualized as being primarily dependent on adequate levels of the coagulation proteins. This concept was based on the clear relationship between the bleeding tendency and factor levels in hemophilia. The field is now evolving toward conceptualizing coagulation as being actively regulated by the specialized cellular components of the process. Rather than conceiving coagulation as only a "cascade" of proteolytic reactions, the coagulation reactions occur as overlapping steps on cell surfaces. Components of the old "extrinsic'" and "intrinsic" pathways of coagulation can be thought of as participating in the initiation and propagation of coagulation reactions, respectively. Thus, these pathways are not redundant as they are portrayed in the cascade model, but play distinct and complementary roles. Our understanding of how specific cellular features control the processes of hemostasis and thrombosis is developing rapidly. This review discusses some aspects of the cellular control of coagulation.
凝血过程在概念上主要被认为依赖于足够水平的凝血蛋白。这一概念基于血友病中出血倾向与因子水平之间的明确关系。现在，该领域正朝着将凝血概念化为由该过程的特殊细胞成分积极调节的方向发展。凝血反应并非仅仅被看作是蛋白水解反应的“级联”，而是在细胞表面以重叠步骤发生。传统凝血“外源性”和“内源性”途径的成分可分别被认为参与凝血反应的启动和传播。因此，这些途径并不像在级联模型中所描述的那样冗余，而是发挥着不同但互补的作用。我们对特定细胞特征如何控制止血和血栓形成过程的理解正在迅速发展。本综述讨论了凝血细胞控制的一些方面。
