Renné T, Oschatz C, Seifert S, Müller F, Antovic J, Karlman M, Benz P M
Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital Solna, Stockholm, Sweden.
J Thromb Haemost. 2009 Jul;7 Suppl 1:79-83. doi: 10.1111/j.1538-7836.2009.03393.x.
The blood coagulation system forms fibrin to limit blood loss from sites of injury, but also contributes to occlusive diseases such as deep vein thrombosis, myocardial infarction, and stroke. In the current model of a coagulation balance, normal hemostasis and thrombosis represent two sides of the same coin; however, data from coagulation factor XI-deficient animal models have challenged this dogma. Gene targeting of factor XI, a serine protease of the intrinsic pathway of coagulation, severely impairs arterial thrombus formation but is not associated with excessive bleeding. Mechanistically, factor XI may be activated by factor XII following contact activation or by thrombin in a feedback activation loop. This review focuses on the role of factor XI, and its deficiency states as novel target for prevention of thrombosis with low bleeding risk in animal models.
血液凝固系统形成纤维蛋白以限制损伤部位的失血,但也会导致诸如深静脉血栓形成、心肌梗死和中风等闭塞性疾病。在当前的凝血平衡模型中,正常止血和血栓形成是同一枚硬币的两面;然而,来自凝血因子XI缺陷动物模型的数据对这一教条提出了挑战。凝血因子XI是凝血内源性途径的一种丝氨酸蛋白酶,对其进行基因靶向会严重损害动脉血栓形成,但与出血过多无关。从机制上讲,凝血因子XI可在接触激活后被凝血因子XII激活,或在反馈激活环中被凝血酶激活。本综述重点关注凝血因子XI的作用及其缺陷状态,将其作为动物模型中预防血栓形成且出血风险低的新靶点。