Haemostasis Lecture notes

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Fibrinolytic system

Fibrinolysis is the enzymatic process used by the body to remove a fibrin-thrombin complex to restore normal smooth flow of blood once the damaged endothelium is repaired and restored.

During the clotting process, tissue plasminogen activator released from the blood vessel wall and the plasma pro-enzyme plasminogen bind the forming fibrin thrombus. When activated, plasminogen is converted to plasmin which degrades the fibrin network, causing the clot to dissolve.

During this process, fibrin is degraded to fibrin degradation products (FDPs) i.e. fragments called D-dimers.

Natural Inhibitors/anticoagulants

These are naturally occurring proteins that play an important role in preventing excessive bleeding. They include:

  1. Anti-thrombin III It binds thrombin to prevent clotting. It can also bind factor Xa.

  2. Protein C

  3. Protein S

Both protein C and S work together to wash up factor XIII and V to prevent clotting.

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