Blood coagulation is a physiological process in which the blood forms an insoluble fibrin clot when the body is injured or blood vessels are damaged, aiming to stop bleeding and promote wound healing. The coagulation process is a complex cascade of biological reactions involving the interaction of multiple coagulation factors. When the blood vessels are damaged, platelets adhere to the injury site and release thromboxane, triggering vasoconstriction and platelet aggregation, forming a primary thrombus. At the same time, damaged tissue releases tissue factor, activating prothrombin and initiating the transformation of thrombin-fibrinogen into fibrin, forming a fibrin network that strengthens platelet aggregation, ultimately resulting in a blood clot. On the other hand, abnormal coagulation function can also lead to bleeding or thrombotic diseases. To prevent abnormal coagulation and thrombus formation, the body has sophisticated anticoagulation mechanisms involving anticoagulant proteins, fibrinolytic enzymes, and platelet inhibitors, which work together to maintain normal blood flow.
The entire coagulation process is precise and balanced in physiology, ensuring the rapid initiation of hemostasis when necessary while avoiding unnecessary thrombus formation, thus maintaining the healthy operation of the blood system.
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Coagulation factors are proteins directly involved in the process of blood clotting. The World Health Organization has assigned numbers to these factors based on their discovery order, such as factor I, II, III, and so on. These factors interact with each other to form a complex cascade reaction network called the coagulation cascade. When a coagulation factor is activated, it is indicated by adding the letter "a" after its corresponding Roman numeral (e.g., factor VII becomes factor VIIa when activated). The table below provides the names and functional descriptions of coagulation factors [1]. It should be noted that factor XIII, which was discovered later, has been shown to have no decisive impact on clotting function, and factor VI had its name withdrawn as it was found to be an activated form of factor V.
Coaqulation Factor Number | Coaqulation Factor Name | Function |
---|---|---|
I | Fibrinogen | Clot formation |
II | Prothrombin | Activation of I, V, VII, VIII, XI, XIII, protein C, platelets |
III | TF | Co-factor of VIIa |
IV | Calcium | Facilitates coagulation factor binding to phospholipids |
V | Proacclerin, labile factor | Co-factor of X-prothrombinase complex |
VI | Unassigned | |
VII | Stable factor, proconvertin | Activates factors IX, X |
VIII | Antihaemophilic factor A | Co-factor of IX-tenase complex |
IX | Antihaemophilic factor B or Christmas factor | Activates X: Forms tenase complex with factor VIII |
X | Stuart-Prower factor | Prothrombinase complex with factor V: Activates factor II |
XI | Plasma thromboplastin antecedent | Activates factor IX |
XII | Hageman factor | Activates factor XI, VII and prekallikrein |
XIII | Fibrin-stabilising factor | Crosslinks fibrin |
XIV | Prekallikrein(F Fletcher) | Serine protease zymogen |
XV | HMWK- (F Fitzgerald) | Co-factor |
XVI | vWf | Binds to VIII, mediates platelet adhesion |
XVII | Antithrombin III | Inhibits IIa, Xa, and other proteases |
XVIII | Heparin cofactor II | Inhibits IIa |
XIX | Protein C | Inactivates Va and VIlla |
XX | Protein S | Co-factor for activated protein C |
HMWK- High molecular weight kininogen; vWf-Von Willebrand factor; TF-Tissue factor
Coagulation process involves the regulation of many coagulation factors. Coagulation factor refers to protein, which is directly involved in blood coagulation process. The World Health Organization numbers it as coagulation factor I-XIII according to the order of its discovery. They interact with each other to form a complex prothrombin activation cascade reaction network.
Coagulation mainly includes two ways: Intrinsic pathway and extrinsic pathway.
● Intrinsic pathway
Mainly occurs when the inner wall of blood vessel is damaged, platelets in blood and substances released from blood vessel wall come into contact with substances in blood, thus starting the coagulation process. Specifically, the activation of the intrinsic coagulation pathway includes the following steps:
(1) Contact activation: When blood vessels are damaged, blood coagulation factors contact with damaged vascular endothelial cells and tissue factor (TF), and then are activated.
(2) Activation of coagulation factors: A series of coagulation factors, including coagulation factor XII, coagulation factor XI, coagulation factor IX, etc., are activated in turn and interact with each other, finally transforming coagulation factor X into activated thrombin IIa.
(3) Thrombin formation: Activated thrombin promotes the transformation of fibrinogen into fibrin, forming a thrombus network.
● Extrinsic pathway
Coagulation pathway initiated by the release of tissue factor from injured tissue. The main feature of exogenous coagulation pathway is that its starting speed is faster than that of internal coagulation pathway, and it is usually used to quickly start the coagulation process to stop bleeding. The steps of exogenous coagulation pathway are as follows:
(1) Tissue factor release: The damaged tissue releases tissue factor.
(2) Tissue factor forms a complex with coagulation factor VII: Tissue factor forms a complex with coagulation factor VII in plasma to activate coagulation factor VII.
(3) Activation of coagulation factor: Activated coagulation factor VII further activates coagulation factor X to form active thrombin.
(4) Thrombin formation: Active thrombin promotes the transformation of fibrinogen into fibrin, forming a thrombus network.
Intrinsic coagulation pathway and exogenous coagulation pathway will eventually converge to the same coagulation end point, forming thrombus. The interaction and adjustment of these coagulation pathways ensure that the human body can form thrombus in time when bleeding, prevent excessive bleeding and promote wound healing.
Anticoagulation mechanism can resist the formation of blood clots, maintain normal blood flow and prevent the formation of abnormal thrombus. Mainly includes the following aspects:
(1) Anticoagulant effect of blood vessel wall: cells and platelets release a variety of cytokines, such as NO (nitric oxide) and PGI2 (prostaglandin), which can inhibit platelet adhesion and aggregation, thus preventing thrombosis.
(2) Anticoagulase system: Anticoagulase is a kind of protein which can inhibit thrombin activity, including antithrombin, protein C and protein S, etc. They can inhibit the production of thrombin in the coagulation cascade, thus reducing the risk of thrombosis.
(3) Fibrinolytic enzyme system: Fibrinolytic enzyme system can dissolve thrombus and prevent thrombus from forming and expanding in blood vessels, mainly including plasminogen, plasmin and plasmin inhibitor (such as PAI-1).
(4) Anticoagulant protein in plasma: The plasma also contains some protein, such as antithrombin III and tissue factor pathway inhibitor, which can inhibit the activity of thrombin, regulate the coagulation process and prevent the occurrence of excessive coagulation.
Code | Product Name | Sensitivity | Detection Range |
---|---|---|---|
CSB-E14235h | Human Thrombin ELISA Kit | 1.95 ng/mL | 7.8 ng/mL-500 ng/mL |
CSB-E13283B | Bovine Fibrinogen,Fb Elisa Kit | 1.56 μg/mL | 3.125 μg/mL-200 μg/mL |
CSB-E13319h | Human Fibrinogen Gamma Chain (FGG)ELISA Kit | 31.25 ng/mL | 125 ng/mL-8000 ng/mL |
CSB-E07913h | Human tissue factor (TF) ELISA kit | 0.78 pg/mL | 3.12 pg/mL-200 pg/mL |
CSB-EL012479HU | Human Kininogen-1(KNG1) ELISA kit | 11.75 ng/mL | 47 ng/mL-3000 ng/mL |
CSB-E16637m | Mouse plasma kallikrein(KLKB1) ELISA Kit | 0.78 ng/mL | 3.12 ng/mL-200 ng/mL |
CSB-E14291h | Human Coagulation Factor XIII A1 Polypeptide(F13A1) ELISA kit | 0.156 ng/mL | 0.625 ng/mL-40 ng/mL |
CSB-E06534p | Pig plasminogen activator inhibitor 1,PAI-1 ELISA Kit | 0.078 ng/mL | 0.312 ng/mL-20 ng/mL |
CSB-E08201r | Rat Fibrinogen,Fbg ELISA Kit | 0.156 μg/mL | 0.312 μg/mL-20 μg/mL |
CSB-E13861h | Human coagulation factor VIII (FVⅢ) ELISA Kit | 3.12 ng/mL | 12.5 ng/mL-800 ng/mL |
CSB-EL021086MO | Mouse Plasma protease C1 inhibitor(SERPING1) ELISA kit | 1.4 ng/mL | 5.6 ng/mL-360 ng/mL |
CSB-E08778h | Human Thrombin activatable fibrinolysis inhibitor,TAFI ELISA Kit | 7.81 ng/mL | 31.25 ng/mL-2000 ng/mL |
CSB-E07948r | Rat plasminogen activator inhibitor 1,PAI1 ELISA Kit | 19.5 pg/ml | 78 pg/ml-5000 pg/ml |
CSB-E09909h | Human activated protein C,APC ELISA Kit | 0.39 pg/mL | 1.56 pg/mL-100 pg/mL |
CSB-E08443h | Human coagulation factor Ⅸ,FⅨ ELISA Kit | ||
CSB-E09902h | Human protein C (PC) ELISA kit | 0.78 ng/mL | 3.12 ng/mL-200 ng/mL |
CSB-EL018754RH | Monkey Vitamin K-dependent protein S(PROS1) ELISA kit | 3.9 ng/mL | 15.6 ng/mL-1000 ng/mL |
CSB-EL018754MO | Mouse Vitamin K-dependent protein S(PROS1) ELISA kit | 1.56 ng/mL | 6.25 ng/mL-400 ng/mL |
CSB-E08525Rb | Rabbit von Willebrand Factor,VWF ELISA Kit | 0.078 ng/mL | 0.312 ng/mL-20 ng/mL |
CSB-E14302h | Human coagulation factor Ⅴ(FⅤ)ELISA Kit | 0.78 ng/mL | 3.12 ng/mL-200 ng/mL |
CSB-E12909h | Human coagulation factor Ⅶ,FⅦ ELISA Kit | 0.078 ng/mL | 0.312 ng/mL-20 ng/mL |
CSB-E08440h | Human coagulation factor Ⅹ,FⅩ ELISA Kit | 0.156 ng/mL | 0.625 ng/mL-40 ng/mL |
References
[1] Palta S, Saroa R, Palta A. Overview of the coagulation system. Indian J Anaesth. 2014 Sep; 58(5):515-23.