What is the role of thrombin in the pathophysiology of disseminated intravascular coagulation (DIC)?

Updated: Dec 06, 2020
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Thrombin produced by the TF/factor VII pathway amplifies both clotting and inflammation through the following activities [23] :

  • Platelet activation, enhancing aggregation and augmenting platelet functions in coagulation

  • Activation of factors VIII, V, and XI, yielding further thrombin generation

  • Enhanced activation of proinflammatory factors via protease-activated receptors (PARs)

  • Activation of factor XIII to factor XIIIa, which augments production of fibrin clots from fibrinogen

  • Activation of thrombin-activatable fibrinolysis inhibitor (TAFI), making clots resistant to fibrinolysis; and

  • Enhanced expression of adhesion molecules (eg, L-selectin), thereby promoting the inflammatory effects of white blood cells (WBCs)


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