What is the role of cell surface–directed hemostasis, in the pathophysiology of factor XIII (FXIII) deficiency?

Updated: Apr 02, 2018
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Perumal Thiagarajan, MD  more...
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Answer

The concept of coagulation as a waterfall or cascade effect has been acknowledged for a long time, with platelets and other cell surfaces providing the anionic phospholipids needed for complex formation, so that reactions can proceed efficiently. One review proposed that coagulation is essentially a cell surface–based event. [67] Platelet FXIII is positioned appropriately to influence the process. (See the diagram below.)

Cell surfaced–directed hemostasis. Initially, a sm Cell surfaced–directed hemostasis. Initially, a small amount of thrombin is generated on the surface of the tissue factor–bearing (TF-bearing) cell. Following amplification, the second burst generates a larger amount of thrombin, leading to fibrin (clot) formation (from article: Factor XIII). Adapted from Hoffman and Monroe. Thromb Haemost. 2001;85(6):958-65.

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