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The division of coagulation in two pathways is arbitrary, originating from laboratory tests in which clotting times were measured either after the clotting was initiated by glass, the intrinsic pathway; or clotting was initiated by thromboplastin (a mix of tissue factor and phospholipids), the extrinsic pathway.
The two chains formed after the cleavage at Arg 320, termed the A and B chains, are linked by a disulfide bond in active thrombin. In the alternate pathway for thrombin activation, prothrombin is first cleaved at Arg 320 , producing a catalytically active intermediate called meizothrombin. [ 16 ]
The prothrombin time (PT) – along with its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) – is an assay for evaluating the extrinsic pathway and common pathway of coagulation. This blood test is also called protime INR and PT/INR.
Therefore, although the coagulation cascade can be triggered in vitro through the intrinsic pathway only, in vivo coagulation is triggered by the extrinsic pathway. However, the model better describing how coagulation works is the so-called cell-based model, a more integrated picture of the whole process, in which phospholipid surfaces, such as ...
Traditional models of coagulation developed in the 1960s envisaged two separate cascades, the extrinsic (tissue factor (TF)) pathway and the intrinsic pathway. These pathways converge to a common point, the formation of the Factor Xa/Va complex which together with calcium and bound on a phospholipids surface, generate thrombin (Factor IIa) from ...
Together with factor VIIa, tissue factor forms the extrinsic pathway of coagulation. This is opposed to the intrinsic (amplification) pathway, which involves both activated factor IX and factor VIII. Both pathways lead to the activation of factor X (the common pathway), which combines with activated factor V in the presence of calcium and ...
A historical name for this measure is the Kaolin-cephalin clotting time (KCCT), [1] reflecting kaolin and cephalin as materials historically used in the test. Apart from detecting abnormalities in blood clotting, [ 2 ] partial thromboplastin time is also used to monitor the treatment effect of heparin , a widely prescribed drug that reduces ...
Characteristics of the velocity of passage of the intrinsic coagulation pathway; Poor plasma (the most convenient to work with, but no realization of the thrombocyte clotting mechanism) Contact activation pathway; Prothrombin time test (or prothrombin test, INR, PT) – velocity of passage of the extrinsic blood coagulation pathway Poor plasma