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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. [31]
Thromboplastin, by itself, could activate the extrinsic coagulation pathway. When manipulated in the laboratory, a derivative could be created called partial thromboplastin, which was used to measure the intrinsic pathway. This test is called the aPTT, or activated partial thromboplastin time. It was not until much later that the subcomponents ...
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 ...
PT measures the following coagulation factors: I (fibrinogen), II (prothrombin), V (proaccelerin), VII (proconvertin), and X (Stuart–Prower factor). PT is often used in conjunction with the activated partial thromboplastin time (aPTT) which measures the intrinsic pathway and common pathway of coagulation. [citation needed]
[4] [5] [6] The ability of FXII to bind to negatively charged surfaces and activate coagulation forms the basis of the aPTT test, in which artificial materials act as a surface for contact activation. This test is used to measure the contact activation pathway (intrinsic pathway) and the common pathway of clotting. [7]
Blood coagulation pathways in vivo showing the central role played by thrombin. Factor Xa is the activated form of the coagulation factor X, also known as thrombokinase. Factor X is an enzyme, a serine endopeptidase, which plays a key role at several stages of the coagulation system. Factor X is synthesized in the liver.
The partial thromboplastin time (PTT), also known as the activated partial thromboplastin time (aPTT or APTT), is a blood test that characterizes coagulation of the blood.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.
[3] [4] Factor X can be activated by both the factor VIIa-tissue factor complex of the extrinsic coagulation pathway and by the tenase complex of the intrinsic pathway. The intrinsic tenase complex is composed of both factor IXa and factor VIIIa. [5] [6] The activation peptide is released when factor X is activated to factor Xa, but the heavy ...