The Biochemistry of Blood Coagulation

Abstract

Thrombin is the central enzyme in hemostasis and thrombosis. The study of its generation has been prompted by the many diseases in which hemostasis and thrombosis play a role. The bleeding disorders like hemophilia A are obvious but rare examples. Much more common is the other extreme: the excessive and unknown reaction of the hemostatic process known as thrombosis and its sequel embolism. Thrombosis on basis of atherosclerosis and thrombosis in the veins are very important pathological processes. Evidence is rapidly accumulating that not only (micro)thrombosis is an important complication of atherosclerosis but also plays a role, maybe even the main role, in the genesis of atherosclerosis. Thrombosis in one form or another may therefore be considered to be a key event in well over half of all deaths in the western society, including well-known diseases as coronary infarction, stroke, circulation disturbances in the legs, kidney disease etc. Thrombin generation therefore is a suitable subject of research in a biochemistry department of a medical faculty. On the other hand it shows so many novel features not recognized in enzymology until now, that it cannot fail to interest even the most basicly interested biochemist.