The Role of Factor XI in Coagulation

The Role of Factor XI in Coagulation
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XI 因子在凝血中的作用

DOI:
--
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发表时间:
1993
影响因子:
6.7
通讯作者:
D. Gailani
D. Gailani
中科院分区:
医学2区
文献类型:
--
作者:
G. Broze;D. Gailani

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在血液凝固的“级联”和“瀑布”理论中,因子XI被设想为通过“接触”激活和“内在”途径在凝固起始中发挥关键作用(1,2)。最近认识到,患者个别缺乏“接触”因素(因子XII。前激肽释放酶或高分子量激肽原[HMWK])不出血(3),Bsterud和Rapaport观察到因子VII组织因子催化复合物不仅激活因子X。还包括因子IX(4),已经表明组织因子和凝血的“外源性”途径是触发体内止血的原因。最近重新发现的凝血调节剂,组织因子途径抑制剂(TFPI)的性质(5-7)。产生因子Xa依赖性反馈抑制因子VII a/组织因子,导致了一种修正的凝血理论的形成,该理论将经典的外源性和内源性凝血途径的成分整合到一个单一的途径中(图1)(5.6)。当伤口部位的血管损伤允许血液暴露于由内皮下的细胞组成性产生的组织因子时,凝血开始。然后,血浆中存在的因子VII或因子VIIa与该组织因子结合,并且因子VII组织因子复合物将某些因子X激活为Xa,
In the "cascade" and "waterfall" theories of blood coagulation, factor XI was envisioned as playing a critical role in the initiation of coagulation through "contact" activation and the "intrinsic" pathway (1,2). The more recent realization that patients individually deficient in a "contact" factor (factor XII . prekall ikrein, o r high molecular weight kininogen [HMWK]) do not bleed (3) and the observation by Bsterud and Rapaport that the factor VIIaltissue factor catalytic complex activates not only factor X. but also factor IX (4), has suggested that tissue factor and the "extrinsic" pathway of coagulation are responsible for triggering hemostasis in vivo. The properties of the recently rediscovered coagulation regulator, tissue factor pathway inhibitor (TFPI) (5-7). which produces factor Xa-dependent feedback inhibition of factor VIIaItissue factor, have led to the formulation of a revised theory of coagulation that integrates components of both the classical extrinsic and intrinsic coagulation pathways into a single pathway (Fig. 1) (5.6). Coagulation is initiated when damage to blood vessels at the site of a wound allows exposure of blood to the tissue factor constitutively produced by cells beneath the endothelium. The factor VII or factor VIIa present in plasma then binds to this tissue factor, and the factor VIIaltissue factor complex activates some factor X to Xa and
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