Development of Procoagulant Binding Sites on the Platelet Surface

Abstract

Vessel wall injury induces two processes that lead to the formation of a stable thrombus and hence to a permanent arrest of bleeding. On one hand, subendothelial structures exposed to the blood stream will initiate platelet adhesion, aggregation and release of granule contents causing the formation of a platelet plug (primary hemostatic plug). On the other hand, tissue thromboplastin released by the damaged vessel wall initiates the activation of the coagulation cascade, leading to the formation of thrombin. The action of thrombin on plasma soluble fibrinogen gives rise to the deposition of an insoluble fibrin network which consolidates the primary hemostatic plug to a stable thrombus. In addition, thrombin formed in the coagulation process will stimulate the platelets. In the present paper, it will be shown that, in turn, platelets will also affect the coagulation process. In other words: there is a mutual interaction between these two processes that are initiated by vessel wall damage.