The coagulation cascade by JKVN5u16

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									The coagulation cascade
    Summary of stages
    Components of the coagulation cascade – key

               Inactivated platelet            Activated platelet


               Vessel wall                TF   Tissue factor


               Inactivated coagulation         Activated coagulation
               factor (various colours)        factor (various colours)

                                          V
               Von Willebrand factor           Von Willebrand factor
         VWF                              W
               (coiled conformation)      F    (stretched conformation)




2

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    The coagulation   Initiation
    cascade



                      Amplification




                      Propagation



                      Stabilisation



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Nov-11
    Initiation

                 VII                  V

         TF
                                           Va
                       TF


                                          X
                            VIIa TF
                                                Prothrombin (II)

         TF                           Xa
                              TF


                                              Thrombin (IIa)

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Nov-11
    Amplification
                            VWF
                                                   Thrombin (IIa)
                            VIII


         TF                                   V
                    VIIIa
                                              XI
                V     TF VIIa
                W                    IX
                F
                        IXa            XIa
         TF
                    VIIIa
                                                     Prothrombin (II)
                                     Xa Va
                       X

                                   Thrombin (IIa)
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Nov-11
    Propagation
                        Prothrombin (II)




         TF
                       Fibrinogen (I)



                  V     Fibrin             Thrombin (IIa)
                      (soluble)
                  W
                  F
                          XIIIa             XIII
         TF




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Nov-11
    Stabilisation              Fibrin
                             (soluble)




         TF



                    V      Fibrin
                    W   (insoluble)
                    F

         TF




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Nov-11
Initiation
    Initiation – 1



         TF




              TF




         TF




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Nov-11
     Initiation – 2

                      VII

          TF

                            TF




                                 VIIa TF

          TF
                                   TF




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Nov-11
     Multi-component enzyme complex



            ENZYME                   SUBSTRATE




             Ca2+                        Ca2+
                       CO-FACTOR



                Activated platelet surface


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Nov-11
     Initiation – 3

                      VII                  V

          TF
                                                Va
                            TF


                                               X
                                 VIIa TF

          TF                               Xa
                                   TF




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Nov-11
     Initiation – 4

                      VII                  V

          TF
                                                Va
                            TF


                                               X
                                 VIIa TF
                                                     Prothrombin (II)

          TF                               Xa
                                   TF


                                                   Thrombin (IIa)

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Nov-11
Amplification
     Amplification – 1
                            VWF
                                   Thrombin (IIa)
                            VIII


         TF
                    VIIIa




         TF




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Nov-11
     Amplification – 2
                             VWF
                                    Thrombin (IIa)
                             VIII


         TF
                     VIIIa


                 V     TF VIIa
                 W
                 F

         TF




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Nov-11
     Amplification – 3
                             VWF
                                                Thrombin (IIa)
                             VIII


         TF
                     VIIIa
                                           XI
                 V     TF VIIa
                 W                  IX
                 F
                         IXa         XIa
         TF




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Nov-11
     Amplification – 4
                             VWF
                                                 Thrombin (IIa)
                             VIII


         TF                                 V
                     VIIIa
                                            XI
                 V     TF VIIa
                 W                  IX
                 F
                         IXa         XIa
         TF
                     VIIIa
                                    Xa Va
                         X


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Nov-11
     Amplification – 5
                             VWF
                                                    Thrombin (IIa)
                             VIII


         TF                                    V
                     VIIIa
                                               XI
                 V     TF VIIa
                 W                    IX
                 F
                         IXa            XIa
         TF
                     VIIIa
                                                      Prothrombin (II)
                                      Xa Va
                         X

                                    Thrombin (IIa)
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Nov-11
Propagation
     Propagation – 1
                         Prothrombin (II)




         TF
                        Fibrinogen (I)



                 V       Fibrin             Thrombin (IIa)
                       (soluble)
                 W
                 F

         TF




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Nov-11
     Propagation – 2
                         Prothrombin (II)




         TF
                        Fibrinogen (I)



                 V       Fibrin             Thrombin (IIa)
                       (soluble)
                 W
                 F
                           XIIIa             XIII
         TF




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Nov-11
Stabilisation
     Stabilisation – 1          Fibrin
                              (soluble)




          TF



                  V         Fibrin
                  W      (insoluble)
                  F

         TF




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Nov-11
     Stabilisation – 2          Fibrin
                              (soluble)




          TF



                  V         Fibrin
                  W      (insoluble)
                  F

         TF




25

Nov-11

								
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