Biochemistry thrombosis and homeostasis - Secondary hemostasis

4 important questions on Biochemistry thrombosis and homeostasis - Secondary hemostasis

Explain the activation of blood coagulation


Thrombin transforms fibrinogen to fibirn and is mass produced (in short time) to do so.
Initiation
  • Tissue factor / Factor 7a complex → activates factor 10 and factor 9
    • factor 7a complex
      • tissue factor (transmembrane domain
      • Gla domain (modified glutamic acids that bind phospholipids)
        • y-carboxylation of glutamic acids
        • dependent on vitamine K
      • Vitamin K antagonist and inhibits vitamin K reductase thereby limiting the activity of the vitamin K dependent carboxylase


Amplification and propagation
  • complex formation between factor 8a/factor 9a and factor 5a/factor 10a

To which factor is the X-linked bleeding disorder hemophilia linked?

Hemophilia A: factor 8
Hemophilia B: factor 9
  • X-linked = only in male
  • treated with purified factor 8 or 9, administrated intravenously
  • treatment expensive and only available in the developed countries
    • FVIII or antiFIX-FX
    • Emicizumab vs factor 8
    • Gene therapy

Explain the conversion of prothrombin into thrombin and by which factor?

Protrhombin is converted into thrombin by factor 10a, which then transforms fibrinogen into fibrin
  • Feedback activation of factor 10, factor 9 and factor 8 amplifies thrombin formation
  • Cleavage by thrombin converts fibrinogen into fibrin by releasing
  • Factor 8a cross-links soluble fibrin into insoluble fibrin clots

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How is the disease called, causing risk factor for venous thrombosis?
Which factor is mutated?

Factor 5 Leiden
  • Factor 5  is mutated at cleavage site for APC

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