title: Thrombin generation in vascular tissue.
abstract: BACKGROUND
  Classically, it is thought that the vast majority of thrombin is generated on the surface of platelets, however, thrombotic events occur in patients despite treatment with potent antiplatelet agents.
  
  
  RESULTS
  In freshly harvested left internal mammary artery (IMA) sections, addition of CaCl2 and platelet-poor plasma (PPP) were sufficient to stimulate a profound burst of thrombin and this effect was inhibited by antitissue factor antibodies. Ultracentrifugation of PPP to remove platelet microparticles had no effect on thrombin generation. Both the extrinsic and factor VIII-dependent pathways were necessary for IMA-supported thrombin generation as PPP derived from individuals deficient in factors V, VII, VIII or X did not support thrombin production. Small amounts of thrombin were generated utilizing factor IX (FIX)-deficient plasma, however, thrombin was not generated by aorta from FIX-deficient mice when FIX-deficient plasma was used. The addition of non-lipidated tissue factor (0.6 pM) and CaCl2 to actively proliferating cultured human aortic smooth muscle cells (SMC) resulted in a pronounced burst of thrombin generation occurring between 3 and 15 min after treatment. In the absence of tissue factor, thrombin was generated but at a slower rate and with a peak value 26% of that observed in the presence of tissue factor.
  
  
  CONCLUSIONS
  Significant thrombin generation can occur on vascular tissue in the absence of platelets or platelet microparticles and on the surface of non-apoptotic SMC.
authors.affiliation: Division of Cardiology, Hematology and Cardiothoracic Surgery and Carolina Cardiovascular Biology Center, University of North Carolina, Chapel Hill, NC 27599-7075, USA.
authors.forename: A
authors.initials: A
authors.lastname: Pathak
authors.forename: R
authors.initials: R
authors.lastname: Zhao
authors.forename: D M
authors.initials: DM
authors.lastname: Monroe
authors.forename: H R
authors.initials: HR
authors.lastname: Roberts
authors.forename: B C
authors.initials: BC
authors.lastname: Sheridan
authors.forename: C H
authors.initials: CH
authors.lastname: Selzman
authors.forename: G A
authors.initials: GA
authors.lastname: Stouffer
mesh_terms: D001011:Aorta / Q000166:cytology; D001779:Blood Coagulation Factors / Q000494:pharmacology; D002122:Calcium Chloride / Q000494:pharmacology; D002478:Cells, Cultured; D004730:Endothelium, Vascular / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007700:Kinetics; D009131:Muscle, Smooth, Vascular / Q000166:cytology / Q000187:drug effects; D010949:Plasma; D013917:Thrombin / Q000096:biosynthesis*; D013925:Thromboplastin / Q000494:pharmacology
chemical_list: D001779:Blood Coagulation Factors; D013925:Thromboplastin; D013917:Thrombin; D002122:Calcium Chloride