Thrombin physiology and pathophysiology.
OBJECTIVE
To review the role of thrombin in physiology and clinical disease and to discuss the pharmacology of antithrombosis.


METHODS
Original research articles, scientific reviews, textbooks.


RESULTS
Thrombin and thrombin receptors are involved in a variety of physiologic and pathologic processes resulting in a great deal of interest in thrombin-related pharmacologic intervention.


RESULTS
Although there is little clinical research data available on thrombin specifically in veterinary patients, some of the original research on protease activated receptors was performed at veterinary institutions and many of the human molecular biology studies have been done on animals including dogs.


CONCLUSIONS
Thrombin plays a significant role in coagulation, anticoagulation, and fibrinolysis. Antithrombotic treatment is focused on preventing thrombosis while maintaining hemostasis. Pharmaceutical agents are selected for the specific component of the coagulation pathway associated with a specific disease process, for a proven prophylactic benefit with procedures that carry a risk of thromboembolism, for rapidity of onset and ease of reversibility, for limited monitoring requirements, and for oral formulation and bioavailablity. Recent insight into other aspects of thrombin physiology presents an opportunity for pharmacologic intervention in a variety of other processes such as inflammation and sepsis, peripheral blood cell activation and chemotaxis, vascular endothelial and smooth muscle activity, cellular development and tissue repair, mitogenesis, neoplasia, and the function of nervous tissue following injury.
Licari
Louis G
LG
Department of Emergency and Critical Care, Fox Valley Animal Referral Center, Appleton, WI 54914, USA. llicari@horizondvm.com
Kovacic
Jan P
JP
D000818:Animals; D001777:Blood Coagulation / Q000502:physiology*; D001778:Blood Coagulation Disorders / Q000378:metabolism / Q000662:veterinary*; D006801:Humans; D013917:Thrombin / Q000378:metabolism*
D013917:Thrombin