title: Recent insights into the role of the contact pathway in thrombo-inflammatory disorders.
abstract: The contact pathway of coagulation consists of the proteins factor XI, factor XII, prekallikrein, and high-molecular-weight kininogen. Activation of the contact system leads to procoagulant and proinflammatory reactions. The contact system is essential for surface-initiated coagulation, as exemplified by aPTT, but there is probably no role for the contact system in initiating physiologic in vivo coagulation. However, over the last few years, there has been renewed interest, especially because of experimental evidence suggesting that the contact system contributes to thrombosis. Knockout mice deficient in one of the contact proteins were protected against artificially induced thrombosis. Furthermore, inhibiting agents such as monoclonal antibodies, antisense oligonucleotides, and small molecules were found to prevent thrombosis in rodents and primates in both venous and arterial vascular beds. Although it remains to be established whether targeting the contact system will be effective in humans and which of the contact factors is the best target for anticoagulation, it would constitute a promising approach for future effective and safe antithrombotic therapy.
authors.affiliation: Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; and.
authors.forename: Maurits L
authors.initials: ML
authors.lastname: van Montfoort
authors.affiliation: Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; and Department of Plasma Proteins, Sanquin Research, Amsterdam, the Netherlands.
authors.forename: Joost C M
authors.initials: JC
authors.lastname: Meijers
mesh_terms: D000818:Animals; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000378:metabolism; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D010641:Phenotype; D013927:Thrombosis / Q000473:pathology*
chemical_list: D001779:Blood Coagulation Factors