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Thrombin



 
 
Thrombin (activated Factor II [IIa]) is a coagulation
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
 protein that has many effects in the coagulation cascade
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
. It is a serine protease
Serine protease

Serine proteases or serine endopeptidases are proteases in which one of the amino acids at the active site is serine.They are found in both single-cell and complex organisms, in both cells with nuclei and without nuclei ....
  that converts soluble fibrinogen into insoluble strands of fibrin
Fibrin

Fibrin is a fibrous protein involved in the clotting of blood, and is non globular. It is a fibrillar protein that is Polymerization to form a "mesh" that forms a hemostasis plug or clot over a wound site....
, as well as catalyzing many other coagulation-related reactions.

prothrombin gene
Gene

A gene is the basic unit of heredity in a living organism. All living things depend on genes. Genes hold the information to build and maintain their cell and pass genetic trait to offspring....
 is located on the eleventh chromosome
Chromosome

A chromosome is an organized structure of DNA and protein that is found in Cell . A chromosome is a single piece of DNA that contains many genes, regulatory sequence and other genetic sequence....
 (11p11-q12). The molecular weight of prothrombin is approximately 72000 gmol-1; in contrast, the molecular weight of thrombin is 36000 gmol-1.






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Encyclopedia


Thrombin (activated Factor II [IIa]) is a coagulation
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
 protein that has many effects in the coagulation cascade
Coagulation

Coagulation is a complex process by which blood forms clots. It is an important part of hemostasis , wherein a damaged blood vessel wall is covered by a platelet and fibrin-containing clot to stop hemorrhage and begin repair of the damaged vessel....
. It is a serine protease
Serine protease

Serine proteases or serine endopeptidases are proteases in which one of the amino acids at the active site is serine.They are found in both single-cell and complex organisms, in both cells with nuclei and without nuclei ....
  that converts soluble fibrinogen into insoluble strands of fibrin
Fibrin

Fibrin is a fibrous protein involved in the clotting of blood, and is non globular. It is a fibrillar protein that is Polymerization to form a "mesh" that forms a hemostasis plug or clot over a wound site....
, as well as catalyzing many other coagulation-related reactions.

Genetics

The prothrombin gene
Gene

A gene is the basic unit of heredity in a living organism. All living things depend on genes. Genes hold the information to build and maintain their cell and pass genetic trait to offspring....
 is located on the eleventh chromosome
Chromosome

A chromosome is an organized structure of DNA and protein that is found in Cell . A chromosome is a single piece of DNA that contains many genes, regulatory sequence and other genetic sequence....
 (11p11-q12). The molecular weight of prothrombin is approximately 72000 gmol-1; in contrast, the molecular weight of thrombin is 36000 gmol-1. Once activated, the catalytic domain of prothrombin is released from prothrombin fragment 1.2. There are an estimated 30 people in the world that have been diagnosed with the congenital form of Factor II deficiency (Degen, 1995), which should not be confused with a mutation of prothrombin. The prothrombin gene mutation is called Factor II mutation. Factor II mutation is congenital. The Factor II mutated gene is not usually accompanied by other factor mutations (i.e. the most common is Factor V Leiden). The gene may be inherited heterozygous, or much more rarely, homozygous, and is not related to gender or blood type. Homozygous mutations increase the risk of thrombosis more than heterozygous mutations, but the relative increased risk is not well documented. Other potential risks for thrombosis, such as oral contraceptives may be additive. The previously reported relationship of inflammatory bowel disease (i.e. Crohn's disease or Ulcerative Colitis) and prothrombin mutation or Factor V Leiden mutation have been contradicted by research.

Physiology


Generation

Thrombin is produced by the enzymatic cleavage of two sites on prothrombin by activated Factor X
Factor X

Factor X, also known by the eponym Stuart-Prower factor or as thrombokinase, is an enzyme of the coagulation. It is a serine protease ....
 (Xa). The activity of factor Xa is greatly enhanced by binding to activated Factor V
Factor V

Factor V is a protein of the coagulation system, rarely referred to as proaccelerin or labile factor. In contrast to most other coagulation factors, it is not enzymatically active but functions as a cofactor....
 (Va), termed the prothrombinase complex. Prothrombin is produced in the liver and is post-translationally modified in a vitamin K
Vitamin K

Vitamin K denotes a group of lipophilic, hydrophobic vitamins that are needed for the posttranslational modification of certain proteins, mostly required for blood coagulation....
-dependent reaction that converts ten glutamic acids on prothrombin to gamma-carboxyglutamic acid (Gla). In the presence of calcium, the Gla residues promote the binding of thrombin to phospholipid bilayers (see the picture). Deficiency of vitamin K or administration of the anticoagulant warfarin
Warfarin

Warfarin is an anticoagulant. It was initially marketed as a pesticide against rats and mice, and is still popular for this purpose, although more potent poisons such as brodifacoum have since been developed....
 inhibits the production of gamma-carboxyglutamic acid residues, slowing the activation of the coagulation cascade.

In human beings the level of prothrombin in the blood stream increases after birth and typically peaks on the 8th day after which the prothrombin level lowers to normal levels.

Action

Thrombin converts fibrinogen to an active form that assembles into fibrin. Thrombin also activates factor XI
Factor XI

Factor XI or plasma thromboplastin antecedent is the zymogen form of factor XIa, one of the enzymes of the coagulation. Like many other coagulation factors, it is a serine protease....
, factor V
Factor V

Factor V is a protein of the coagulation system, rarely referred to as proaccelerin or labile factor. In contrast to most other coagulation factors, it is not enzymatically active but functions as a cofactor....
, and factor VIII
Factor VIII

Factor VIII is an essential thrombusting factor. In humans, Factor VIII is encoded by the F8 gene. Defects in this gene results in hemophilia A, a common Dominance_#Recessive_trait X-linked coagulation disorder....
. This positive feedback accelerates the production of thrombin.

Factor XIII
Factor XIII

Factor XIII or fibrin stabilizing factor is an enzyme of the coagulation that crosslinks fibrin. When thrombin has converted fibrinogen to fibrin, the latter forms a proteinaceous network in which every E-unit is crosslinked to only one D-unit....
 is also activated by thrombin. Factor XIIIa is a transglutaminase
Transglutaminase

Transglutaminases are a family of enzymes that catalyze the formation of a covalent bond between a free amine group and the gamma-carboxamid group of protein- or peptide-bound glutamine....
 that catalyzes the formation of covalent bonds between lysine and glutamine residues in fibrin. The covalent bonds increase the stability of the fibrin clot.

Platelets

In addition to its activity in the coagulation cascades, thrombin also promotes platelet
Platelet

Platelets, or Thrombocyte, are small, irregularly shaped anuclear cells, 2-4?m in diameter, which are derived from fragmentation of precursor megakaryocytes....
 activation, via activation of protease-activated receptor
Protease-activated receptor

Protease-activated receptors are a subfamily of related G protein-coupled receptors that are activated by cleavage of part of their extracellular domain....
s on the platelet.

Negative feedback

Thrombin bound to thrombomodulin activates protein C
Protein C

Protein C is a major physiological anticoagulant. It is a vitamin K-dependent serine protease enzyme that is activated by thrombin into activated protein C ....
, an inhibitor of the coagulation cascade. The activation of protein C is greatly enhanced following the binding of thrombin to thrombomodulin
Thrombomodulin

Thrombomodulin, Cluster of differentiation141 or BDCA-3 is an integral membrane protein expressed on the surface of endothelial cells. In humans, thrombomodulin is encoded by the THBD gene....
, an integral membrane protein expressed by endothelial cells. Activated protein C inactivates factors Va and VIIIa. Binding of activated protein C to protein S leads to a modest increase in its activity.

Role in disease

Activation of prothrombin is crucial in physiological and pathological coagulation. Various rare diseases involving prothrombin have been described (e.g., hypoprothrombinemia
Hypoprothrombinemia

Hypoprothrombinemia is a blood disorder in which a deficiency of Thrombin results in impaired Coagulation, leading to an increased physiological risk for bleeding, especially in the gastrointestinal system, cranial vault, and superficial integumentary system....
). Anti-thrombin antibodies
Anti-thrombin antibodies

Anti-thrombin antibodies are autoantibodies directed against thrombin that may constitute a fraction of lupus anticoagulant and are seen an increased levels in lupus erythematosus....
 in autoimmune disease
Autoimmune disease

Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body attacks its own cells....
 may be a factor in the formation of the lupus anticoagulant
Lupus anticoagulant

Lupus anticoagulant is a medical phenomenon where autoantibody bind to phospholipids and proteins associated with the cell membrane. Since interactions between the cell membrane and clotting factors are necessary for proper functioning of the coagulation cascade, the lupus anticoagulant can interfere with blood clotting as well as in-vitro t...
 also known as (antiphospholipid syndrome
Antiphospholipid syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome is a disorder of coagulation, which causes blood clots in both artery and veins, as well as pregnancy-related complications such as miscarriage, Premature birth, or severe preeclampsia....
). Hyperprothrombinemia
Hyperprothrombinemia

Hyperprothrombinemia is a disorder of prothrombin which leads to hypercoagulation.Substitution of adenine for guanine at position 20210 of the prothrombin gene, known as the prothrombin 20210a mutation, prothrombin 20210 mutation and, less precise, just factor II mutation, leads to hypercoagulability and may be a factor th...
 can be caused by a mutation at 20210a.

Thrombin, a potent vasoconstrictor
Vasoconstrictor

#REDIRECT vasoconstriction...
 and mitogen
Mitogen

A mitogen is a chemical substance, usually some form of a protein, that encourages a cell to commence cell division, triggering mitosis.Mitogens trigger signal transduction pathways in which mitogen-activated protein kinase is involved, leading to mitosis....
, is implicated as a major factor in vasospasm
Vasospasm

Vasospasm refers to a condition in which blood vessels spasm, leading to vasoconstriction. This can lead to tissue ischemia and death . Cerebral vasospasm may arise in the context of subarachnoid hemorrhage....
 following subarachnoid hemorrhage
Subarachnoid hemorrhage

A subarachnoid hemorrhage is bleeding into the subarachnoid space?the area between the arachnoid and the pia mater surrounding the brain. This may occur spontaneously, usually from a ruptured cerebral aneurysm, or may result from head injury....
. Blood from a ruptured cerebral aneurysm
Cerebral aneurysm

A cerebral aneurysm or brain aneurysm is a cerebrovascular disease disorder in which weakness in the wall of a brain artery or vein causes a localized vasodilation or ballooning of the blood vessel....
 clots around a cerebral artery
Artery

Arteries are blood vessels that carry blood away from the heart. All arteries, with the exception of the pulmonary and umbilical arteries, carry oxygenated blood....
, releasing thrombin. This can induce an acute and prolonged narrowing of the blood vessel, potentially resulting in cerebral ischemia
Cerebral ischemia

Brain ischemia, also known as cerebral ischemia, is the reduction of blood flow to the brain. Brain ischemia has been connected to cerebral hypoxia and, if prolonged, to cerebral infarction....
 and infarction
Infarction

In medicine, an infarction results in the death of a macroscopic area of tissue in an organ due to loss of adequate blood supply. This dead tissue is then known as necrosis....
 (stroke
Stroke

A stroke is the rapidly developing loss of brain function due to a disturbance in the blood supply to the brain. According to the National Stroke Association, a "stroke" occurs when a blood clot blocks and artery or a blood vessel breaks, interrupting blood flow to an area of the brain....
).

Biotechnology

Due to its high proteolytic specificity, thrombin is a valuable biochemical tool. The thrombin cleavage site (Leu-Val-Pro-Arg-Gly-Ser) is commonly included in linker regions of recombinant fusion protein constructs. Following purification of the fusion protein, thrombin can be used to selectively cleave between the Arginine and Glycine residues of the cleavage site, effectively removing the purification tag from the protein of interest with a high degree of specificity.

Pharmacology

Prothrombin complex concentrate
Prothrombin complex concentrate

Prothrombin Complex Concentrate is a combination of blood clotting factors II, VII, IX and X. It reverses the effect of warfarin and is used in cases of significant bleeding in patients with a coagulopathy ....
 and fresh frozen plasma
Fresh frozen plasma

Fresh Frozen Plasma is defined as the fluid portion of one unit of human blood that has been centrifuged, separated, and frozen solid at within 6 hours of collection....
 are prothrombin-rich coagulation factor preparations that can be used to correct deficiencies (usually due to medication) of prothrombin. Indications include intractable bleeding due to warfarin
Warfarin

Warfarin is an anticoagulant. It was initially marketed as a pesticide against rats and mice, and is still popular for this purpose, although more potent poisons such as brodifacoum have since been developed....
.

Manipulation of prothrombin is central to the mode of action of most anticoagulant
Anticoagulant

An anticoagulant is a substance that prevents blood coagulation; that is, it stops blood from clotting. A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombosis disorders....
s. Warfarin
Warfarin

Warfarin is an anticoagulant. It was initially marketed as a pesticide against rats and mice, and is still popular for this purpose, although more potent poisons such as brodifacoum have since been developed....
 and related drugs inhibit vitamin K
Vitamin K

Vitamin K denotes a group of lipophilic, hydrophobic vitamins that are needed for the posttranslational modification of certain proteins, mostly required for blood coagulation....
-dependent carboxylation of several coagulation factors, including prothrombin. Heparin
Heparin

Heparin, a highly-sulfated glycosaminoglycan, is widely used as an injectable anticoagulant and has the highest negative charge density of any known biomolecule....
 increases the affinity of antithrombin
Antithrombin

Antithrombin is a small protein molecule that inactivates several enzymes of the coagulation system. It is a glycoprotein produced by the liver and consists of 432 amino acids....
 to thrombin (as well as factor X
Factor X

Factor X, also known by the eponym Stuart-Prower factor or as thrombokinase, is an enzyme of the coagulation. It is a serine protease ....
a). The direct thrombin inhibitor
Direct thrombin inhibitor

Direct thrombin inhibitors are a class of medication that act as anticoagulants by directly inhibiting the enzyme thrombin. Some are in clinical use, while others are undergoing clinical development....
s, a newer class of medication, directly inhibit thrombin by binding to its active site.

History


After the description of fibrinogen and fibrin, Alexander Schmidt
Alexander Schmidt (physiologist)

Alexander Schmidt was a physiologist who was born on the Island of Mohn, which today is called Muhu, Estonia. In 1858, he received his medical doctorate from the University of Dorpat, and later was an assistant to Felix Hoppe-Seyler in Berlin, and Carl Ludwig in Leipzig....
 hypothesised the existence of an enzyme that converts fibrinogen into fibrin in 1872.

See also

  • The Proteolysis Map
    The Proteolysis Map

    The Proteolysis MAP is an integrated web resource focused on proteases....


External links

  • Anti-coagulation & proteases by The Proteolysis Map
    The Proteolysis Map

    The Proteolysis MAP is an integrated web resource focused on proteases....
    -animation
  • PMAP: The Proteolysis Map
    The Proteolysis Map

    The Proteolysis MAP is an integrated web resource focused on proteases....
    /Thrombin


Further reading


  • Degen S: Prothrombin. In: High K, Roberts H, eds. Molecular Basis of Thrombosis and Hemostasis. New York, NY: Marcel Dekker; 1995:75.