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FXIIa's cleavage of FXI initiates coagulation. In the contact activation system or CAS, three proteins in the blood, factor XII (FXII), prekallikrein (PK) and high molecular weight kininogen (HK), bind to a surface and cause blood coagulation and inflammation. FXII and PK are proteases and HK is a non-enzymatic co-factor
The division of coagulation in two pathways is arbitrary, originating from laboratory tests in which clotting times were measured either after the clotting was initiated by glass, the intrinsic pathway; or clotting was initiated by thromboplastin (a mix of tissue factor and phospholipids), the extrinsic pathway.
HMWK is one of four proteins which interact to initiate the contact activation pathway (also called the intrinsic pathway) of coagulation: the other three are Factor XII, Factor XI and prekallikrein. HMWK is not enzymatically active, and functions only as a cofactor for the activation of kallikrein and factor XII.
The extrinsic pathway of apoptosis refers to cell death induced by external factors that activate the death-inducing signaling complex. The extrinsic pathway of blood coagulation is also known as the tissue factor pathway and refers to a cascade of enzymatic reactions resulting in blood clotting and is done with the addition of injured tissue ...
Together with factor VIIa, tissue factor forms the extrinsic pathway of coagulation. This is opposed to the intrinsic (amplification) pathway, which involves both activated factor IX and factor VIII. Both pathways lead to the activation of factor X (the common pathway), which combines with activated factor V in the presence of calcium and ...
Therefore, although the coagulation cascade can be triggered in vitro through the intrinsic pathway only, in vivo coagulation is triggered by the extrinsic pathway. However, the model better describing how coagulation works is the so-called cell-based model, a more integrated picture of the whole process, in which phospholipid surfaces, such as ...
In coagulation, the coagulation factor X can be activated into factor Xa in two ways: either extrinsically or intrinsically. The activating complexes are together called tenase . Tenase is a blend word of "ten" and the suffix "-ase", which means, that the complex activates its substrate (inactive factor X) by cleaving it.
Factor Xa also plays a role in other biological processes that are not directly related to coagulation, like wound healing, tissue remodelling, inflammation, angiogenesis and atherosclerosis. Inhibition of the synthesis or activity of Factor X is the mechanism of action for many anticoagulants in use today.