Molecular Basis of Blood Coagulation

The hemostatic process has evolved to provide damage recognition and protection from blood loss after perforation of the vasculature, while at the same time preventing the systemic activation of the clotting system. The fine line between bleeding, hemostasis, and thrombosis is defined by the complex interplay between pro- and anticoagulant materials provided by the blood, the vasculature, and subvascular elements. Blood coagulation can best be understood if viewed as a choreographed system that starts from an inventory of the key players, the relationship or connectivity of these players, and the dynamic catalytic processes. These processes together keep blood in a fluid state but primed to react to vascular injury in an explosive manner. This chapter describes the process of blood coagulation in terms of the inventory, the connectivity, and then the dynamics.