Definition: |
In addition to its function in cleaving soluble fibrinogen to form insoluble fibrin monomers, thrombin can also activate an anticoagulant pathway. Thrombomodulin (TM), a receptor present on the endothelial cell surface, binds thrombin and alters thrombins substrate specificity through an allosteric mechanism. Bound to TM, thrombin can no longer efficiently proteolyse its procoagulant substrates FV, FVIII and fibrinogen. The thrombin-TM complex proteolytically activates its substrate protein C (PC) to activated protein C (APC). In complex with its cofactor protein S (PS), APC rapidly inactivates procoagulant factors FVa and FVIIIa by further proteolysis in a negative feedback loop |