Review ArticleThe role of the red cell membrane in thrombin generation
Section snippets
Background
Red blood cells (RBCs) are the most abundant cellular component of blood and have been extensively characterized since their initial observation in the late 1600s [1]. They make up the majority of the cellular fraction of blood, comprising 35–45% of the blood volume. The unique discoid shape (Fig. 1) of the RBC plasma membrane provides the biological and mechanical properties necessary to perform its primary role in hemoglobin-mediated oxygen transport throughout the body. In general, RBCs have
Red Blood Cells and Thrombin Generation
The first study directly examining the contribution of RBCs to thrombin generation was reported by Peyrou et al. in 1999 [27]. This group took advantage of the growing field of tissue factor-activated thrombin generation assays (TGA) [28] in platelet poor (PPP) and platelet rich plasma (PRP) to gain insight into the cellular contributions to thrombin generation. Owing to the complexity of the assay, the authors simplified it to directly measure the hemostatic properties of “normal” RBCs in
Conclusions
Thrombin generation occurs via an integrated enzymatic cascade that involves plasma, tissue, blood and cell components. Platelets have been traditionally viewed as the primary cellular component playing an active role in thrombin generation. Upon activation by thrombin and other activators, platelets support binding of the coagulation complexes (intrinsic factor Xase and prothrombinase) on their membranes which serves to localize thrombin generation near the site of vascular injury [10], [23],
Conflict of Interest Statement
Matt Whelihan has no conflicts of interest to declare. Ken Mann is consultant to Daiichi-Sankyo, Merck, Baxter, GTI, Alnylam, T2 Biosystems and chairman of the board of Haematologic Technologies, Inc.
Acknowledgments
KGM received funding from the National Institutes of Health P01HL046703.
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