FACTORS WHICH PREVENT

BLOOD CLOTTING IN NORMAL

VASCULAR SYSTEM

Endothelial Surface Factors

a. Smoothness of the endothelial surface
o prevents contact activation of the intrinsic clotting system
b. Layer of glycocalyx on the endothelium
o Glycocalyx mucopolysaccharide adsorbed to the surface of the

endothelium

o Repels clotting factors and platelets, thereby preventing activation of

c. Thrombomodulin
o A protein bound with the endothelial membrane, which binds thrombin

clotting

Antithrombin Factors
a. fibrin threads
o formed during the process of clotting
o adsorb about 85 to 90 percent of the thrombin, preventing the spread of thrombin
into the remaining blood
prevents excessive spread of the clot

b. antithrombin III
o antithrombin-heparin cofactor
o an alpha-globulin
o thrombin not adsorbed by the fibrin threads combines with antithrombin III
o blocks the effect of the thrombin on the fibrinogen and then also inactivates
thrombin during the next 12 to 20 minutes

Heparin
Powerful naturally-occurring anticoagulant
Its concentration in the blood is normally low
Widely used as a pharmacological agent in medical practice in much higher concentrations to
prevent intravascular clotting
A highly negative charged conjugated polysaccharide and has little or no anticoagulant
property by itself
o But when combined with antithrombin III, the effectiveness of antithrombin III increases by a
hundredfold to a thousandfold
Heparin + antithrombin III
o Removes factors IX, X, XI, XII and thrombin
Produced by basophils and mast cells, which are abundant in the tissue surrounding the
capillaries of the lungs and liver
o Large quantities of heparin might be needed in these areas because the capillaries of the
lungs and
liver receive many embolic clots formed in slowly flowing venous blood
o Sufficient formation of heparin prevents further growth of the clots

A2-macroglobulin
Combines with proteolytic coagulation factors
Acts as binding agent
Activity not accelerated by heparin
An effective slow inhibitor of plasmin activity
(fibrinolytic system inhibitor)

A2-antiplasmin
A rapid inhibitor of plasmin activity (fibrinolytic system
inhibitor)