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Intrinsic vs Extrinsic Coagulation Pathways

The coagulation cascade consists of the intrinsic and extrinsic pathways that ultimately converge on the common pathway. The extrinsic pathway is initiated by tissue factor and involves blood and vascular elements. The intrinsic pathway is initiated by components within the vasculature. A major difference is that the intrinsic pathway activates factor IX via factor XIa alone, while the extrinsic pathway requires both calcium ions and tissue factor to activate factor IX via factor VIIa. Both pathways generate thrombin which converts fibrinogen to fibrin to form a clot.

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490 views10 pages

Intrinsic vs Extrinsic Coagulation Pathways

The coagulation cascade consists of the intrinsic and extrinsic pathways that ultimately converge on the common pathway. The extrinsic pathway is initiated by tissue factor and involves blood and vascular elements. The intrinsic pathway is initiated by components within the vasculature. A major difference is that the intrinsic pathway activates factor IX via factor XIa alone, while the extrinsic pathway requires both calcium ions and tissue factor to activate factor IX via factor VIIa. Both pathways generate thrombin which converts fibrinogen to fibrin to form a clot.

Uploaded by

roshmae
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

COAGULATION CASCADE

DIFFERENCE BETWEEN INTRINSIC AND EXTRINSIC PATHWAY


The clotting cascade consists of two separate initial
pathways (INTRINSIC AND EXTRINSIC) that
ultimately converge on the COMMON PATHWAY .
EXTRINSIC PATHWAY
principal initiating pathway of in vivo blood coagulation
involves both blood and vascular elements
critical component is TISSUE FACTOR (TF, sometimes referred to as
thromboplastin)
TF in concert with activated Factor VIIa and phospholipid to convert
Factor IX (from intrinsic system) to IXa and Factor X (from the extrinsic
system) to Xa
coagulant activity of Factor VII, the major plasma component of the
extrinsic pathway, is increased by Factor IXa of Factor XIIa of the
contact system
Tissue Trauma

Tissue Factor

Factor VII Factor VIIa Calcium Ions

Factor X

Factor Xa
Thrombin
Factor V Calcium Ions

Prothrombin Activator

Prothrombin
INTRINSIC PATHWAY

coagulation initiated by components entirely contained within the


vasculature
results in the activation of Factor IX by Factor XIa, providing a
pathway independent of Factor VII for blood coagulation
Included in the intrinsic pathway is the contact system by which skin,
muscle, connective tissue, and a variety of other surfaces may act as
activators
Among the events associated with the contact system are activation
of Factor XI by the XIIIa/activated high molecular with kinogen (HKa)
complex.
A major difference between the intrinsic and extrinsic pathways is
that whereas the activation of Factor IX by IXa requires only the
presence of ionized calcium, the activation of Factor IX by VIIa (in the
extrinsic system) requires both calcium and tissue factor. Importantly,
Factor XIa converts Factor X (in the extrinsic system) to Factor Xa in
concert with the tenase complex (PL/VIIIa)
Factor Xa, regardless of how it is formed, is the active catalytic
component of the prothrombinase complex, which converts
prothrombin to thrombin.
Thrombin cleaves fibrinopeptides from fibrinogen, allowing the
resultant fibrin monomers to polymerize, and converts Factor XIII to
XIIIa, which crosslinks the fibrin clot.
Thrombin accelerates the process by its potential to activate Factors V
and VIII. A number of natural plasma inhibitors retard clotting,
including C1-inhibitor (C1 INH), tissue factor pathway inhibitor (TFPI),
and antithrombin II (ATIII).
The fibrin molecules aggregate together, trapping platelets,
erythrocytes, and leukocytes to form the clot. The clot then contracts,
pulling together the edges of the injured surface.
Trauma to Blood Cells
Exposure of Blood to Collagen

Factor XI

Factor X
High Molecular
Factor XII Kinogen
Factor Xa

Factor XIIa Factor XI Calcium Ions


Calcium Ions

Factor VIIIa Factor V


Factor XIa

Calcium Ions
Prothrombin
Factor IX Activator

Factor IXa

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