Initiation of coagulation cascade

Summary
Organism
Homo sapiens (human)
Reactome
R-HSA-9769735
PubChem
R-HSA-9769735
Description
  • The initiation phase of coagulation proceeds through the tissue factor (TF)-mediated generation of a small amount of thrombin on the plasma membrane surfaces of TF-bearing cells (e.g., fibroblasts, smooth muscle cells and pericytes) (reviewed by Rao LVM & Pendurthi UR 2012; Grover SP & Mackman N 2018). Additionally, activated cells (e.g., polarized macrophages) and apoptotic cells, along with certain cancer cells, release TF-bearing extracellular vesicles (EVs) with procoagulant activity (Hohensinner PJ et al., 2021; reviewed by Hisada Y et al., 2022; Sachetto ATA et al., 2023). TF is predominantly maintained in a cryptic, coagulant-inactive state on the surfaces of resting cells or EVs (Schecter AD et al. 1997; Bach RR 2006; Kothari H et al. 2013; Grover SP & Mackman N 2018). Upon tissue injury or inflammation TF is converted into its procoagulant isoform at the membrane surface. Ca²⁺-dependent exposure of phosphatidylserine (PS), hydrolysis of sphingomyelin (SM) and thiol-disulfide exchange within TF are thought to synergistically contribute to the activation of TF on the outer plasma membrane (Langer F & Ruf W 2014; Ansari SA et al. 2019). Activated TF becomes exposed to circulating blood and the extracellular part of TF binds both the zymogen factor VII (FVII) and its active serine protease form FVIIa with very high affinity and specificity (Vadivel K& Bajaj SP 2012; Prasad R & Sen P 2018). The TF:FVIIa complex initiates the coagulation protease cascade by converting zymogens FIX and FX to active proteases FIXa and FXa, which are involved in the generation of thrombin.

    Aberrant expression of TF is associated with various coagulopathies. For example, the procoagulant properties of EVs bearing TF may contribute to thrombosis and disseminated intravascular coagulation in pathophysiologic conditions such as cancer, sepsis, and infection (reviewed by Mackman N et al., 2021; Hisada Y et al., 2022; Sachetto ATA et al., 2023).

Click on a node on the pathway to see its details. Glycoproteins are marked with a glycoprotein icon in their name.
Displaying entries 1 - 10 of 22 in total
UniProt ID Protein Name Gene Symbol Pathway Viewer
O00468 Agrin
  • AGRIN
  • AGRN
view
O75056 Syndecan-3
  • KIAA0468
  • SDC3
view
O75487 Glypican-4
  • GPC4
  • UNQ474/PRO937
view
P00451 Coagulation factor VIII
  • F8
  • F8C
view
P00734 Prothrombin
  • F2
view
P00740 Coagulation factor IX
  • F9
view
P00742 Coagulation factor X
  • F10
view
P01008 Antithrombin-III
  • AT3
  • PRO0309
  • SERPINC1
view
P04275 von Willebrand factor
  • F8VWF
  • VWF
view
P07225 Vitamin K-dependent protein S
  • PROS
  • PROS1
view
Displaying all 2 entries
GlyCosmos Lectin UniProt ID Lectin Name Pathway Viewer
GL_005327 O00468 Agrin view
GL_005334 P98160 Basement membrane-specific heparan sulfate proteoglycan core protein view

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Acknowledgements

Supported by JST NBDC Grant Number JPMJND2204

Partly supported by NIH Common Fund Grant #1U01GM125267-01


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Last updated: April 6, 2026