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(Circulation Research. 2001;89:117.)
© 2001 American Heart Association, Inc.

Review

Regulation of Vascular Bed–Specific Prothrombotic Potential

Jay M. Edelberg, Patricia D. Christie, Robert D. Rosenberg

From the Departments of Medicine and Cell Biology (J.M.E.), Weill Medical College of Cornell University, New York, NY, and Department of Biology (P.D.C., R.D.R.), Massachusetts Institute of Technology, Cambridge, Mass.

Correspondence to Jay M. Edelberg, Weill Medical College of Cornell University, 525 E 68th St, A352, New York, NY 10021. E-mail jme2002{at}mail.med.cornell.edu

Joseph Loscalzo, Guest Editor This Review is part of a thematic series on New Directions in Thrombosis, which includes the following articles:Nitric Oxide Insufficiency, Platelet Activation, and Arterial ThrombosisNew Tricks for Old Dogs: Nonthrombotic Effects of Thrombin in Vessel Wall BiologyRegulation of Vascular Bed–Specific Prothrombotic PotentialInsights Into Mechanisms of Thrombosis From Genetic ModelsMolecular Pathogenesis of Antiphospholipid Antibody Syndrome

Abstract— Hemostasis is the result of interdependent and complex systemic and local endothelial pathways that govern vascular integrity and rheology. A striking feature of hypercoagulable conditions is the focal nature of the resultant thrombotic pathology. Such disorders in hemostasis may be associated with distinct vascular beds, thus implying that the relative combined contribution of individual regulatory pathways may be specific and/or unique to a particular locale in the vasculature. Systemic factors and platelets mediate the formation of fibrin deposition; however, it is the diverse interrelationships in the interaction of these systemic elements with the local endothelial components that dictate vascular bed–specific hemostatic regulation. Indeed, the local activation of coagulation cascades, rather than increases in systemic thrombotic potential, is what leads to fibrin formation in different vascular beds. Hence, the propensity for congenital or acquired disorders to result in local thrombotic pathology is based on the relative contribution of the various hemostatic regulatory pathways in individual vascular beds. The present review highlights the role of local endothelial regulation in the interaction between local and systemic elements that contribute to vascular bed–specific prothrombotic potential.

Key Words: endothelium • thrombosis • hemostasis • coagulation

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