Abstract
Thrombosis results, in part, from localized accumulation of fibrin, implying an imbalance between its rate of formation and dissolution. Astrup postulated that patency of the vascular system depended on a dynamic equilibrium between constantly active coagulation and fibrinolytic systems. Reviews of this hypothesis have concluded that neither thrombin nor plasmin proteolysis makes a major contribution to fibrinogen turnover in normal individuals and that the hypothesis of a dynamic equilibrium between clotting and lysis remains unproven. Thus, the current view is that plasmin simply serves the function of a fibrinolytic enzyme digesting fibrin in the vascular system. Here, I promote the alternative view that the relative rates of proteolysis of the B beta chain of fibrinogen by thrombin and plasmin determine the occurrence of thrombosis. This view is supported by recent data and can be used to make some readily testable predictions.
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