Regulation and Dysregulation of Thrombin Activity

Abstract

Thrombin is the enzyme of the haemostasis system that stands at the crossroads between the coagulation cascade and coagulation inhibition by protein C, between plasma coagulation factors and cells involved in haemostasis and between haemostasis and the immune system. Allosteric regulation of thrombin and its interaction with various partners in blood plasma and on the surface of the endothelium and platelets provides a wide variety of thrombin functions. The thrombin activity regulation is multifactorial, so a failure of any part of this system leads to serious consequences. An example of this are thrombotic/bleeding complications during endothelial dysfunction, infections, inflammation and uncontrolled treatment.

This review aims to summarize current knowledge about thrombin structure, functions and regulation. Collected data suggest a crucial role of thrombin in different pathologies accompanied by blood coagulation disorders, in particular diseases causing endothelial dysfunction, such as COVID-19.