10. Hemostasis and Vascular Inflammation

  1. Gary S. Hoffman MD, MS3,
  2. Cornelia M. Weyand MD, PhD4,
  3. Carol A. Langford MD, MHS3 and
  4. Jörg J. Goronzy MD, PhD4
  1. Lawrence Leung MD1,2 and
  2. John Morser PhD1,2

Published Online: 3 MAY 2012

DOI: 10.1002/9781118355244.ch10

Inflammatory Diseases of Blood Vessels, Second Edition

Inflammatory Diseases of Blood Vessels, Second Edition

How to Cite

Leung, L. and Morser, J. (2012) Hemostasis and Vascular Inflammation, in Inflammatory Diseases of Blood Vessels, Second Edition (eds G. S. Hoffman, C. M. Weyand, C. A. Langford and J. J. Goronzy), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118355244.ch10

Editor Information

  1. 3

    Department of Rheumatic and Immunologic Diseases, Center for Vasculitis Care and Research, Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA

  2. 4

    Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA

Author Information

  1. 1

    VA Palo Alto Health Care System, Palo Alto, CA, USA

  2. 2

    Stanford University School of Medicine, Stanford, CA, USA

Publication History

  1. Published Online: 3 MAY 2012
  2. Published Print: 8 JUN 2012

ISBN Information

Print ISBN: 9781444338225

Online ISBN: 9781118355244



  • Aggregation;
  • coagulation;
  • dendritic cell;
  • immunity;
  • inflammation;
  • platelet;
  • protease activated receptor (PAR);
  • thrombin;
  • thrombomodulin


Activation of platelets and the clotting cascade represents the immediate response at a vascular injury site. Thrombin plays a pivotal role in this process. In addition to providing the necessary blood clotting control, thrombin activates the protease activated receptors on many different cell types, providing a molecular link between coagulation and inflammation. On the other hand, when thrombin binds to thrombomodulin on endothelial cell surface, it activates both protein C and plasma procarboxypeptidase B. While activated protein C and plasma carboxypeptidase B both have a role in regulating blood clotting, they also have intrinsic anti-inflammatory properties. Thrombomodulin itself interacts with dendritic cells. Thus, many components of the complex hemostatic response contribute to the development of the tissue inflammation, either directly or indirectly impact the innate and adaptive immune system, and represent an integral part of host defense. Additional studies on this interface between coagulation, inflammation and immunity will reveal new insights in disease pathogenesis and result in new opportunities in clinical diagnostics and therapeutics.